Uterus

The uterus (uterus) is unpaired smooth muscle hollow body in which there are developments of an embryo and incubation of a fruit. The uterus in a cavity of a small pelvis, mezoperitonealno, behind from a bladder, ahead from a rectum is located. At women of reproductive age length of a uterus makes about 7-8 cm, width – 4 cm. At not giving birth women the mass of a uterus is equal to 40-50 g, at giving birth – about 80 (it is connected with a hypertrophy of a muscular coat). The uterus – quite mobile body, and depending on an arrangement of the next bodies it can hold various position. Normal the uterus is in situation антефлексио (the longitudinal axis is oriented along a basin axis), антеверзио (the filled bladder, and also a rectum slightly incline a uterus forward). The most part of a surface of body, except a vulval part of a neck of uterus, is covered with a peritoneum.

The uterus consists of three parts:

• the uterine fundus – acts slightly above the line of a confluence of uterine tubes, it is a convex upper part;
• body of the womb – a middle part of a cone-shaped form;
• neck of uterus – the rounded part narrowed lower.

The lower part of a neck of uterus presses in a vagina, and the upper part lying above a vagina – a supravaginal part is called a vulval part. On a vulval part the opening of a neck of uterus, at not giving birth women having rounded shape, and at giving birth – slit-like is located.

Uterus wall layers

The wall of a uterus has three layers:

• the perimetrium (serous layer) – on a bigger surface of a front, back wall and an uterine fundus is densely spliced with a myometrium, in the field of an isthmus is attached рыхло;
• the myometrium (muscular layer) – consists of three layers of smooth muscles (outside longitudinal, average circular, internal longitudinal) with impurity of elastic fibers and fibrous connecting fabric;
• the endometria (mucous membrane) – is formed by the cylindrical epithelium having superficial (functional) and deep (basal) layers.

Uterus at pregnancy

The uterus at pregnancy undergoes essential changes. Actively the muscular layer increases. Muscle fibers increase in length, and also become more volume. Besides, in them protein content – actomyosin which is responsible for muscular contractions increases. For the prevention of premature reduction of muscles of a uterus there is a hormone progesterone. At its insufficient development there are reductions of a muscular layer of a uterus. In this case it is about the raised uterus tone. Periodically arising increase in a tone of a uterus is norm option, but continuous substantial increase of a tone of a uterus can have an adverse effect on fetation as at reduction of a muscular layer blood vessels therefore fruit food is broken are squeezed. The main danger is made by insufficient blood supply of a brain of a fruit. The uterus at pregnancy increases from first weeks, reaching the maximum sizes to the term of childbirth.

Uterus muscles always are in a tone, not only at pregnancy. They constantly relax, are reduced. Increase in a tone of a uterus is observed at sexual intercourse, and also at periods that in the first case promotes advance of spermatozoa, in the second – to rejection of a functional layer of an endometria.

Erosion of a neck of uterus, treatment

One of widespread diseases of reproductive system of the woman is the erosion of a neck of uterus. Treatment of this pathology is highly effective, but has to be carried out in time. The term "erosion of a neck of uterus" is meant as the center of injury of a mucous membrane of a neck of uterus. Treatment of an erosion includes the following methods:

• conization;
• laser coagulation;
• chemical coagulation;
• radio surgical method.

Hysteromyoma, treatment

One more widespread pathology is the hysteromyoma. This high-quality new growth arising in myometriums. Myoma represents chaotically intertwining smooth muscle fibers. Nodes of myoma reach enough large sizes, several kilograms can weigh. Symptoms of this pathology are menorrhagias, pain and pressure sense in the bottom of a stomach. Also there can be symptoms of disturbance of functioning of the next bodies: a rectum, a bladder, the hysteromyomas arising at the large sizes. Treatment of this disease can have waiting character (it is justified at slow-growing myoma). In addition to medicamentous therapy, such methods as removal of a uterus, embolization of uterine arteries, FUZ-ablation of myoma are applied to treatment of myoma.

Removal of a uterus

Removal of a uterus, or hysterectomy, – one of widespread operative measures in gynecologic practice. Removal of a uterus is applied at those diseases when use of alternative methods of treatment is impossible. Indications to performing this surgery are, in addition to a hysteromyoma, endometriosis, a prolapse of the uterus, abnormal uterine bleedings, uterus cancer, cancer of a neck of uterus, ovaries, uterine tubes are.

Depending on volumes of the deleted fabrics distinguish such types of a hysterectomy:

• the subtotal hysterectomy (amputation of a uterus) – is carried out with preservation of a neck;
• the total hysterectomy (extirpation) – a uterus is removed with a neck;
• the gisterosalpingoovariektomiya – a uterus is removed with appendages;
• the radical hysterectomy – a uterus is removed with appendages, a neck, an upper part of a vagina, and also surrounding cellulose, lymph nodes.