Loss (omission) of a uterus

Description:

The falling of the womb and vaginas has the greatest practical value among anomalies of provision of generative organs. In structure of gynecologic incidence about 28% are the share of a share of omissions and losses of generative organs. Because of anatomic proximity and a community of sustentaculums this pathology often causes anatomo-functional insolvency of adjacent bodies and systems (an urine incontience, insolvency of a proctal sphincter).

Distinguish the following options of omission and loss of generative organs:
omission of a front wall of a vagina. Quite often together with a front wall of a vagina falls, and sometimes and a part of a bladder - the tsistotsel (cystocele) drops out;
omission of a back wall of a vagina which sometimes is followed by omission and loss of a front wall of a rectum - a rectocele (rectocele);
incomplete prolapse of the uterus: the neck of uterus or reaches a sexual crack, or goes beyond its limits, at the same time the body of the womb remains within a vagina;
full prolapse of the uterus: all uterus goes beyond a sexual crack.

At omission and loss of generative organs lengthening of a neck of uterus (elongation) is often noted.

Reasons loss (omissions) of a uterus:

Omission and loss of generative organs - a polyetiological disease, are its cornerstone insolvency of muscles of a pelvic bottom and the copular device of a uterus, the increased intra belly pressure. Insolvency of muscles of a pelvic bottom promotes:
traumatic childbirth;
insolvency of connective tissue structures in the form of the "system" insufficiency which is shown hernias of other localizations;
disturbance of synthesis of steroid hormones (oestrogenic insufficiency);
chronic diseases with disturbance of exchange processes, microcirculation.

Under the influence of one or several listed factors there comes functional insolvency of the copular device of internal generative organs and a pelvic bottom. At increase in intra belly pressure bodies begin to be squeezed out out of limits of a sexual crack.

Symptoms loss (omissions) of a uterus:

Omission and loss of generative organs develop slowly. The main symptom of a prolapse of the uterus and walls of a vagina is the feeling of "foreign body" in a vagina. The surface of the dropped-out part of generative organs covered with a mucous membrane is exposed to keratinization, becomes opaque, is similar to dry skin with cracks, grazes, and then and ulcerations. Further patients complain of the feeling of weight and pain in the bottom of a stomach, a waist, a sacrum amplifying in time and after walking at a weight raising, at cough, sneezing. Stagnation of blood and a lymph in the dropped-out bodies leads to cyanosis of mucous membranes and hypostasis of the subject fabrics. On the surface of the dropped-out brand neck the dekubitalny ulcer quite often forms.

The prolapse of the uterus is followed by difficulty of an urination, existence of a residual urine, stagnation in uric ways and then infection at first lower, and when progressing process and upper parts of uric system. The existing full loss of internal generative organs is long can be the cause of a hydronephrosis, a hydroureter, obstruction of ureters.

At every 3rd patient with a prolapse of genitalias proctologic complications develop. The most frequent of them - locks, and in one cases they are an etiological factor of a disease, in others - the investigation and display of a disease.

Diagnosis:

The diagnosis of omission and loss of generative organs is put on the basis of data of survey. At an obligatory rectal research pay attention to existence or expressiveness of a rectocele, a condition of a sphincter of a rectum.

At the expressed disturbances of an urination it is necessary to conduct a research of uric system, according to indications appoint a tsistoskopiya, excretory urography, an urodynamic research. Also ultrasonography of bodies of a small pelvis is shown.

Treatment loss (omissions) of a uterus:

Treatment of patients decides on omissions and losses of generative organs by extent of omission of internal generative organs; existence and the nature of the accompanying gynecologic pathology; opportunity and need of preservation or recovery of genital, menstrual functions; features of dysfunction of a large intestine and sphincter of a rectum, age of patients; the accompanying extragenital pathology and a risk degree of surgical intervention.

At small omissions of internal generative organs when they do not reach an entrance of the vagina, and in the absence of dysfunction of the next bodies perhaps conservative maintaining patients with purpose of a complex of physical exercises.