Falling of the womb

Falling of the womb – the shift of anatomo-physiological position of a neck and an uterine fundus below anatomic border. This deviation is almost always followed by nagging pains and unpleasant feelings in a vagina and the lower part of a stomach, disturbance of urethral function and pathological vulval allocations. The falling of the womb arises when weakening muscles and fastion of a pelvic bottom and uterine sheaves.

Falling of the womb – quite frequent pathology which is found at patients of all age. It is diagnosed for 10% of patients up to 30 years, at 40% of patients comes to light at the age of 30-40 years, at 50% of patients the disease is shown after 50 years. This morbid condition almost always carries the progressing current. In process of a falling of the womb the accompanying functional disturbances become more expressed that the moral and physical suffering brings to the woman and most often leads to full or partial disability.

Classification of a falling of the womb

Allocate several stages of a falling of the womb. The neck is defined on stages of omission of a neck and a body of the womb in the field of an entrance to a vagina, but does not support limits of a sexual crack. At a partial prolapse of the uterus the neck is shown from a sexual crack at cough, sneezing, physical tension, a raising of weights. At incomplete loss a body of the womb (partially) and a neck act from a sexual crack. At full loss of a bottom and body of the womb there is a uterus exit for borders of a sexual crack.

Reasons of a falling of the womb

The falling of the womb can be promoted by injuries of muscles of a pelvic bottom, birth trauma (imposing of obstetric nippers, vacuum extraction of a fruit or extraction of a fruit buttocks), the undergone surgeries on generative organs (a radical vulvektomiya), deep ruptures of a crotch, inborn defects of pelvic area, the deficit of estrogen developing in a menopause, a dysplasia of connecting fabric, disturbance of an innervation of an urinogenital diaphragm.

The risk of development of a falling of the womb increases at advanced and senile age, at chronic cough, locks, at heavy lifting and hard physical work, and also with the increased intra belly pressure caused by obesity and tumors of an abdominal cavity. Most often in development of this pathology interaction of many factors under the influence of which the muscular device of a pelvic bottom and internals weakens plays a role.

Symptoms of a falling of the womb

In the absence of due treatment the falling of the womb gradually progresses, displacing bodies of a small pelvis.

Nagging pains and pressure in the field of a sacrum, waists, in the bottom of a stomach, feeling of a foreign body in a vagina can be symptoms of a falling of the womb in an initial stage, the despareuniya (painful sexual intercourse), emergence of bloody allocations or is more white from a vagina. As characteristic display of this pathology serve disturbances of menstrual function as an algodismenorea and a hyper polymenorrhea.

Later urological disturbances join symptoms of a falling of the womb in 50% of cases: the speeded-up or complicated urination, stagnation in urinary bodies, and also the infection of upper and lower parts of an urinary path leading to development of cystitis, pyelonephritis and urolithiasis.

Colitis, locks, incontience of gases and calla belong to proctologic complications at a falling of the womb. When progressing a disease the education which is independently found by the patient acting from a sexual crack becomes the leading sign of omission. Omission most often leads to disturbance of blood circulation in bodies of a small pelvis, to emergence of developments of stagnation, cyanosis of a mucous membrane of a uterus and hypostasis of adjacent fabrics.

Diagnosis and treatment of a falling of the womb

The falling of the womb usually is found during gynecologic survey. At pryamokishechny and vaginal examonation the doctor determines the shift of walls of a bladder, vagina and rectum. It is obligatory for all patients with this pathology the kolposkopiya is appointed.

For specification of the diagnosis the doctor can appoint a gisterosalpingoskopiya and a diagnostic scraping of a cavity of the uterus, ultrasonic diagnosis of bodies of a small pelvis, a computer tomography, бакпосев urine, capture of smears to flora and excretory urography.

Patients with this pathology in addition look round the urologist and the proctologist. Doctors carry out assessment of a condition of sphincters of a bladder and rectum for identification of an incontience of urine and gases at a tension.

At the choice of tactics of treatment of a falling of the womb severity of pathology, existence and the nature of the gynecologic diseases accompanying omission, an opportunity and need of preservation and recovery of genital and menstrual functions is considered. The age of the patient, the nature of disturbances of functions of sphincters of a rectum and bladder, large intestine, and also degree of surgical and anesthesiology risk in the presence of the accompanying pathologies is not less important.

Conservative treatment of a falling of the womb most often includes gynecologic massage, medical exercises, introduction to a vagina of the ointments containing estrogen and metabolites. Medical exercises at a falling of the womb are directed to strengthening of muscles of a prelum abdominale and pelvic bottom.

Use of vulval pessaries (thick rubber rings of various diameter) is shown to patients of advanced age. Air in a pessary gives it elasticity and elasticity. At introduction to a vagina the ring of a pessary rests against walls of a vagina and fixes a neck of uterus in a special opening. At use of pessaries every day it is necessary to carry out vulval syringing by Furacilin solution, broth of a camomile or solution of potassium permanganate. Three-four weeks in a row are recommended to leave pessaries in a vagina, and then to take a break in treatment for two weeks.

At inefficiency of conservative therapy surgical treatment is appointed. All operations at a falling of the womb can be structured on the main sign – the anatomic education involved for correction and strengthening of position of separate bodies. Plastic surgeries at a falling of the womb are directed to strengthening of fastion and muscles of a pelvic bottom. Operations on shortening and strengthening of the round sheaves supporting a uterus give the greatest number of a recurrence.

At the present stage preference is given to the combined surgical treatment including at the same time both a colpoplasty, and a metropexy, and strengthening of the muscular device of a pelvic bottom.

After operation usually appoint a course of conservative actions – physiotherapy exercises, an exception of heavy exercise stresses, a dietotherapy for elimination of locks. Exercises at a falling of the womb can be carried out also for prevention of a disease.