Rectal Prolapse | HealthLink BC

Topic Overview

What is rectal prolapse?

Rectal prolapse occurs when part or all of the wall of the rectum slides out of place, sometimes sticking out of the anus. See a picture of rectal prolapse.

There are three types of rectal prolapse.

• Partial prolapse (also called mucosal prolapse). The lining (mucous membrane) of the rectum slides out of place and usually sticks out of the anus. This can happen when you strain to have a bowel movement. Partial prolapse is most common in children younger than 2 years.
• Complete prolapse. The entire wall of the rectum slides out of place and usually sticks out of the anus. At first, this may occur only during bowel movements. Eventually, it may occur when you stand or walk. And in some cases, the prolapsed tissue may remain outside your body all the time.
• Internal prolapse (intussusception). One part of the wall of the large intestine (colon) or rectum may slide into or over another part, like the folding parts of a toy telescope. The rectum does not stick out of the anus. (See a picture of intussusception.) Intussusception is most common in children and rarely affects adults. In children, the cause is usually not known. In adults, it is usually related to another intestinal problem, such as a growth of tissue in the wall of the intestines (such as a polyp or tumour).

In severe cases of rectal prolapse, a section of the large intestine drops from its normal position as the tissues that hold it in place stretch. Typically there is a sharp bend where the rectum begins. With rectal prolapse, this bend and other curves in the rectum may straighten, making it difficult to keep stool from leaking out (fecal incontinence).

Rectal prolapse is most common in children and older adults, especially women.

What causes rectal prolapse?

Many things increase the chance of developing rectal prolapse. Risk factors for children include:

• Cystic fibrosis. A child who has rectal prolapse with no obvious cause may need to be tested for cystic fibrosis.
• Having had surgery on the anus as an infant.
• Malnutrition.
• Deformities or physical development problems.
• Straining during bowel movements.
• Infections.

Risk factors for adults include:

• Straining during bowel movements because of constipation.
• Tissue damage caused by surgery or childbirth.
• Weakness of pelvic floor muscles that occurs naturally with age.

What are the symptoms?

The first symptoms of rectal prolapse may be:

• Leakage of stool from the anus (fecal incontinence).
• Leakage of mucus or blood from the anus (wet anus).

Other symptoms of rectal prolapse include:

• A feeling of having full bowels and an urgent need to have a bowel movement.
• Passage of many very small stools.
• The feeling of not being able to empty the bowels completely.
• Anal pain, itching, irritation, and bleeding.
• Bright red tissue that sticks out of the anus.

See a doctor if you or your child has symptoms of rectal prolapse. If it is not treated, you may have more problems. For example, the leaking stool could get worse, or the rectum could be damaged.

How is rectal prolapse diagnosed?

Your doctor will diagnose rectal prolapse by asking you questions about your symptoms and past medical problems and surgeries. He or she will also do a physical examination, which includes checking the rectum for loose tissue and to find out how strongly the anal sphincter contracts.

You may need tests to rule out other conditions. For example, you may need a sigmoidoscopy, a colonoscopy, or a barium enema to look for tumours, sores (ulcers), or abnormally narrow areas in the large intestine. Or a child may need a sweat test to check for cystic fibrosis if prolapse has occurred more than once or the cause is not clear.

How is it treated?

Prolapse in children tends to go away on its own. You can help keep the prolapse from coming back. If you can, push the prolapse into place as soon as it occurs. You can also have your child use a potty-training toilet so that he or she does not strain while having a bowel movement.

Sometimes children need treatment. For example, if the prolapse doesn’t go away on its own, an injection of medicine into the rectum may help. If the prolapse was caused by another condition, the child may need treatment for that condition.

Home treatment for adults may help treat the prolapse and may be tried before other types of treatments.

• If your doctor says it’s okay, you can push the prolapse into place.
• Avoid constipation. Drink plenty of water, and eat fruits, vegetables, and other foods that contain fibre. Changes in diet often are enough to improve or reverse a prolapse of the lining of the rectum (partial prolapse).
• Do Kegel exercises to help strengthen the muscles of the pelvic area.
• Don’t strain while having a bowel movement. Use a stool softener if you need to.

People who have a complete prolapse or who have a partial prolapse that doesn’t improve with a change in diet will need surgery. Surgery involves attaching the rectum to the muscles of the pelvic floor or the lower end of the spine (sacrum). Or surgery might involve removing a section of the large intestine that is no longer supported by the surrounding tissue. Both procedures may be done in the same surgery.

Manual Reduction of Prolapsed Rectum

Author

Richard S Krause, MD Senior Clinical Faculty/Clinical Assistant Professor, Department of Emergency Medicine, University of Buffalo State University of New York School of Medicine and Biomedical Sciences

Richard S Krause, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Chief Editor

Vikram Kate, FRCS, MS, MBBS, PhD, FACS, FACG, FRCS(Edin), FRCS(Glasg), FIMSA, MAMS, MASCRS, FFST(Ed) Professor of General and Gastrointestinal Surgery and Senior Consultant Surgeon, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), India

Vikram Kate, FRCS, MS, MBBS, PhD, FACS, FACG, FRCS(Edin), FRCS(Glasg), FIMSA, MAMS, MASCRS, FFST(Ed) is a member of the following medical societies: American College of Gastroenterology, American College of Surgeons, American Society of Colon and Rectal Surgeons, Fellow of the Faculty of Surgical Trainers (RCSEd), Royal College of Physicians and Surgeons of Glasgow, Royal College of Surgeons of Edinburgh, Royal College of Surgeons of England, Society for Surgery of the Alimentary Tract, Fellow of the Faculty of Surgical Trainers (RCSEd)

Disclosure: Nothing to disclose.

Additional Contributors

Luis M Lovato, MD Associate Clinical Professor, University of California, Los Angeles, David Geffen School of Medicine; Director of Critical Care, Department of Emergency Medicine, Olive View-UCLA Medical Center

Luis M Lovato, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Acknowledgements

The Chief Editor would like to acknowledge the assistance of Dr Gurushankari Balakrishnan, Junior Resident, Department of Surgery, and Ms Misha Madan, MBBS trainee, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry, India, in updating the review of this article.

Cystocele (Fallen or Prolapsed Bladder): Symptoms & Treatment

Overview

What is a cystocele?

Normal Pelvis

Pelvis with a cystocele (fallen bladder)

A cystocele ― also known as a prolapsed, herniated, dropped or fallen bladder (where your urine or “water” is stored) ― occurs when ligaments that hold your bladder up and the muscle between a woman’s vagina and bladder stretches or weakens, allowing the bladder to sag into the vagina.

There are three grades of cystocele:

• Grade 1 (mild): The bladder drops only a short way into the vagina.
• Grade 2 (moderate): The bladder drops to the opening of the vagina.
• Grade 3 (severe): The bladder bulges through the opening of the vagina.

Symptoms and Causes

What causes a cystocele?

Risk factors for a cystocele include:

• Vaginal births, which may involve straining the muscles of the floor of the pelvis.
• Family history.
• Obesity.
• Intense physical activity, including lifting heavy objects.
• Hysterectomy.
• Constipation and/or repeated muscle straining during bowel movements.
• Frequent coughing.
• Aging and a drop in the hormone estrogen. Estrogen helps keep muscles around the vagina strong, but women produce less estrogen as they enter menopause (the end of menstrual periods).

What are the symptoms of a cystocele?

• Feeling or seeing something bulging through the vaginal opening
• Difficulty emptying the bladder (urinating)
• Having to run to the bathroom frequently to pass water, or just a feeling as if you have to go a lot.
• Frequent urinary tract infections.
• Feeling of fullness, heaviness, or pain in the pelvic area or lower back. This feeling may get worse when the person is standing, lifting, coughing, or as the day goes on.
• The bladder bulging into or out of the vagina.
• Painful sex.
• Problems inserting tampons or applicators.

Diagnosis and Tests

How is a cystocele diagnosed?

A Grade 2 or Grade 3 cystocele can be diagnosed from a description of symptoms and from an examination of the vagina.

The doctor may also perform certain tests, including the following:

• Urodynamics: Measures the bladder’s ability to hold and release urine.
• Cystoscopy (cystourethroscopy): A long tube-like instrument is passed through the urethra to examine the bladder and urinary tract for malformations, blockages, tumors, or stones.

Management and Treatment

How is a cystocele treated?

If it is not bothersome, a mild cystocele may not require any treatment other than avoiding heavy lifting or straining that could cause the problem to get worse.

Other potential treatment options include the following:

• Weight loss.
• Estrogen replacement therapy.
• Kegel exercises to strengthen the openings of the urethra, vagina and rectum. These exercises involve tightening the muscles that are used to stop the flow of urine, holding for 10 seconds, and then releasing.
• If symptoms are modest, a device called a pessary may be placed in the vagina to hold the bladder in place. Pessaries are available in a number of shapes and sizes to ensure a proper fit. A pessary has to be removed and cleaned on a regular basis in order to avoid infection or ulcers.

What happens during and after surgery for a cystocele?

A moderate or severe cystocele may require reconstructive surgery to move the bladder into a normal position. There are a number of ways to perform this surgery, including an anterior repair. In an anterior repair, an incision (cut) is made in the wall of the vagina and the tissue that separates the bladder from the vagina is tightened. Another option, for more severe prolapse, is to place a synthetic material with a robotic or laparoscopic approach through the abdomen. This method may give more support to the tissue and help prevent the condition from happening again.

The patient usually goes home the day of the surgery. Complete recovery typically takes four to six weeks.

For women who never plan on having sexual intercourse again, surgeries that sew the vagina shut and shorten it so it no longer bulges are nearly 100 percent effective.

What can be expected after treatment for a cystocele?

In mild cases, non-surgical treatments may be all that is needed to successfully deal with a cystocele.

When surgery is performed for more serious cases, some women will eventually need another surgery because the first surgery failed, the cystocele returned or another pelvic floor problem developed. Women who are older, who smoke, are diabetic, or who have had a hysterectomy, may be at higher risk for complications.

Prevention

How can a cystocele be prevented?

Certain risk factors, including heavy physical work, being overweight, and constipation, can be controlled, while risk factors such as family history cannot. As the population ages, the occurrence of cystocele is likely to increase.

Outlook / Prognosis

What is the prognosis (outlook) for someone with a cystocele?

Although not life-threatening, a cystocele can have a negative impact on a woman’s quality of life. If it is not treated at all, the condition can continue to get worse. In the worst cases, the woman may be unable to urinate, which can cause kidney damage or infection.

Pelvic Organ Prolapse – American Family Physician

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Rectal Prolapse | CS Mott Children’s Hospital

Topic Overview

What is rectal prolapse?

Rectal prolapse occurs when part or all of the wall of the rectum slides out of place, sometimes sticking out of the anus. See a picture of rectal prolapse.

There are three types of rectal prolapse.

• Partial prolapse (also called mucosal prolapse). The lining (mucous membrane) of the rectum slides out of place and usually sticks out of the anus. This can happen when you strain to have a bowel movement. Partial prolapse is most common in children younger than 2 years.
• Complete prolapse. The entire wall of the rectum slides out of place and usually sticks out of the anus. At first, this may occur only during bowel movements. Eventually, it may occur when you stand or walk. And in some cases, the prolapsed tissue may remain outside your body all the time.
• Internal prolapse (intussusception). One part of the wall of the large intestine (colon) or rectum may slide into or over another part, like the folding parts of a toy telescope. The rectum does not stick out of the anus. (See a picture of intussusception.) Intussusception is most common in children and rarely affects adults. In children, the cause is usually not known. In adults, it is usually related to another intestinal problem, such as a growth of tissue in the wall of the intestines (such as a polyp or tumor).

In severe cases of rectal prolapse, a section of the large intestine drops from its normal position as the tissues that hold it in place stretch. Typically there is a sharp bend where the rectum begins. With rectal prolapse, this bend and other curves in the rectum may straighten, making it difficult to keep stool from leaking out (fecal incontinence).

Rectal prolapse is most common in children and older adults, especially women.

What causes rectal prolapse?

Many things increase the chance of developing rectal prolapse. Risk factors for children include:

• Cystic fibrosis. A child who has rectal prolapse with no obvious cause may need to be tested for cystic fibrosis.
• Having had surgery on the anus as an infant.
• Malnutrition.
• Deformities or physical development problems.
• Straining during bowel movements.
• Infections.

Risk factors for adults include:

• Straining during bowel movements because of constipation.
• Tissue damage caused by surgery or childbirth.
• Weakness of pelvic floor muscles that occurs naturally with age.

What are the symptoms?

The first symptoms of rectal prolapse may be:

• Leakage of stool from the anus (fecal incontinence).
• Leakage of mucus or blood from the anus (wet anus).

Other symptoms of rectal prolapse include:

• A feeling of having full bowels and an urgent need to have a bowel movement.
• Passage of many very small stools.
• The feeling of not being able to empty the bowels completely.
• Anal pain, itching, irritation, and bleeding.
• Bright red tissue that sticks out of the anus.

See a doctor if you or your child has symptoms of rectal prolapse. If it is not treated, you may have more problems. For example, the leaking stool could get worse, or the rectum could be damaged.

How is rectal prolapse diagnosed?

Your doctor will diagnose rectal prolapse by asking you questions about your symptoms and past medical problems and surgeries. He or she will also do a physical exam, which includes checking the rectum for loose tissue and to find out how strongly the anal sphincter contracts.

You may need tests to rule out other conditions. For example, you may need a sigmoidoscopy, a colonoscopy, or a barium enema to look for tumors, sores (ulcers), or abnormally narrow areas in the large intestine. Or a child may need a sweat test to check for cystic fibrosis if prolapse has occurred more than once or the cause is not clear.

How is it treated?

Prolapse in children tends to go away on its own. You can help keep the prolapse from coming back. If you can, push the prolapse into place as soon as it occurs. You can also have your child use a potty-training toilet so that he or she does not strain while having a bowel movement.

Sometimes children need treatment. For example, if the prolapse doesn’t go away on its own, an injection of medicine into the rectum may help. If the prolapse was caused by another condition, the child may need treatment for that condition.

Home treatment for adults may help treat the prolapse and may be tried before other types of treatments.

• If your doctor says it’s okay, you can push the prolapse into place.
• Avoid constipation. Drink plenty of water, and eat fruits, vegetables, and other foods that contain fiber. Changes in diet often are enough to improve or reverse a prolapse of the lining of the rectum (partial prolapse).
• Do Kegel exercises to help strengthen the muscles of the pelvic area.
• Don’t strain while having a bowel movement. Use a stool softener if you need to.

People who have a complete prolapse or who have a partial prolapse that doesn’t improve with a change in diet will need surgery. Surgery involves attaching the rectum to the muscles of the pelvic floor or the lower end of the spine (sacrum). Or surgery might involve removing a section of the large intestine that is no longer supported by the surrounding tissue. Both procedures may be done in the same surgery.

(PDF) Image Based Measurements for Evaluation of Pelvic Organ Prolapse

S. Onal et al. / J. Biomedical Science and Engineering 6 (2013) 45-55

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90,000 Pelvic organ prolapse – WMT High Tech Clinic

Prolapse (prolapse) of the pelvic organs – a condition that develops due to a violation of the natural support of the pelvic organs (uterus, bladder, colon or rectum) and leading to displacement in the vagina or beyond. The main reason for the prolapse of the pelvic organs is damage to the supporting apparatus of the pelvic floor – the ligaments and fascia, which braid the pelvic organs and fix (hang) them to the walls of the pelvis.

CAUSES OF THE DISEASE

• Pregnancy and childbirth. During this period, there is a change in the qualitative composition of the pelvic floor tissues, they become more elastic and extensible. In some patients, unfortunately, the restoration of the previous properties of the ligaments and fascia does not occur. Also during childbirth, part of the fascia, ligaments and muscles are damaged. This happens in the case of complicated labor (large fetus, rapid labor, episiotomy (perineal incision), use of obstetric forceps, vacuum, etc.) during labor.etc.).
• Hard physical work. In this case, a process similar to childbirth develops – the supporting structures of the pelvis cannot withstand the stress and are torn.
• Chronic constipation, respiratory diseases, accompanied by persistent cough. This includes obesity, which also leads to increased stress on the ligamentous apparatus of the pelvic floor.
• Hereditary connective tissue weakness. Often such women have concomitant diseases such as hemorrhoids, varicose veins of the lower extremities, pathology of the musculoskeletal system.

TYPES OF PROTECTION OF THE PELVIS ORGANS

According to the localization of the leading point of prolapse, there are:

• Cystocele – descent of the bladder – descent of the anterior wall of the vagina.
• Rectocele – prolapse of the rectum – prolapse of the posterior wall of the vagina.
• Enterocele – omission of the loops of the small intestine – omission of the posterior fornix of the vagina.
• Uterocele – prolapse of the uterus – apical prolapse.
• Prolapse of the vaginal dome – apical posthysterectomy prolapse.

DIAGNOSTICS

At the WMT clinic, gynecologists carry out a number of diagnostic procedures that help determine the exact condition of the patient:

1. Gynecological examination
2. Valsalva test (straining)
3. Cough test with moderately filled bladder for the diagnosis of urinary incontinence
4. Evaluation of the strength of the pelvic floor muscles (perineometry)
5. Active detection of complaints:
   • Vaginal discomfort
   • Sexual contact is accompanied by discomfort or extraneous sounds
   • Pain, feeling of pressure, feeling of a foreign body in the vagina
   • Involuntary leakage of urine when coughing, laughing, sneezing
   • Constipation or gas incontinence
   • Difficulty or, conversely, frequent urination, feeling of incomplete emptying of the bladder

TREATMENT OF PELVIS ORGANS PROLAPS

At the WMT clinic, doctors use all existing treatment methods: conservative and operative.

Conservative tactics is used for pelvic floor weakness without traumatic injury. Includes:

• Lifestyle changes aimed at reducing intra-abdominal pressure (quitting smoking, preventing constipation, maintaining normal weight, etc.)
• Pelvic floor muscle training is an effective non-surgical method of treatment; it can be used both as monotherapy and in combination with gynecological pessaries.

Surgical treatment is used when there is traumatic injury to the pelvic structures, 3-4 degree of prolapse, no effect from conservative therapy, reproductive function realized.

There are different types of operations:

1. Anterior and posterior colporrhaphy. Restore the integrity of tissues and the normal position of organs without the use of additional devices. With this type of surgery, it is necessary to determine the exact location of the ligament and fascia ruptures and eliminate the existing defects with your own tissues. The patient’s own tissues are used to repair the tears of the ligaments and fascia. These operations are physiological and relatively safe.
2. For recurrent forms of pelvic organ prolapse, WMT surgeons use mesh implant surgery.In the area of ​​damage, implants are installed that replace the functions of the destroyed ligaments. Most often, synthetic mesh endoprostheses (meshes) are used for this. After installation, the meshes sprout with their own tissues and fully perform the functions of artificial ligaments and fascia. Young age and regular sex life is a contraindication for these types of operations.
3. Sling operations, TVT-O, TOT. The essence of the operations is that a loop is inserted under the middle part of the urethra, which supports the urethra, preventing urine from flowing out under tension.After such operations, a woman can return to a full life the next day after the operation.

APPOINTMENT

Make an appointment with a gynecologist at the WMT clinic by phone 8 (861) 206-03-03 . or leave a request on the website.

Treatment of genital prolapse in Chelyabinsk

Main types of operations for correction of genital prolapse

1. Operations aimed at strengthening the pelvic floor – colpoperineolevatoroplasty.
2. Vaginal extirpation of the uterus (if necessary with laparoscopic assistance) in combination with colpoperineolevatoroplasty; Manchester operation; colpfixation according to Mc Call.
3. Operations using laparoscopic access: sacral colp fixation with a synthetic prosthesis.
4. Various types of mesh-plastic (Prolift, Apogee, Perigee, etc.).
5. Operations with the so-called rigid fixation of the prolapsed organs to the walls of the pelvis.
6. Operations aimed at strengthening the fixation apparatus of the uterus (cardinal, sacro-uterine ligaments) by stitching them together, transposition, etc.
7. Operations aimed at partial obliteration of the vagina (median Neigebauer-Lefort colporrhaphy).

Anterior and posterior colporrhaphy with levatoroplasty with own tissues is performed for patients of different ages, with a moderate degree of prolapse of the vaginal walls, without gynecological pathology and connective tissue dysplasia syndrome, with sufficient sexual activity. The advantages of this type of surgery are ease of performance, low trauma, and a short rehabilitation period.

Vaginal extirpation of the uterus in combination with colpoperineolevatoroplasty with own tissues is the most common operation to correct genital prolapse. Its implementation is advisable in case of prolapse of the uterus and the walls of the vagina, as well as with the prolapse of the genital apparatus in combination with concomitant pathology of the cervix and body of the uterus.

A separate surgical technique is Mc Call colpofixation (ligature technique for fixing the dome of the vagina to the sacrospinal ligaments), which is now widely used for prolapse of the dome and walls of the vagina after extirpation of the uterus.

In the presence of an appendage pathology accompanying genital prolapse, the method of vaginal extirpation of the uterus with appendages with laparoscopic assistance has proven itself well.

Manchester operation (amputation of the cervix in combination with colporrhaphy) occupies a narrow niche in the line of methods for surgical correction of genital prolapse, since it can be effective only if the position of the uterus in the small pelvis is maintained. In this case, prolapse should be due to a combination of elongation of the cervix with prolapse and prolapse of the walls of the vagina.

Sacrovaginopexy with a synthetic prosthesis is currently performed mainly by laparoscopic access, which significantly reduces the trauma of the operation. It should be noted that this technique is the operation of choice in patients of fertile age with recurrent forms of prolapse, connective tissue dysplasia syndrome.

Colporrhaphy with synthetic prostheses (Opur, Lintex, …) are highly effective operations for the correction of genital prolapse. The complexity of this type of surgery (the presence of “blind” stages), severe intra- and postoperative complications require from the operating surgeon not only the exact execution of the surgical procedure, but also strict adherence to the indications for correction of genital prolapse using this technique.

Indications for colporrhaphy with a synthetic prosthesis:

1. Relapses of genital prolapse;
2. Connective tissue dysplasia syndrome;
3. Decompensated forms of genital prolapse.

Considering that the installation of a synthetic prosthesis by vaginal access causes severe dyspareunia, it is necessary to recommend this technique for correcting genital prolapse to elderly patients with a lack of sexual activity.

Operations with the so-called rigid fixation of the prolapsed organs to the pelvic walls or fixation of the uterine stump or vagina with the stumps of the ligamentous apparatus of the uterus and appendages are currently used as a stage of abdominal amputation (extirpation) of the uterus with a combination of gynecological pathology and genital prolapse.

Operations aimed at partial obliteration of the vagina (median Neigebauer-Lefort colporrhaphy) have been undeservedly forgotten. Being simple in execution and practically free of relapses, they can be more widely used in elderly patients with genital prolapse without concomitant gynecological pathology.

“Laparoscopy is the best option for today.” Why Every Woman Should Know About Genital Prolapse

Photo: Masha Mozharova

Genital prolapse – what is it and why should every woman know about it?

Genital prolapse is a prolapse or prolapse of the pelvic organs, that is, the bladder, rectum, uterus and cervix.There are different stages of prolapse. The very last, fourth, is when the pelvic organs extend beyond the genital slit.

Prolapse is a very common problem that affects about 50% of women. It begins most often after childbirth. Even after the first birth, physiological stage I and II prolapse occurs, and after the second, third, and so on, the prolapse naturally progresses. In addition, prolapse is most common in women who are overweight, in women who lift weights or whose work is related to physical activity, progresses during menopause.Another risk factor is a genetic pathology of connective tissue, in which little collagen is produced, which is responsible for the strength of the ligamentous apparatus, which makes the ligaments weak and unable to hold organs in the place where they should be anatomically.

Prolapse can have different symptoms associated with the prolapse of an organ. If, for example, prolapse of the bladder dominates, then the patients complain of dysuria, urinary incontinence, night trips to the toilet, unbearable urge to urinate or, conversely, difficulty urinating, frequent urinary infections, recurrent cystitis.If rectal prolapse dominates, the same problems with stool occur. But more often than not, there is no isolated prolapse of only one organ: when the uterus descends, it pulls the bladder and rectum with it. This is a complex problem, which, in fact, is at the junction of three specialties – urology, gynecology and proctology. In our country, these areas of knowledge are very divided: only a certified gynecologist has the right to deal with problems of the uterus, only a certified urologist can deal with the problems of the uterus, and a proctologist with the rectum.People who have genital prolapse surgery must have multiple certifications.

The second difficulty lies in the fact that the treatment of prolapse is a surgery of small spaces, very delicate, difficult, since the organs are closely adjacent to each other and it is critically important not to touch the nerves or damage the vessels. Therefore, the treatment of prolapse should be dealt with only by a pelvic surgeon who perfectly knows the anatomy of the pelvic organs, understands the functional features of their work and can perform the operation so that the organs work adequately after it.Otherwise, it happens that the surgeon sews everything into place and the anatomy is in order, but after the operation the bladder does not empty, urinary retention or chronic constipation occurs and the patients only get worse. Finding the right surgeon is important, but keep in mind that there are few such specialists.

What are mesh implants and why were they banned in America?

While there are no rigorous guidelines and clear algorithms for the treatment of prolapse in the world, this is a young area that is still being explored.Therefore, there is some confusion in this area. But recently, the approach to surgical treatment of genital prolapse has changed significantly.

For the last 20 years, vaginal mesh implants have been actively used to treat genital prolapse. Installing a mesh through the vagina is, at first glance, a rather simple operation to perform, it is not difficult for a surgeon to learn this technique. Therefore, the use of nets has become very widespread in the world, the operation was performed by both urologists and gynecologists. At first it seemed that this technique was giving good results, but over time, long-term consequences began to appear.And then it turned out that the percentage of complications is high.

About 40% of patients are not satisfied with the results. First, they often had a relapse, that is, the return of the “disease.” Secondly, the most frequent and formidable complication of operations was the development of pelvic pain and sexual dysfunctions. These complications not only sharply reduce the quality of life, but also often practically disable the patients. These complications of the operation are associated with the fact that the implant is installed by touch – the mesh is blindly fixed to the pelvic ligaments and lifts the organs up.It is very easy to damage the pelvic plexus and the vessels that run along the ligaments.

Patients with complications became regular “clients” of neuropathologists, psychotherapists and other specialists in the treatment of chronic pain syndrome. In the end, the victims began to unite in groups, turn to lawyers, they were paid huge compensation, which led to the fact that in April 2019 the FDA banned the use of any mesh prostheses for correcting genital prolapse by vaginal access.The ban on nets has sparked a violent response from the medical community. The correctness of this decision is still openly discussed at the congresses. Surgeons who have become experts in “vaginal” surgery with a minimum of complications over the course of 20 years categorically did not support the taboo on nets. They say that for a certain category of patients, vaginal surgery should remain an option – for example, for elderly patients with a history of strokes and heart attacks, since this operation can be done under spinal anesthesia, that is, relatively non-traumatic.

In fact, the situation is this – if the surgeon has a lot of experience, then his patients really have few complications. And of course, if the operation is performed on a ninety-year-old grandmother for whom general anesthesia is contraindicated and who is unlikely to be sexually active and is unlikely to be bothered by problems of sexual dysfunction, then yes, the installation of a mesh is indicated for such a patient. But the problem is that in reality, this surgery is undertaken by all and sundry and is done by everyone.

In Russia and in Europe, except for England, nobody banned nets.Surgeons simply switched to new manufacturers – European and domestic. Fortunately, there is an alternative to this treatment.

Photo: Masha Mozharova

What is laparoscopic promontofixation and why is the future behind it?

The future, of course, belongs to a fundamentally different surgery. Today, the most correct alternative to surgical treatment of prolapse is laparoscopic promontofixation. The operation is performed through small centimeter incisions in the abdominal cavity using very small laparoscopic instruments and a special camera.

The camera provides high magnification and very good visualization. Now there are even 3D cameras with which you can see a volumetric image, which allows you to make this surgery as accurate as possible. Such operations are practically bloodless. It turns out to see and bypass the vessels, nerves. The uterus, lowered during prolapse, is pulled up and sewn to the sacrum – as nature intended. After all, the uterus is anatomically supported by the sacro-uterine ligaments, which stretch and weaken over time, which is why prolapse occurs.We are restoring the physiological normal state. Since in such an operation there is no contact of the mesh with the vaginal mucosa, this eliminates the risk of infectious complications. At the same time, we combine the laparoscopic stage with plastic surgery of the vaginal walls with our own tissues – we restore, narrow the vagina, we can sew damaged muscles and fascia – the vagina after that looks the same as before childbirth. This allows us to completely restore and even improve the sexual function of our patients. There is no pelvic pain after this operation.And the percentage of relapse tends to zero.

Urodynamics – what is it and how to solve five problems in one operation?

In 30-50% of cases, genital prolapse is accompanied by various types of urinary incontinence. To determine the form of incontinence, it is necessary to perform a urodynamic examination before the operation. This allows the function of the bladder to be assessed and surgery to be planned to correct the disturbance. If, for example, urinary incontinence is associated with an overactive bladder, we know that just by removing the prolapse, this type of urinary incontinence will go away on its own.If we see that incontinence occurs during exercise (stressful form), we simultaneously place a special sling under the urethra while correcting the prolapse – this is the gold standard for correcting stress incontinence. In total, we can solve up to five different pelvic problems in one anesthesia. And, like the rest of the world, we adhere to the principles of fast track surgery – we do everything for early rehabilitation and patient recovery after surgery. Usually, patients in our hospital spend no more than one or two days.

Photo: Masha Mozharova

Long-term results of laparoscopy

Laparoscopic promontofixation is such an interesting and exciting new surgery that I devoted my doctoral thesis to researching its results. Patients have been included in my study since 2013, that is, I analyzed all patients who have been operated on over the past six years. None of them had clinically significant relapse and pain, and overall the results are very good.

Laparoscopy is by far the best option for pelvic surgery. There is also the Da Vinci robot – in fact, the same laparoscopic operation, but performed using a robotic installation. Unfortunately, laparoscopic surgery is difficult to learn and takes several years. First you need to practice on animals, then on humans. Young doctors are mastering laparoscopy, and there are practically no such people among the older generation who would retrain. There are not so many laparoscopic training centers in the world.Surgeons who can afford it travel for at least a year to a training center in France, which, by the way, is headed by our compatriot Revaz Bochorishvili. There are now only two or three specialists in Moscow, who have more than 300-500 experience behind them and whom you can safely trust.

I’d like to see more training centers teaching laparoscopic surgery in Russia. Because in the foreseeable future, I see that up to 90% of all surgical interventions will be performed endoscopically or laparoscopically.

Author: Asya Chachko

Why do we need a female urologist, we told here.

90,000 Genital prolapse

Genital prolapse is a violation of the position of the uterus and / or the walls of the vagina, manifested by the displacement of the genitals before the entrance to the vagina or prolapse outside the vagina.

This pathology is also called prolapse or prolapse of the internal pelvic organs.

Classification of genital prolapse by degrees:

• I st. The walls of the vagina are lowered no more than to the entrance to the vagina.
• II Art. The walls of the vagina are located outside of the vaginal opening.
• III Art. Complete vaginal prolapse, with the entire uterus (body and cervix) outside the opening.

In relation to the walls of the vagina:

• Cystocele – prolapse of the anterior wall of the vagina along with the bladder.
• Rectocele – prolapse of the posterior wall of the vagina, along with the rectum.

Risk factors for prolapse:

1. Pregnancy and childbirth, including those accompanied by tears of the walls of the vagina and perineum, as well as if various obstetric aids were used.

After childbirth, the muscles of the anterior abdominal wall and pelvic floor are overstretched. And it doesn’t matter if there was a birth through a natural birth canal or by a cesarean section. Pregnancy for more than 20 weeks leads to a decrease in the tone and strength of the pelvic floor muscles and stretching of the ligamentous apparatus.

2. Features of the constitution, increased nutrition and obesity.
3. Chronic increase in intra-abdominal pressure (when performing hard physical work, with coughing and constipation)
4. Lack of estrogen – hypoestrogenism. Most often this occurs due to the onset of menopause or after surgical removal of the ovaries.
5. Systemic connective tissue dysplasia.

With a prolapse of the genitals, a woman begins to worry about the following symptoms:

• Urination disorder – frequent urge, urinary incontinence when laughing, sneezing, coughing, running.
• Weak, intermittent or splashing urine stream.
• Irresistible urge to urinate immediately.
• Feeling of incomplete emptying of the rectum or bladder;
• Intake of air into the vagina during exercise.
• Decrease in vaginal sensitivity during sexual intercourse.
• Severity in the lower abdomen, pain in the chair, lower back – aggravated in an upright position, after lifting the weight.
• More pronounced disorders of the pelvic organs include the sensation of a foreign body in the vagina, definition of the walls of the vagina at the entrance to the vagina
• a feeling of heaviness, a foreign object in the perineum;

If there is a suspicion of prolapse of the genitals, it is enough to come for a routine examination to a gynecologist.He will see and assess the severity of the problem with a simple examination in mirrors and prescribe treatment.

Treatment:

• Medication- does not help to cure prolapse, but can be used in the early stages, as well as in preparation for surgical treatment.
• Sanitation of the vagina, restoration of biocenosis.
• Correction of hormonal background, local application of Estriol preparations.
• Stool normalization to prevent constipation.
• Correction of body weight – its reduction.
• A fairly effective method of prevention, as well as treatment in the early stages of prolapse, is therapeutic exercises or Kegel exercises. It helps the intimate muscles work, improving blood circulation in the small pelvis. Pelvic floor muscle training is not effective without special advice from a gynecologist and personal advice. It is possible to select a special simulator for vaginal muscles
• Another method of conservative correction method is the use of a vaginal pessary (or ring).They are inserted into the vagina and provide effective support to the pelvic floor muscles and relieve pressure on the bladder and bowels. Vaginal pessaries are selected individually by the doctor. And are indicated for those patients for whom surgical treatment is contraindicated.
• Surgical treatment. It is used for the prolapse of the pelvic organs of 2-3 degrees.

Be healthy!

Make an appointment with a gynecologist

Obstetrician-gynecologist – Moldovan Anastasia Gennadievna

You can make an appointment by phone (391) 218-35-13 or through your personal account

Journal of obstetrics and women’s diseases

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90,000 Uterine prolapse: symptoms, diagnosis, treatment

Anatomy of the female reproductive system

Causes of genital prolapse

• Hereditary predisposition

• Heavy physical activity

• Obesity

• Pathology of connective tissue

• Childbirth, especially traumatic

Symptoms of uterine prolapse

With prolapse of the pelvic organs, women complain of pressure or discomfort in the lower abdomen, constipation, urinary incontinence and the sensation of a foreign body in the vagina.

First stage

The cervix is ​​located above the entrance to the vagina, the organ is not visible from the outside.

Second stage

Even slight straining, such as sneezing or coughing, causes a short-term appearance of the cervix in the genital opening.

Third stage

Incomplete prolapse of the uterus without connection with straining.

Fourth stage

Complete prolapse of the uterus, the organ cannot be inserted back.

Diagnosis of prolapse of organs

In order to diagnose prolapse (prolapse) of the pelvic organs, the gynecologist carefully asks the patient about the complaints, the time and condition of the appearance of unpleasant symptoms. After that, a vaginal and rectal examination is performed while lying and standing.

Treatment of uterine prolapse

When the lowering of the pelvic organs is insignificant, expectant tactics may be recommended. The doctor gives recommendations on lifestyle changes and selects special exercises to strengthen the muscles of the pelvic floor.A pessary, a removable vaginal device that supports the organs, may also be prescribed. With a severe degree of prolapse, as well as in the absence of the expected effect from conservative therapy, surgical treatment is performed.

There are two types of interventions for pelvic organ prolapse:

1. obliterating surgery – narrowing or closing of the vagina to support the prolapsed organs
2. reconstructive surgery – keeping the organs in the correct places.During such an intervention, the surgeon moves the organs back to their original position and fixes them there using a special mesh

Pelvic organ prolapse surgery can be performed using one of three methods:

1. Open surgery through a long incision on the anterior abdominal wall
2. Laparoscopy – using endoscopic instruments through small incisions in the abdomen
3. High-tech operation with the da Vinci surgical robot.

How the da Vinci Surgical Robot Works

Using the da Vinci robot, a special retaining mesh is placed through small incisions in the abdominal wall. The surgeon controls the instruments inside the patient’s body with the help of special joysticks and controls his work, carefully observing the monitor – a three-dimensional image of the operated organs is broadcast on it. Such operations require high qualifications, extensive experience and special skills.

Installed mesh during uterine prolapse

Advantages of the da Vinci operation for uterine prolapse

Surgical treatment of pelvic organ prolapse with the da Vinci robot achieves:

1. Reducing the risk of postoperative complications compared to open access ^4.5
2. Reduction of hospitalization period ^4.5.8.9
3. Reducing the likelihood of postoperative complications
4. Reducing the likelihood of reoperation
5. A good aesthetic result: the procedure is performed through small incisions, so the scars after such an operation are minimal

As with any transaction, no one can guarantee that the listed benefits will be present in each case, since each case is unique.Patients should discuss the appropriate surgical risks with their physicians.

More About Surgical Risks

Neck Prolapse (Neck Prolapse) | Symptoms, treatment, exercise, advice ++

Neck prolapse is a condition of damage to one of the intervertebral discs of the cervical spine (neck). A prolapsed neck (neck prolapse) means that a softer mass (nucleus pulposus) has pushed through the more fibrous outer wall (annulus fibrosus) and thus presses on the spinal canal.

It is important to know that neck prolapse can be asymptomatic or symptomatic. Pressure on the nerve roots in the neck, neck pain and nerve pain down the arm can feel like a nerve root that is irritated / pinched.

In this article we will talk more about:

• Strength and stretching exercises for neck prolapse (with video)

• Symptoms of a prolapsed neck

• Causes of neck prolapse

• Who has a prolapsed neck?

• Diagnosis of a prolapse of the neck

  + Visualization

• Neck prolapse treatment

• Neck Lowering Exercises

Scroll below to see more instructional videos of good exercises for you with neck prolapse.

VIDEO: 5 Clothes Exercises Against Stiff Neck and Nervous Neck Pain

Neck prolapse and tight neck muscles often (unfortunately) go hand in hand. This is because the area around a disc injury often becomes extremely sensitive to pain and thus causes significant muscle tension. Regular use of gentle stretching exercises can help relieve pressure on irritated nerves and loosen tight neck muscles.

These five movements and stretching exercises are soft and adaptable.

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VIDEO: Strength Exercises for Elastic Shoulders

Many people underestimate the importance of shoulder function for a healthy and healthy neck. By strengthening your shoulders and shoulder blades, you can get rid of overworked neck muscles, stiff joints, and irritated nerve roots. This training program shows you how to train with elastic to get the most out of your workout.

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Definition – cervical prolapse

“Prolapse” indicates that it is a soft mass of an intervertebral disc that has protruded out through the outer wall. The diagnosis usually involves the lower back or neck – when it comes to prolapse of the cervix, it is (usually) more serious than prolapse of the lumbar (lower back) – this is because some of the nerve roots in the neck, incl.h. controls the function of the diaphragm / respiration. Cervical means the neck is affected.

Symptoms of a prolapse of the neck (prolapse of the cervix)

Typical symptoms are radiating or hasty pain / discomfort in the arm, radiating from the neck. Often referred to as nerve pain. Symptoms will vary depending on whether the nerve root is affected or not – as mentioned, prolapse can be asymptomatic if there is no pressure on adjacent nerve roots.If there is indeed a root lesion (pinching of one or more nerve roots), symptoms will vary depending on which nerve root is affected. It can cause both sensory (numbness, tingling, radiation and sensory disturbances) and motor (decreased muscle strength and fine motor skills) symptoms. Prolonged squeezing can also lead to decreased muscle strength or muscle wasting (atrophy).

Does prolapse hurt?

A prolapse may or may not be symptomatic — a disc injury does not mean neck and arm pain.In other words, people with prolapse can walk without pain. This is additionally determined by whether there is pressure / pinching of nearby cervical nerve roots, which is determined by the position, size, direction, and appearance of the prolapse.

Numbness and radiant pain

Symptoms may include numbness, radiation, tingling, and an electric shock that enters the arm, and sometimes muscle weakness or muscle wasting (with prolonged loss of nerve power).Symptoms vary.

In folklore, this condition is often incorrectly called “a disc in the neck.” – this is wrong, because the discs get stuck between the cervical vertebrae and cannot “slip out” – only the soft mass inside the disc can move (ie, not the disc itself, but only its contents). Feel free to contact us at Our Facebook page if you have any questions or comments.

Root infection against C7 (may occur with prolapse in C6 / C7)

• Sensory sensation: Impairment or increased sensation may occur in the associated dermatome that extends down to the middle finger.
• Motor Skills: Muscles whose nerves are powered by C7 can also be weakened during muscle testing. The list of muscles that can be affected is long, but often the impact is most noticeable when testing the strength of the triceps muscle or lattissimus dorsi, since they receive their nerve signals only from the C7 nerve root. Other muscles that are affected, but which are also supplied by other nerves, are the muscles of the forearm (including pronator circular and flexor carpus ulna) and wrist flexors and wrist extensors.

For your information: thus, prolapse at the neck levels affects the inferior nerve root – if there is a prolapse at the C7 / T1 level, it affects the C8 nerve root. But if a prolapse of T1 / T2 is to occur, that is, between the two upper thoracic vertebrae, then this may be a lesion of the T1 nerve root.

Why does neck prolapse most often occur in the lower cervical vertebrae?

The reason these two areas are most often affected is due to pure anatomy.These are the areas that are located at the bottom of the neck and therefore have to do most of the work when it comes to absorbing shock and wearing the head. They are also particularly vulnerable when working in a forward bent and static working position (for example, this is also one of the positions in which most neck blows and ailments occur). Unbeknownst to many, these sharp kinks and “cuts” in the neck act as a defense mechanism to prevent damage to more delicate structures such as soft intervertebral discs.It’s just the body’s way of telling you that you’ve tried to do something that you don’t have enough supporting muscles or function to do, and it asks you to heed its warnings. Many people choose not to listen when the body is reporting danger and thus stress trauma occurs, for example. disc injury or disc disruption in the neck.

Les også: – 5 individual exercises for you with neck prolapse

Why do you have neck prolapse? Possible reasons?

There are many factors that determine whether you have prolapse, both epigenetic and genetic.

Genetic causes

Among the congenital reasons why you can get prolapse, we find the shape and curves of the back and neck – for example, a very straight pillar of the neck (the so-called straightened cervical lordosis) can lead to the fact that the load forces are not distributed over the joints as a whole. but then, rather, it strikes what we call transition joints, since the forces thus pass directly through the column without diminishing through the bends.The junction is the area where one structure merges into another – an example is the cervicothoracic junction (CTO), where the neck meets the thoracic spine. It is also no coincidence that it is in this joint that the joint between C7 (lower cervical joint) and T1 (upper chest joint) is located. has the highest rate of neck prolapse.

Anatomically, it is possible to be born with a weaker and thinner outer wall (annulus fibrosus) of the intervertebral disc – this will naturally have a higher risk of disc injury / disc prolapse.

epigenetics

Epigenetic factors mean the conditions around us that affect our life and our health. It can be socioeconomic conditions, such as poverty, which means you cannot afford to visit a clinician when the pain first started, and thus you were unable to do what was needed before it happened. prolapse. … It can also be diet, smoking, activity level, and so on.Did you know, for example, that smoking can lead to increased muscle pain and poor healing due to decreased circulation?

Work / Load

A work area that contains many heavy lifts in unfavorable positions (for example, bending forward with twisting) or constant compression (pressure across the back – for example, from heavy packaging or a bulletproof vest), over time can lead to overload and damage to the lower cushions. fabrics.intervertebral discs. This, in turn, can cause the soft mass to flow out and create the basis for shedding. In the event of a collapsed neck, it is often possible to see the person performing static and demanding work – among other things, several veterinarians, surgeons and dental assistants suffer from their random static position during work.

Who is affected by cervical prolapse?

The disease primarily affects young people aged 20-40 years.This is due to the fact that the internal mass (nucleus pulposus) at this age is still soft, but gradually hardens with age, and thus the likelihood of shedding is also reduced. On the other hand, wear changes and spinal stenosis are common causes of bone pain in those over 60 years of age.

– The neck is a complex structure that also requires some training and attention.

Does prolapse disappear? Or do I need help?

Dropout is a dynamic structure.That is, the body recognizes this as a problem and constantly tries to destroy it by sending enzymes to the site. These enzymes try to “eat” the part of the disc nucleus that has pushed through the outer wall. Thus, in an ideal world, the prolapse will gradually recede and disappear. The only problem is that a person who has had a prolapse will unfortunately often have it due to poor habits, poor lifting / training technique, and generally too little core / back training.Thus, a person must completely change behavior, exercise habits and movement patterns – and this is easier said than done. Then it might be okay with a little outside help, like a physical therapist or a modern chiropractor (someone who works with muscles, joints and exercises) – they can tell you what you are doing wrong and what to focus on in the future to maximize your chances of recovery.

Diagnostics of the lowering of the neck

Clinical examination and history taking will be central to the diagnosis of cervical prolapse.Thorough examination of muscle, neurological and joint function is essential. It should also be possible to exclude other differential diagnoses. See a doctor, chiropractor, or chiropractor to diagnose your pain – these three officially approved health care professions have the longest education and are also eligible for diagnostic imaging (such as an MRI scan if needed).

Neurological symptoms of cervical prolapse

A thorough neurologic examination will examine the strength of the lower extremities, lateral reflexes (patella, quadriceps and Achilles), sensory and other impairments.

Diagnostic imaging of cervical prolapse (X-ray, MRI, CT or ultrasound)

X-rays can show the state of the vertebrae and other related anatomical structures – unfortunately, it cannot visualize current soft tissues and the like. One MRI scan is most commonly used to diagnose a prolapse of the cervix. This can show exactly what is causing the nerve compression. In those patients who cannot receive MRI due to contraindications, CT can be used with contrast to assess the condition.

X-ray of prolapse of the cervix

X-ray does not show prolapse of the cervix (prolapse of the neck). This is because X-rays cannot visualize soft tissues, tendons, and ligaments well enough. This is why MRI is used to determine if there is a disc injury. In this image, we see a neck with a whiplash injury – this we see, among other things, on the straightened (almost reverse) bend of the neck (straightened cervical lordosis).

MRI image of neck prolapse

This MRI scan shows a pinched spine between cervical vertebrae C6 and C7 due to a herniated disc.

CT image of cervical prolapse

Here we see a no contrast CT image that shows the neck and head. CT is used when a person is unable to take an MRI scan, for example, due to metal in the body or an implanted pacemaker.

Treatment of cervical prolapse

Usually, it is not the prolapse itself that is treated, but the symptoms and disorders associated with the trauma itself. This can include physically treating nearby tense muscles and joint treatment of stiff joints to ensure the best possible function. Traction therapy (also called spinal decompression) can also be a useful tool for relieving compression pressure from the lower vertebrae, discs, and nerve roots.Other treatments are dry needle treatment, anti-inflammatory laser treatments, and / or muscle pressure wave treatments. Of course, treatment is combined with gradual, progressive training. Here is a list of treatments for cervical prolapse. Treatment may be carried out by, among others, public health authorized physicians such as physical therapists, chiropractors, and chiropractors. As mentioned, it is also recommended to combine treatment with training / exercise.

Physical processing

Massage, muscle work, joint mobilization, and other similar physical methods can relieve symptoms and improve circulation to affected areas.

Physiotherapy

It is generally recommended to instruct patients with cervical prolapse on how to exercise correctly through a physical therapist or other clinician (such as a modern chiropractor or chiropractor).A physical therapist can also help relieve symptoms.

Surgery / Surgery

If the condition worsens significantly or you do not experience any improvement with conservative treatment, surgery may be required to free the area. The operation is always risky and is a last resort.

laser therapy

Class 3B laser therapy has also been shown to have a documented effect on neck prolapse.Treatment can stimulate recovery and cause the disease to heal itself faster than without treatment. In accordance with the Radiation Protection Regulations, laser therapy should only be used by authorized medical personnel, and the regulations state that only a physician, chiropractor, and physical therapist may be approved for such use.

Row Bench / Cox Therapy

The traction and traction bench (also called the stretching bench or the steering bench) are spinal decompression instruments that have been used with relatively good effect.The patient lies on the bench so that the area to be extended / decompressed falls into the part of the bench that separates and thus opens the spinal cord and associated vertebrae, which we know provides symptom relief. Most often, treatment is done by a chiropractor, chiropractor, or physical therapist.

Les også: 11 exercises against Ischialga

Neck Descent Surgery

Government orthopedic surgeons have strict requirements as to whether to perform surgery for prolapse – unfortunately, private clinics do not always do this.The reason they are so serious is that neck surgery carries a high risk if something goes wrong, such as increased pain or permanent injury. Thus, neck surgery is only for those who really need it and who, for example, have a CSM.

Several studies have shown that surgery often has a good short-term effect, but in the long term it can worsen symptoms and pain. This may be due to the formation of scar tissue / tissue damage in the operated area, which, like distant prolapse, puts pressure on the nearby nerve roots.The only difference is that scar tissue and damaged tissue cannot be operated on. It should also be borne in mind that the operation is performed in a very sensitive area, and therefore there is a possibility that surgeons will damage the nerves, which, in turn, can lead to worsening nerve symptoms / diseases and / or irreversible decrease in muscle strength and atrophy.

Select scalpel exercise

A prolapsed neck can be incredibly tiring, painful and frustrating, but we strongly recommend that you try all of the options before going under the knife.Yes, the scalpel is perhaps the most “attractive choice” with its false promises of quick fixes, but gradual learning is always the best (but most boring) choice. Work hard and with determination. Set yourself goals in between and get help from a doctor so you can stay motivated and avoid exercises that you absolutely shouldn’t do.

Exercises against prolapse of the cervix

Exercises aimed at relieving symptoms in the neck area will primarily focus on releasing the affected nerve, strengthening the associated muscles, and especially the rotator cuff, shoulder and neck muscles.Among other things, we recommend that you focus on exercising your shoulder muscles. We also recommend that you get a specific exercise program from your doctor that is right for you. Sling training is also appropriate later.

Related article: – How to get stronger in the shoulders and shoulder blades

Further Reading: – Neck pain? YOU MUST KNOW THIS!

sources:
– PubMed

Frequently Asked Questions regarding prolapsed neck / prolapsed neck / disc injury:

Can I get a sore throat with a prolapsed neck?

Yes, sore throat can occur due to tension in the neck muscles, which are associated with pain in the back, front or side of the neck.It is often associated with myalgia in the sternocleidomastoid muscle, a muscle that is often overactive when the neck is prolapsed because of its desire to protect the injured area. Other muscles that can cause neck pain are the muscles of the upper trapezium, scalene muscle, and jaw (digastric and pterygoid).

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