Picture of prolapsed cervix: eMedicineHealth Page Not Found
What Does A Cervix Look Like? 7 Cervix Pictures, Explained
Think of your cervix as the gatekeeper to your uterus. Lots of things—like tampons, fingers, penises, sex toys, and other germ-carrying items—can get to your cervix, but they aren’t getting past it. Your cervix, in its 24/7 role of keeping your uterus happy and healthy, won’t let that happen.
Likewise, there are things—like mucous, menstrual blood, and the occasional baby—that need to get out of your uterus. Your cervix is the bouncer, deciding what and when things go in and come out of the most vital piece of your reproductive system. Yet, despite benefiting from its work, day in and day out, chances are you don’t know much about it.
So…what does a cervix even look like?
Great Q! Your cervix is the “neck” of your uterus, positioned at the top of your vaginal canal. Because of its location, seeing your cervix isn’t as easy as squatting over a hand mirror, like you would if you were examining your other lady bits, but it is possible with the right tools.
All you need is a flashlight, a mirror, a retractable speculum, and a little courage. If you don’t have a speculum just lying around your bathroom (and if you do, we want to hear that story!) you can buy a starter kit for $22.95 from the Beautiful Cervix Project. It even comes with a handy map to guide you through your own nethers. Once there you can admire the beauty of your own, unique cervix and even snap some cervix pictures if you’re so inclined. (Use this handy video guide for tips on getting a good picture of your vaginal canal and cervix.)
The Beautiful Cervix Project is a movement to better understand and appreciate the awesomeness of the underrated cervix. O’Nell Starkey started it as a project for midwifery school, with her husband taking snaps of her cervix throughout her cycle. She quickly discovered, as she’s put it, “Cervices are amazing!”
After sharing her images with the world, she found that other women also wanted to see their own cervices (that’s plural for cervix!), leading her to start the Beautiful Cervix Project, as well as live workshops dedicated to helping women learn about and appreciate their bodies.
“What I have learned by creating this website is that people from all over the world are curious about their bodies, cervices, and the menstrual cycle—everyone from newly menstruating teens, pregnant people, medical students, people with abnormal Paps, to people trying to conceive, artists, educators, and the list goes on,” Starkey says. “Cervical self-exam is about educating and empowering people by contradicting some of the shame and under-education we have about our bodies and menstrual cycles.
The Beautiful Cervix Project is dedicated to people working to reclaim their entire bodies as beautiful and lovable. The more we know about ourselves, the more we feel confident to advocate and care for ourselves.”
While each cervix is slightly different (which is why we recommend checking out your own cervix!), they all go through similar changes during your monthly cycle, when you’re pregnant, during labor and delivery, and after giving birth. Curious? Starkey was kind enough to share some cervix pictures to help you see what your cervix is up to. ..right now.
During the Follicular Phase
Beautiful Cervix Project
When your cervix is just hanging out, the visible part of the cervix protrudes into the vaginal canal and is covered by smooth, pink, squamous epithelium, says Kim Thornton, M.D., a reproductive endocrinologist at Boston IVF. In this picture, the cervix is preparing for ovulation by preparing more fluid.
Beautiful Cervix Project
The cervix looks a little bit like a donut. When it’s closed, the hole looks like a dimple, but it opens during ovulation to let sperm in, explains Ronald D. Blatt, M.D., gynecologist and chief surgeon and medical director of the Manhattan Center for Vaginal Surgery.
During the Luteal Phase
Beautiful Cervix Project
After ovulation, the cervix prepares for menstruation. In this picture the cervix is just doing its thing, waiting for either a pregnancy or shark week to happen. The average cervix measures 3 to 5 centimeters in length and 2 to 3 centimeters in diameter, Thornton says.
Beautiful Cervix Project
When your flow comes to visit, you know the blood is coming from somewhere up in there, but this picture shows exactly how it comes out of your cervix. Again, the dimple in the center—called the os—is in the open position to release menstrual fluids, Blatt says.
Beautiful Cervix Project
This is a picture of the cervix just minutes after the woman had an orgasm during sex (you can even see the semen pooled around the bottom). Depending on the size of you and your partner’s anatomy, the penis can bump into the cervix during sex. Some women find the sensation enjoyable and may even orgasm from it, according to a study published in the journal Hormones and Behavior. Others find repeated thrusting into the cervix to be incredibly painful and it can cause bruising or even tearing of your cervical tissue.
Beautiful Cervix Project
Your sex life and monthly cycle may keep your cervix busy, but the real work happens during pregnancy and delivery. In this picture, the woman is about two months pregnant. The white goo, called leukorrhea, is very common type of vaginal discharge that can occur during pregnancy and is nothing to worry about, Starkey says.
During a Pap Smear
Beautiful Cervix Project
Getting swabbed for a Pap smear and HPV test isn’t anyone’s idea of a good time but it’s a necessary evil to catch cervical cancer and other diseases before they can cause more harm. But you don’t have to do them every year, says Devorah Daley, M.D., ob-gyn at Weill Cornell Medicine and NewYork-Presbyterian. “The recommendation is to have your first Pap smear at age 21—it does not matter when sexual activity has started,” she says. “After that, for younger women, every other year is sufficient. Starting at age 30, we recommend every three years if you’re doing just the Pap.”
If, however, you get co-tested—meaning your Pap and HPV tests are collected at the same time—Dr. Daley says you can stretch that time frame out to five years. “Even if you were to leave the office and come in contact with [HPV], it doesn’t cause initial problems for about five years,” she says.
It’s believed that more than 90 percent of cervical cancer cases are caused by HPV, according to the Centers for Disease Control and Prevention, with higher incidence rates among Black and Hispanic people. However, it’s hard to know whether that prevalence is due to socioeconomic factors (such as access to health care) or other variables.
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Pelvic Organ Prolapse | Michigan Medicine
What is pelvic organ prolapse?
Pelvic organ prolapse occurs when a pelvic organ—such as your bladder—drops (prolapses) from its normal place in your lower belly and pushes against the walls of your vagina. This can happen when the muscles that hold your pelvic organs in place get weak or stretched from childbirth or surgery.
Many women will have some kind of pelvic organ prolapse. It can be uncomfortable or painful. But it isn’t usually a big health problem. It doesn’t always get worse. And in some women, it can get better with time.
More than one pelvic organ can prolapse at the same time. Organs that can be involved when you have pelvic prolapse include the:
What causes pelvic organ prolapse?
Pelvic organ prolapse is most often linked to strain during childbirth. Normally your pelvic organs are kept in place by the muscles and tissues in your lower belly. During childbirth these muscles can get weak or stretched. If they don’t recover, they can’t support your pelvic organs.
Pelvic organ prolapse can be made worse by anything that puts pressure on your belly, such as:
- Being very overweight (obesity).
- A long-lasting cough.
- Frequent constipation.
- Pelvic organ tumors.
Older women are more likely to have pelvic organ prolapse. It also tends to run in families.
What are the symptoms?
Symptoms of pelvic organ prolapse include:
- Feeling pressure from pelvic organs pressing against the vaginal wall. This is the most common symptom.
- Feeling very full in your lower belly.
- Feeling as if something is falling out of your vagina.
- Feeling a pull or stretch in your groin area or pain in your lower back.
- Releasing urine without meaning to (incontinence), or needing to urinate a lot.
- Having pain in your vagina during sex.
- Having problems with your bowels, such as constipation.
How is pelvic organ prolapse diagnosed?
Your doctor will ask questions about your symptoms and about any pregnancies or health problems. Your doctor will also do a physical exam, which will include a pelvic exam.
How is it treated?
Decisions about your treatment will be based on which pelvic organs have prolapsed and how bad your symptoms are.
If your symptoms are mild, you may be able to do things at home to help yourself feel better. You can relieve many of your symptoms by adopting new, healthy habits. Try special exercises (called Kegels) that make your pelvic muscles stronger. Reach and stay at a healthy weight. Avoid lifting heavy things that put stress on your pelvic muscles.
If you still have symptoms, your doctor may have you fitted with a device called a pessary to help with the pain and pressure of pelvic organ prolapse. It is a removable device that you put in your vagina. It helps hold the pelvic organs in place. But if you have a severe prolapse, you may have trouble keeping a pessary in place.
Surgery is another treatment option for serious symptoms of pelvic organ prolapse. But you may want to delay having surgery if you plan to have children. The strain of childbirth could cause your prolapse to come back.
You may want to consider surgery if:
- You have a lot of pain because of the prolapsed organ.
- You have a problem with your bladder and bowels.
- The prolapse makes it hard for you to enjoy sex.
Types of surgery for pelvic organ prolapse include:
- Surgery to repair the tissue that supports a prolapsed organ.
- Surgery to repair the tissue around your vagina.
- Surgery to close the opening of your vagina.
- Surgery to remove the uterus (hysterectomy).
Pelvic organ prolapse can come back after surgery. Doing Kegel exercises to make your pelvic muscles stronger will help you recover faster from surgery. The two together can help you more than surgery alone.
Pelvic organ prolapse is usually caused by damage to the tissues (muscles, ligaments, and connective tissue) that support the pelvic organs. Damage or stretching of these tissues allows the organs to move out of their normal positions. This causes them to press against (and sometimes move) the inside walls of the vagina.
Having a baby makes it more likely that you will have pelvic organ prolapse later. Vaginal childbirth has been strongly linked to weakened and stretched support structures in the pelvic area. This loss of support is the biggest cause of pelvic organ prolapse. Having a cesarean section, on the other hand, seems to be less strongly linked to pelvic organ prolapse.
Another cause of reduced support in the pelvis is lower levels of the hormone estrogen. Estrogen levels are lower during and after menopause. The lower levels of estrogen in the body mean less collagen, a protein that helps the pelvic connective tissues stretch and return to their normal positions.
Other conditions that may cause pelvic organ prolapse include:
- Obesity, which can lead to long-term pressure within the abdomen.
- Smoking and/or lung disorders, which are often causes of chronic coughing.
- Conditions affecting the spinal cord, such as muscular dystrophy, multiple sclerosis, and spinal cord injury, that cause paralysis of the muscles of the pelvic floor.
Although many women who have pelvic organ prolapse do not have symptoms, the most common and bothersome symptom is pressing of the uterus or other organs against the vaginal wall. The pressure on your vagina may cause minor discomfort or problems in how your pelvic organs work. Symptoms of pelvic organ prolapse include:
- A feeling of pelvic pressure.
- A feeling as if something is actually falling out of the vagina.
- A pulling or stretching in the groin area or a low backache.
- Painful intercourse.
- Spotting or bleeding from the vagina.
- Urinary problems, such as involuntary release of urine (incontinence) or a frequent or urgent need to urinate, especially at night.
- Problems with bowel movements, such as constipation or needing to support the back (posterior) of the vaginal wall to have a bowel movement.
Symptoms of pelvic organ prolapse are made worse by standing, jumping, and lifting and usually are relieved by lying down.
The pelvic organs are kept in place by the muscles and connective tissues of the pelvis (pelvic diaphragm). The vagina of an adult woman is normally a round-topped, muscular tube that also supports the other pelvic organs. The pelvic muscles and tissues can be stretched or damaged, most commonly by childbirth. When they don’t recover, they lose their ability to support the organs.
The location and severity of pelvic organ prolapse is related to where in the pelvis the injury or muscular damage has occurred. You may have several areas of injury that contribute to prolapse. Prolapse may occur after surgery to remove the uterus (hysterectomy) if the procedure removes or damages support of the bladder, urethra, or bowel wall. If other conditions, such as childbirth, damage muscles or nerves in the pelvis, the pelvic diaphragm may lose its dome shape. It may become more like a funnel and then bulge down into or out of the vagina.
Pelvic organ prolapse may increase pressure on the vagina and interfere with sexual activity, sometimes leading to sexual dysfunction. For more information, see the topic Sexual Problems in Women.
Lower estrogen levels during and after menopause make pelvic organ prolapse more likely. Estrogen helps your body to make collagen, a protein that enables the supportive tissues of the pelvis to stretch and return to their normal positions. When estrogen levels go down, so do collagen levels. Less collagen makes it more likely that those supportive tissues will tear.
Pelvic organ prolapse may be a progressive condition, gradually getting worse and causing more severe symptoms. But in many cases it does not progress and may improve over time.
What Increases Your Risk
Pelvic organ prolapse is often related to stretching and pressure during labor and childbirth. This can occur when a woman delivers a large baby [over 9 lb (4 kg)] or when she has a long, difficult labor and delivery. Pelvic organ prolapse most often appears during menopause, as pelvic tissues damaged during childbearing age and lose strength.
Other things that may increase the risk for pelvic organ prolapse include:
- Obesity. Women who are overweight have increased pressure in the abdomen and have a higher rate of pelvic organ prolapse.
- Smoking and lung conditions that cause chronic coughing, which increases pressure in the abdomen and pelvis.
- Constipation. Chronic constipation causes increased pressure from the bowel on the vaginal wall.
- Certain occupations that require heavy lifting.
- Diseases of the nervous system. Pelvic organ prolapse is more common in women who have multiple sclerosis, muscular dystrophy, or a spinal cord injury than in women who do not have such conditions.
- Genetic factors. A weakness in the supportive tissue of the pelvis can be passed through families. If your mother or sister has had pelvic organ prolapse, you may be more likely to get it too.
When should you call your doctor?
Call your doctor to schedule an appointment if:
- You notice a bulge of tissue inside your vagina or bulging out of your vagina.
- You have a sensation of pulling or increased pelvic pressure that is made worse when you strain or lift but is relieved when you lie down.
- Pain in your low back or pelvic area is interfering with your daily activities.
- Sexual intercourse has become difficult or painful.
- You have irregular spotting or bleeding from the vagina.
- Urinary symptoms, such as involuntary release of urine (incontinence), urinating frequently, having an urgent need to urinate, or urinating frequently at night, have developed and are interfering with your daily activities.
- You have difficulty having a bowel movement.
Watchful waiting is a period of time during which you and your doctor observe your symptoms or condition without using medical treatment. This period may vary from a few days to weeks, months, or years. If you have been diagnosed with pelvic organ prolapse and you do not have symptoms, or if you have mild symptoms that are not interfering with your daily activities, you may wish to try watchful waiting. Many women who have pelvic organ prolapse do not have symptoms, so they do not require treatment.
If you have symptoms, such as a feeling of pressure in your vagina, schedule an appointment with your doctor.
Who to see
Your doctor can evaluate symptoms caused by pelvic organ prolapse. Pelvic organ prolapse can be diagnosed and treated by the following health professionals:
Exams and Tests
A prolapse of a pelvic organ is sometimes difficult to diagnose. Pelvic organ prolapse that does not cause symptoms is often discovered during a routine exam. You may be aware that there is a problem but be unsure of the exact location or cause. If prolapse is suspected, your doctor will take your medical history, including your symptoms and your history of pregnancies and other health problems, and do a physical exam, including a pelvic exam.
Tests may be done to find out the nature of a prolapse, particularly if it is causing problems with bladder or bowel function. These tests include:
Doctors use a classification system to determine the level of an organ’s prolapse. Identifying the exact level of prolapse helps guide decisions about which treatments are most likely to offer long-term success. One standard classification uses “stages” of prolapse and is based on how close the lowest part of the organ is to the opening of your vagina (the hymen).
Many women who have pelvic organ prolapse do not have symptoms and do not require treatment. If your symptoms are bothersome, you may want to consider treatment. Treatment decisions should take into account which organs are affected, how bad symptoms are, and whether other medical conditions are present. Other important factors are your age and sexual activity.
Many women are able to reduce pain and pressure from a pelvic organ prolapse with nonsurgical treatment, which may include making lifestyle changes, doing exercises, and/or using a removable device called a pessary that is placed into the vagina to support areas of prolapse.
If your pelvic organ prolapse is causing pain or problems with bowel and bladder functions or is interfering with your sexual activity, you may want to consider surgery. Surgical procedures used to correct different types of pelvic organ prolapse include repair of the supporting tissue of the prolapsed organ or vagina wall. Another option is the removal of the uterus (hysterectomy) when it is the prolapsed organ or if it is causing the prolapse of other organs (such as the vagina).
Sometimes surgery cannot repair all the prolapsed organs. And sometimes pelvic organ prolapse comes back after surgery.
Pelvic organ prolapse can be a long-lasting condition. But it does not have to be a cause of symptoms that disrupt your life. Many women with pelvic organ prolapse are able to relieve their symptoms without treatment by adjusting their activities and lifestyle habits. These changes might include:
- Doing pelvic floor (Kegel) exercises every day to tighten and strengthen pelvic muscles.
- Eating high-fiber foods to prevent constipation. Get at least 20 g of fiber a day.
- Reaching and staying at a healthy weight.
- Avoiding activities that stress your pelvic muscles, such as heavy lifting.
If your symptoms are not relieved by these lifestyle changes, you may want to consider treatment for pelvic organ prolapse. Treatment will be different depending on which organs are involved, how bad your symptoms are, and what other medical conditions are present. Treatment may include using a pessary, a removable device that is placed into the vagina to support areas of prolapse.
Pelvic organ prolapse can be a long-lasting condition. But it often responds to adjustments in activities and lifestyle habits. If you have tried self-care, such as eating high-fiber foods, staying at a healthy weight, and doing pelvic floor (Kegel) exercises, but your symptoms are increasingly bothersome, you may want to consider nonsurgical treatment. Treatment will be different depending on which organs are involved, how bad your symptoms are, and what other medical conditions are present. Treatment may include using a pessary, a removable device that is placed into the vagina to support areas of pelvic organ prolapse.
Treatment if the condition gets worse
If you have pain and discomfort from pelvic organ prolapse that does not respond to nonsurgical treatment and lifestyle changes, you may want to consider surgery. The choice of surgery depends upon which organs are involved, how bad your symptoms are, and what other medical conditions are present. Also, your surgeon may have experience with and preference for a certain procedure. Types of surgery for pelvic organ prolapse include:
Often the doctor does more than one of these surgeries at the same time. These surgeries are designed to treat specific symptoms. So other symptoms may remain after surgery.
For help deciding about surgery, see:
What to think about
If you are considering having children, you may want to delay pelvic organ surgery. If you have surgery and then deliver a child vaginally, the strain on your pelvic organs may cause them to prolapse again.
Sometimes surgery cannot repair all the prolapsed organs. And sometimes surgery to repair pelvic organ prolapse will lead to prolapse in another area.
Pelvic organ prolapse may be a progressive condition, gradually getting worse and causing more severe symptoms. But in many cases it does not progress and may improve over time.
Pelvic organ prolapse is most often a result of tissue damage caused by labor and childbirth. Although you may not be able to prevent the damage to your pelvic organs caused by childbearing, you may be able to control the progression of the prolapse. Lifestyle changes that may slow the prolapse process include:
- Reaching and staying at a weight that is healthy for your height.
- Not smoking. The chronic cough associated with smoking may cause or speed pelvic organ prolapse.
- Correcting constipation. The straining caused by constipation weakens and damages the connective tissue and muscles in the pelvis.
- Avoiding heavy lifting and jumping.
- Doing pelvic strengthening exercises (Kegel exercises) every day. These exercises help strengthen the muscles of the pelvis.
Home treatment can relieve the discomfort of pelvic organ prolapse. It can also help to keep prolapse from getting worse.
- Do Kegel exercises every day to strengthen the muscles and ligaments of the pelvis.
- Prevent or correct constipation. The straining caused by constipation increases pressure from the bowel on the vaginal wall and weakens and damages the connective tissue and muscles in the pelvis.
- Try gentle exercise. Take a short walk each day. Gradually increase your walking time until you are walking for at least 20 minutes each day.
- Make sure you drink enough fluids.
- Eat plenty of high-fiber foods such as whole grains, fruits, and vegetables every day. Have a bran muffin or bran cereal for breakfast, and try eating a piece of fruit for an afternoon snack. Try to eat about 20 g of fiber every day.
- Schedule time each day for a bowel movement—after breakfast, for example. Having a daily routine may help. Take your time.
- If you continue to be constipated, try taking processed or synthetic fiber (such as Citrucel, Metamucil, or Perdiem) each day.
- If your stools are very hard, try taking a stool softener, such as Colace, to prevent straining.
- Reach and stay at a healthy weight.
- Avoid activities that stress your pelvic muscles, such as heavy lifting.
Although taking or applying the hormone estrogen will not cure an existing pelvic organ prolapse, it is sometimes prescribed for women during menopause to preserve or strengthen the tissues of the pelvis, which may help prevent prolapse. Estrogen prevents drying and thinning of the vaginal tissues (vaginal atrophy) and improves your ability to effectively use a support device for your vagina (pessary).
Studies have shown that taking estrogen therapy (ET) or hormone therapy (HT) can increase risks of serious diseases. Estrogen as a low-dose vaginal cream is not thought to pose the same risks to women’s health. Talk to your doctor about taking or applying estrogen.
If you have pain and discomfort from pelvic organ prolapse that does not respond to nonsurgical treatment and lifestyle changes, you may want to consider surgery. The choice of surgery depends upon which organs are involved, how bad your symptoms are, and what other medical conditions are present. Also, your surgeon may have experience with and preference for a certain procedure. The goals of surgery are to relieve your symptoms and restore the normal functioning of your pelvic organs.
There are several types of surgery to correct stress urinary incontinence. These can be done at the same time as surgery to repair prolapse. These surgeries lift the urethra and/or bladder into their normal position.
For help deciding about surgery, see:
Surgical procedures used to correct different types of pelvic organ prolapse include:
What to think about
Surgeries are designed to treat specific symptoms, so you may still have other symptoms after surgery. An examination while you have a pessary in your vagina may help the doctor see if urinary incontinence would be a problem after surgery. If the exam shows that urinary incontinence will be a problem, another surgery can be done at the same time to fix the problem.
Surgery in one part of your pelvis can make a prolapse in another part worse, possibly requiring separate treatment in the future.
Pelvic organ prolapse is strongly linked to labor and vaginal delivery. So you may want to delay surgery if you plan to have children.
You may be able to relieve symptoms of pelvic organ prolapse by using a pessary. A pessary is a removable device that fits into your vagina and supports the pelvic organs, helping to keep them in place.
What to think about
Many women can successfully control symptoms of pelvic organ prolapse for years using a vaginal pessary. But if you have a severe prolapse, you may have difficulty keeping a pessary in place.
Other Works Consulted
- Deng DY (2008). Female urology and sexual dysfunction. In EA Tanagho, JW McAninch, eds., Smith’s General Urology, 17th ed., pp. 611-624. New York: McGraw-Hill.
- Feiner MC, et al. (2010). Surgical management of pelvic organ prolapse in women. Cochrane Database of Systematic Reviews (5).
- Gleason JL, et al. (2012). Pelvic organ prolapse. In JS Berek, ed., Berek and Novak’s Gynecology, 15th ed., pp. 906–939. Philadelphia: Lippincott Williams and Wilkins.
- Hamilton C, et al. (2015). Gynecology. In FC Brunicardi et al., eds., Schwartz’s Principles of Surgery, 10th ed., pp. 1671–1707. New York: McGraw-Hill Education.
- Lentz GM (2012). Anatomic defects of the abdominal wall and pelvic floor. In GM Lentz et al., eds., Comprehensive Gynecology, 6th ed., pp. 453–474. Philadelphia: Mosby Elsevier.
- Onwude JL (2012). Genital prolapse in women, search date August 2011. BMJ Clinical Evidence. Available online: http://www.clinicalevidence.com.
- Reynolds RK, Loar PV (2010) Gynecology. In GM Doherty, ed., Current Diagnosis and Treatment: Surgery, 13th ed., pp. 966-984. New York: McGraw-Hill.
- Winters JC, et al. (2012). Vaginal and abdominal reconstructive surgery for pelvic organ prolapse. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 3, pp. 2069–2114. Philadelphia: Saunders.
Current as of:
July 17, 2020
Author: Healthwise Staff
Sarah Marshall MD – Family Medicine
Kathleen Romito MD – Family Medicine
Martin J. Gabica MD – Family Medicine
Femi Olatunbosun MB, FRCSC – Obstetrics and Gynecology
IDENTIFYING PELVIC ORGAN PROLAPSE —
Identifying Pelvic Organ Prolapse
By Mary O’Dwyer
Many women are interested in learning self-examination skills for detecting pelvic organ prolapse (POP). Self-examination for POP is done in supported lying then standing, with one foot on a stool so gravity helps with assessment. Angle a mirror for observation and keep a pad and pen close to note any findings.
Empty your bladder first and be conscious of relaxing PF muscles during the examination.Cough strongly and look for movement of a vaginal wall down to/out of, the vaginal entrance. Note if a smooth bulge balloons towards the front or back of your vagina or if the firmer cervix is descending.Bear down firmly (pelvic floor relaxed) for 6-8 seconds, looking for any movement down to/out of the vaginal walls.When the cervix or a vaginal wall protrudes like a golf or tennis ball shape, this is a significant prolapse. When the prolapse skews more to one side, a levator ani tendon tear (from the pubic bone) is suspected. When a vaginal wall bulges into your inserted fingers (and not out of the vaginal entrance), the prolapse is contained internally.
Insert 1 or 2 freshly washed fingers vaginally, and note how many finger joints penetrate before feeling the firm cervix at the top of the vagina (feels like a dimpled chin). If the cervix is descended, push it upwards to gauge how far it lifts. Note how far it descends with coughing, then bearing down.
Tighten and lift PF muscles to determine if this action lifts or pushes the cervix down. If the PF muscles feel strong and coordinated during the lift, the utero- vaginal prolapse is more likely due to damage of supporting ligaments and connective tissue (rather than muscle weakness). If the cervix descends, a bearing down action is being used.
Anterior (front) vaginal wall prolapse:
Insert 1 or 2 fingers and place over the front vaginal wall (facing the bladder) to feel any bulging under your fingers, first with strong coughing and then with sustained bearing down. A definite bulge of the wall under your fingers indicates a front vaginal wall prolapse. Next, tighten the PF muscles before coughing to gauge if this action controls any front wall bulging.
Posterior (back) vaginal wall prolapse:
Insert 1 or 2 fingers and place over the back vaginal wall (facing the rectum), to feel any bulging under your fingers, first with strong coughing and then sustained bearing down. A definite bulge under your fingers indicates a back vaginal wall prolapse. Next, tighten the PF muscles before coughing to gauge if this action controls any back wall bulging.
To identify a small intestinal prolapse, hold a tongue depressor (looks like a thick ice cream stick) over the back vaginal wall and reach your fingers up to the top of the back wall. Repeat the coughing and bearing down tests. The small intestinal prolapse presents with the upper back vaginal wall (the area between the back wall and cervix) descending down from above the depressor.
Discuss any positive findings with a gynaecologist and women’s health physiotherapist to determine suitable treatment options.
Habits Contributing To Pelvic Organ Prolapse:
Below are listed the daily habits and conditions that greatly contribute to and aggravate an existing pelvic organ prolapse (POP).
Straining to open the bowel progressively damages nerves supplying PF muscles, causing a loss of bladder and bowel control. Chronic straining weakens bladder, uterine or bowel supports and contributes to POP. Delayed or incomplete emptying is typically due to prolapse of the back (posterior) vaginal wall or failure to release the anal sphincter.
Too Much Fat
Women with a larger waist measurement have a higher risk of pelvic floor dysfunction (incontinence and POP). Visceral fat accumulates internally around the pelvic organs forcing PF muscles to work harder to support the weighted organs. Visceral fat acts like an endocrine gland releasing chemicals that weaken connective tissues ability to recover after damage, e.g. after childbirth or pelvic surgery. Overweight incontinent women gain significant improvement of their continence when they lose weight. Research shows that a diet high in calories and saturated fat (found in cream, cheese, processed meats, fried food) causes a 2.5 times increased risk of incontinence in women, possible due to the inflammatory effect of saturated fat and associated endothelial dysfunction (associated with urinary incontinence).
The internal abdominal pressure created by heavy lifting overwhelms pelvic floor control when the muscles lack quick strength, coordinated lift and hold. If PF muscles fail to lift and hold during heavy tasks, internal supporting ligaments are at risk of being stretched, leading to POP.
Over challenging Exercise
The pelvic floor is a smaller muscle group that is rarely trained to counter internal pressure rises and often fatigues long before the heart or lungs during exercise. The endurance required for a long run, a 60-minute interval class or prolonged exercise is considerable. Pelvic floor damage occurs when the pelvic floor fatigues part way through a workout. Building abdominal strength with upper abdominal bracing exercises increases intra abdominal pressure that has the potential to overwhelm pelvic floor control.
Repeated rises of intra-abdominal pressure or even one sudden, heavy episode may result in pelvic floor damage, even POP, in some women. If continued fast or high-load exercise results in loss of PF and core muscle control, other muscles substitute to provide trunk stability. Over time the body adopts incorrect muscle substitution and altered posture when the PF and core muscles repeatedly fail in their roles of strength and endurance.
Returning to exercise or lifting heavy weights before regaining PF muscle strength and postural alignment postpartum, results in more strain and damage to pre-weakened muscle, supporting ligaments and connective tissue supports.
Conversely, sustained vigorous exercise (without rest periods) in some women results in increased PF muscle tone causing continued muscular over activity. Poor bladder and bowel control, painful intercourse and some pelvic pain syndromes are related to increased resting tone (tightness) in PF muscles. Muscular hyperactivity during exercise is avoided by building in regular relaxation breaks, and changing over challenging exercise or training programmes.
Poor postural control
Sitting and standing tall keeps pelvic floor and core muscles active in their low-level endurance mode. The inner cylinder of postural muscles switches on when we become upright each morning and responds with higher bursts of activity depending on the task involved. Our commonly adopted position of slumped sitting switches off these muscles which help provide pelvic organ support, spinal stability and protect joints against wear and tear from gravitational loading when we sit, stand, walk and exercise.
Women with chronic lung or respiratory disorders (asthma, cystic fibrosis, bronchitis) or who smoke, have a higher rate of stress incontinence. Lifting up PF muscles, described as the ‘knack,’ before coughing helps prevent urine loss and future POP.
Pregnancy and Childbirth
The use of forceps or ventouse (vacuum extraction) to assist birth is associated with a higher rate of damage to PF muscles and tendons. Anterior vaginal prolapse is associated with rupture on the levator ani tendon off one or both sides of the pubic bone when rotational forceps are used to assist birth. POP is more common when the first time mother is over 35, baby is malpositioned, and a higher birth weight, and second stage is prolonged.
Weak Connective Tissue
Collagen is the protein in connective tissue giving strength to skin, joints, muscles, ligaments and tendons. Studies indicate when a mother experiences POP, daughters have a higher risk of future POP. Hyper mobile joints (knees, elbows, fingers and thumbs that bend too far backwards) due to joint laxity and soft tissue elasticity are a predicator of a higher risk of POP following childbirth. It is important for mums with hypermobile joints to focus on PF exercises and protective habits and discuss birthing options with their caregiver. For more information: www.hypermobility.org.
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Pelvic Prolapse Imaging – StatPearls
Pelvic floor prolapse is the herniation of the pelvic organs through the perineum. Depending on the pelvic organ involved, pelvic prolapse further categorizes into the anterior compartment containing urinary bladder(cystocele), the middle compartment containing uterine or vaginal prolapse (uterus or vagina), or the posterior compartment containing either the small bowel loops (enterocele) or rectum (rectocele). Pelvic prolapse is very common among multiparous women over 50, affecting approximately 50% of women over age 50. The patients present with symptoms of stress fecal or urinary incontinence, uterine prolapse, constipation, or incomplete defecation. Besides, pelvic prolapse can negatively impact the patient’s body image and sexuality. Pelvic prolapse treatments range from non-surgical approaches like Kegel exercise and pessary to various surgical procedures. Treatments of pelvic prolapse significantly contribute to the healthcare cost in the United States, estimated at approximately $300 million from 2005 to 2006. 
Pelvic floor prolapse is most often clinically diagnosed through physical exams and medical history. Imaging plays a limited role in evaluating mild cases of pelvic prolapse that involve a single pelvic compartment and organ. Nonetheless, translabial ultrasound and dynamic pelvic MRI (MR defecography) serve as valuable tools in diagnosing pelvic prolapse in complex cases involving multiple compartments and multiple pelvic organs. Also, pelvic MRI provides pre-operative planning for complex cases. The article will discuss translabial ultrasound and dynamic pelvic MRI in the evaluation of pelvic prolapse.
The pelvic anatomy divides into three compartments: anterior, middle, and posterior. The anterior compartment contains the bladder and urethra. The vagina and uterus are within the middle compartment. Finally, the posterior compartment contains the sigmoid colon, rectum, and anal canal.
The pelvic muscles, ligaments, and fascia prevent prolapse of the pelvic organs in each compartment. The most crucial pelvic fascia is endopelvic fascia, and it supports the uterus and vagina. Endopelvic fascia is composed of the uterosacral ligament, parametrium, and paracolpium. Pubocervical fascia is between the anterior vaginal wall and pubis; it supports the bladder. Lastly, the rectovaginal fascia supports the rectum. It situates between the posterior vaginal wall and rectum. The primary supporting pelvic muscles include iliococcygeal, pubococcygeal, and puborectal muscles. These are clearly visible on the pelvic MRI. On the other hand, the pelvic ligaments and fascia are less well appreciated on the MRI, but their dysfunctions can be inferred from the prolapse of pelvic organs in each compartment. In healthy patients, the pelvic muscles, ligaments, and fascia prevent the prolapse of pelvic organs and keep the rectum, vagina, and urethra elevated near the pubic symphysis.
Plain films are usually not appropriate for the evaluation of pelvic prolapse. Barium defecography is in use at some places as a part of the assessment of pelvic floor dysfunctions, however, with the advent of newer and non-ionizing radiation imaging techniques like MR defecography, barium defecography has become largely obsolete.
Due to concern for radiation exposure and availability of MRI, which provides a better soft-tissue resolution, computed tomography (CT) is usually not appropriate for the evaluation of pelvic prolapse; however, one should look on sagittal abdomen and pelvis images for hint of pelvic floor prolapse by drawing a pubococcygeal line and see for overt prolapse and then recommend a dynamic MRI pelvis (MR Defecogram) for further evaluation.
Dynamic magnetic resonance imaging (MRI) provides an accurate assessment of pelvic prolapse. MRI provides a better anatomic detail compared to the translabial ultrasound and is also useful as a preoperative tool. Furthermore, the MRI examination does not require bowel preparation and does not involve sensitive pelvic exposure. Despite its benefits, the MRI is not widely available, expensive, and contraindicated in patients with MRI incompatible devices or hardware.
The patient lies supine in the MRI scanner. This examination utilizes a 1.5 or 3.0 Tesla magnet. Despite the fact pelvic prolapse is most prominent in the upright position, obtaining the images supine does not significantly compromise the diagnostic accuracy. The study is performed following the administration of warm ultrasound gel per rectally, as this makes the rectal more prominent. The patient is encouraged to retain some urine in the urinary bladder as this will help diagnose cystocele. The duration of the scan is approximately 15 minutes. However, the length of the examination can be longer if additional images are necessary. Typical MRI protocol involves a large field of view in the sagittal plane and a small field of view in the axial plane. Images are obtained during the resting phase, the squeezing or kegel phase, with the Valsalva maneuver (straining phase) and defecation or evacuation phases. Coronal plane images are optional and usually not obtained.
The interpretation of the images involves drawing the following lines: pubococcygeal line, M-Line, H-Line, and the anorectal angle. Pubococcygeal line demarcates the level of the pelvic floor. The line is drawn between the inferior border of the pubic symphysis and the last intercoccygeal joint. Pelvic organ prolapse is subjectively assessed at rest, squeezing, or kegel phase, with the Valsalva maneuver, as well as the defecation phase. The degree of pelvic prolapse can be graded based on the depth of the descent below the pubococcygeal line as mild (less than 3 cm), moderate (3 to 6 cm), and severe (greater than 6 cm). H- line defines the anterior-posterior width of the levator hiatus. The line is drawn between the inferior border of the pubic symphysis and the anterior wall of the rectum at the anorectal junction. The normal H- line should measure less than 5 cm. Finally, M-line measure the descendants of the levator hiatus. It is drawn perpendicular to the pubococcygeal line and intersects the inferior portion of the H-line. The normal M-line should measure less than 2 cm. H-line greater than 5 cm and M-line greater than 2 cm at rest or with the Valsalva indicates pelvic muscle weakness. The anorectal junction is an important landmark and helps in measuring the anorectal angle. The anorectal angle is the angle between the anal canal central axis and the posterior border of the distalmost portion of the rectum. The normal anorectal angle is between 108 and 127 degrees during the resting phase and denotes the functioning of the puborectalis muscle. Normally, the angle should open or become more obtuse with straining/Valsalva and defecation by approximately 20 degrees. Chronic functional constipation is a significant symptom and can adversely affect one’s social and personal life. The technical term for this is dyssynergic defecation or spastic pelvic floor syndrome. This condition characteristically presents by an inappropriate lack of relaxation of the puborectalis and external anal sphincter, leading to the urge of defecation without actual fecal emptying. Treatment includes biofeedback therapy, which uses psychophysiological tracings to improve physiological responses. Biofeedback therapy has proven to be very useful in these cases.
Translabial ultrasound is a relatively inexpensive way of evaluating pelvic prolapse and is widely available. Besides, the ultrasound does not produce ionizing radiation and allows dynamic evaluation of the pelvic floor. However, the diagnostic quality of the ultrasound exam depends on the sonographer’s skill level and interpreting radiologist familiarity with the examination. The examination also requires bowel preparation before the start of the exam due to fecal content in the rectum impairing the diagnostic accuracy. Furthermore, the translabial ultrasound is considered a sensitive exam involving genitalia and rectum. Despite the limitations of the exam, the translabial ultrasound is a widely available, safe, and inexpensive way of evaluating pelvic prolapse.
The patient is in the dorsal lithotomy position (hip flexed and abducted). The bladder must be empty before the examination.2).
Nuclear medicine studies are usually not appropriate for the evaluation of pelvic prolapse.
Angiography is usually not appropriate for the evaluation of pelvic prolapse.
As discussed above, the patient lies supine on the MRI examination. During the translabial ultrasound, the patient is in the dorsal lithotomy position (hip flexed and abducted).
Pelvic prolapse is a common condition affecting approximately 50% of parous women above 50. The treatments for pelvic prolapse significantly contribute to the health care cost in the United States. Pelvic prolapse is a clinical diagnosis. However, the dynamic MRI and translabial ultrasound are valuable tools for complicated multicompartment pelvic prolapse when the physical examination is often difficult.
Continuing Education / Review Questions
Pelvic Prolapse. Contributed by Ilsup Yoon, MD
This sagittal image from MR Defecography shows severe perineal descent syndrome involving the posterior compartment. Also note the moderate to severe anterior rectocele. No intrarectal intuscusseption or internal prolapse was seen. This image also demonstrates (more…)
Demystifying pelvic organ prolapse – UChicago Medicine
Reproductive and urologic health can be a cause for concern for many people. Often, the topic of pelvic organ prolapses is not discussed until a patient has already experienced symptoms. As a urogynecologist, an important part of my role is to help patients understand what pelvic prolapses are and what can be done to treat them.
What is a prolapse and how does it occur?
Pelvic organ prolapse is a sagging of the support of the uterus or vaginal walls. As the support weakens, the walls and/or uterus can drop towards the vaginal opening. As prolapse worsens, the walls or uterus can come through the opening and a vaginal bulge can be seen.
Who is at risk to experience a pelvic prolapse and how common are they?
Pelvic organ prolapse occurs as a result of weakening of the pelvic support structures. This is a result of a combination of childbirth injury, genetics, aging and chronic straining with constipation. It is very common, with about 50 percent of women having some degree of prolapse. Over 12 percent of American women will have surgery for it in their lifetime.
If prolapse is untreated, what can occur?
Prolapse is not a dangerous condition, but it can be uncomfortable. Symptoms of prolapse can include a sensation of pressure in the pelvis or vagina, difficulty emptying your bowels or bladder, and discomfort if the uterine tissue bulges out of the vaginal opening. It is generally safe to leave prolapse untreated unless the prolapse is very large or causes difficulty with bowel or bladder emptying.
How is prolapse treated?
There are multiple options for treating prolapse. Pelvic floor or kegel exercises can be helpful in reducing prolapse symptoms, but will not make the prolapse go away. A pessary — a vaginal support — can also be placed in the vagina to hold up the uterus or vaginal walls. With the prolapse pushed back up, most women get relief from their symptoms. Prolapse can also be repaired surgically. A wide variety of minimally invasive procedures can be performed to repair prolapse. They are tailored to address the specific site of the prolapse, the amount of prolapse and to meet your specific goals and preferences.
What can patients do to minimize risk of prolapsing or assist with healing after a prolapse?
You can promote pelvic health by first making sure that you have a strong pelvic floor. Doing Kegel exercises is one of the best ways to make sure that your muscles are supporting your pelvis to the best of their ability. Avoidance of chronic straining is also helpful. Make sure your diet contains enough fiber to avoid constipation. Avoiding smoking and reducing chronic coughing will also reduce strain on the pelvic floor.
Is it possible to experience a prolapse multiple times?
Prolapse is similar to a hernia you might get in the abdominal wall. Like a hernia, prolapse can come back after it is surgically repaired.
What can you share about your research on pelvic organ prolapse?
I am interested in finding new methods and materials to help with treating pelvic organ prolapse and urinary incontinence. There is a lot of potential for new biologic materials to help improve the strength of our prolapse repairs. I am a member of the Center for Advanced Regenerative Engineering, a partnership of researchers across Chicago, where I am involved with a project focused on attempting to regenerate bladder tissue and muscle to help treat urinary incontinence.
National Animal Disease Information Service
Author: Phoebe McCarter BVSC MRCVS. Images courtesy of Phil Scott DVM&S BVM&S CertCHP DSHP DipECBHM FRCVS
Published: September 2019
Vaginal prolapse occurs during the last month of pregnancy. It is typically seen in around 1% (1 in 100) of pregnant sheep but may affect up to 15% of sheep within a flock. Any ewes which have prolapsed must be clearly identified and culled at the end of the season as they will most likely re-prolapse if allowed to breed again.
Many factors have been implicated in the cause of vaginal prolapse including:
- Excessive body condition (BCS 4 and above on a scale of 1-5)
- Multiple lambs in utero
- High fibre diets, particularly those containing root crops
- Limited exercise in housed ewes
- Lameness leading to prolonged periods lying down
- Short-docked tails (although vaginal prolapses are also seen in undocked mountain breeds)
- Steep fields
- Sub-clinical hypocalcaemia
The size of a vaginal prolapse can vary from a small area of dorsal vaginal wall to a larger structure of up to 20 cm when the prolapse may contain urinary bladder, uterine horn(s) or both of these structures.
Figure 1: A vaginal prolapse extending for 10-12 cm.
Figure 2: The diameter of this vaginal prolapse extends to 20 cm and it contains the urinary bladder
Figure 3: Short-docked tails have been implicated in vaginal prolapse.
Ewes with vaginal prolapse may show many behavioural signs consistent with first stage labour including:
- Isolation from the remainder of the flock
- Failure to come forward for concentrate feeding
- Long periods spend lying on their side with repeated, short-duration, forceful abdominal straining and associated vocalisation
Figure 4: Ewe straining with a vaginal prolapse showing behaviour consistent with first stage labour
The length of time the prolapse has been present directly affects the degree of contamination (with faeces, bedding material, soil etc.), the damage to the vaginal tissue and therefore the overall outcome of the case. If it is not noticed and addressed promptly the vaginal wall can quickly become swollen and friable, which greatly increases the risk of tears or rupture during manual replacement. Compromised blood supply to the tissue will eventually result in necrosis. Prognosis in these cases is hopeless and the ewe should be euthanased.
Treatment of vaginal prolapse
If it is necessary to transport sheep with vaginal prolapse to the veterinary surgery, then the prolapse should be covered with a towel soaked in warm water to prevent further contamination and damage.
Effective caudal analgesia (epidural injection of lignocaine) administered by a veterinary surgeon greatly aids replacement of the vaginal prolapse. Emptying of the bladder can then be readily achieved in the standing ewe by raising the prolapse relative to the vulva thereby reducing the fold in the neck of the bladder at which point urine is able to flow freely.
Figure 5: The prolapse should be carefully cleaned in warm water containing disinfectant solution.
The vaginal prolapse should be replaced with the ewe standing; in some cases the vaginal prolapse will return to the normal position within five minutes once the epidural has taken effect and the ewe has stopped straining. If not, gentle pressure around the prolapse coupled with the use of obstetrical lubricant will help to invert the vagina again. There is no reason to suspend the ewe by the hind limbs to replace a vaginal prolapse.
Figure 6: Administration of local anaesthetic to block straining by the ewe.
An anti-inflammatory drug will be administered by the vet to reduce pain. Antibiotics may be given if there is evidence of infection or severe tissue damage. Your vet will advise which drug is most suitable, and the correct route and course of administration.
Methods of retention after replacement of vaginal prolapse
Methods of retention after replacement of vaginal prolapse include the Buhner suture, plastic retention devices and harnesses or trusses.
A modified Buhner suture of 5 mm nylon tape is placed in the tissue around the vulva 2 cm from the labia and tightened to allow an opening of 1.5 cm diameter (two fingers’ width). The modified Buhner suture can easily be untied to allow examination of the vulva and vagina for signs of first stage labour. This method of retention should only ever be used by a veterinary surgeon using the appropriate equipment and pain relief.
Figure 7: Pain-free insertion of a Buhner suture using epidural anaesthesia.
Figure 8: Buhner suture is tightened to allow an opening of 1.5 cm diameter (one-two fingers).
The Buhner suture should be untied well before the expected lambing date, which can be estimated from the ewe’s keel mark, monitoring of the ligaments around the tail head which slacken close to lambing, and udder development and accumulation of colostrum in the teats.
Ewes should also be monitored for the signs of the first stage of labour in case estimated lambing dates prove inaccurate. These include:
- separation from the remainder of the group,
- frequent getting up and lying down,
- sniffing at the ground, and abdominal straining
- foetal membranes present at the vulva.
If the cervix has already fully dilated, and first stage labour completed before the ewe is noticed, a lamb may be forcefully expelled as soon as the retention suture has been slackened.
Fig 9: The Buhner suture must be released before the expected lambing date. Note the foetal membranes indicating first stage labour in this ewe.
Sutures which penetrate into the vagina, must be avoided as urine scalding around the suture material and secondary bacterial infection lead to discomfort and straining, making re-prolapse much more likely.
All ewes with retention sutures for vaginal prolapse must be clearly identified and staff notified that there could be problems at lambing with these sheep. Permanent ewe identification is essential to ensure culling before the next breeding season.
Plastic retention devices
Plastic retention devices are shaped such that the central loop is placed within the vagina which is then held within the pelvic canal by the two side arms tightly tied to the fleece of the flanks. These devices can work well in mild early cases, but in more severe cases where the ewe is straining and prolapsing despite the presence of the device veterinary advice should be sought.
Fig 10: Plastic retention devices can work well in mild early cases.
Figure 11: The plastic retention device is not working in this case – effective pain relief is essential in such cases; veterinary advice must be sought.
Harnesses or trusses
Figure 12: Effective management of a vaginal prolapse in a Blueface Leicester ewe using a truss.
Harnesses and trusses are very useful in situations where the prolapse is detected early and there is little superficial trauma/contamination. Harnesses and trusses must be fitted carefully, and inspected regularly, to prevent pressure sores.
Complications resulting from vaginal prolapse
Complications resulting from vaginal prolapse include:
- Incomplete cervical dilation with possible prolapse during lambing
- Death of lambs causing death of the ewe
Abortion may occur 24 to 48 hours after replacement of the vaginal prolapse. It is not known whether this event is a consequence of trauma to the placenta during prolapse or other factors. Ewes must be confined and carefully supervised after replacement of prolapses for signs of impending abortion.
Incomplete cervical dilation
Trauma, infection and swelling of the vaginal tissue of the prolapse may result in incomplete cervical dilation (ringwomb) during first stage labour. In this situation typical ringwomb management strategies e.g. the use of muscle relaxants and calcium will not work, and if the cervix does not respond to gentle manipulation with a clean, gloved hand, then the lamb(s) should be delivered by caesarean section.
Figure 13: Trauma and swelling of the vaginal prolapse may result in ringwomb during first stage labour.
Death of the ewe
Lambs which die because of a vaginal prolapse and are subsequently not expelled promptly may cause death of the ewe due to toxaemia and sepsis. Ewes which have prolapsed must be closely monitored for signs of labour or ill health, and appropriate action taken in a timely fashion.
Figure 14: Ewe with bloated abdomen caused by a gas-filled uterus containing rotten lambs shortly before euthanasia.
Uterine prolapse affects approximately 0.1% (1 in 1000) of ewes during lambing. The prolapse may occur either immediately after lambing or after an interval of 12 to 48 hours. In the first instance prolapse usually occurs as a consequence of prolonged second stage labour and the delivery of a large singleton lamb.
Uterine prolapse occurring after an interval of 12 to 48 hours generally results from straining caused by pain arising from infection and swelling of the vagina and vulva which have developed consequent to assisted delivery of the lamb(s).
Figure 15: Uterine prolapse following the birth of a large single lamb.
Fig 16: Uterine prolapse occurring 48 hours after an assisted lambing. Straining caused by pain from infection and swelling of the vagina and vulva caused the prolapse.
The everted uterus is readily identifiable by its large size (up to 50 cm long and 25 cm in diameter) extending from the vulva to below the level of the hocks with prominent caruncles (raised circular areas where the placenta was attached to the uterus) and adherent foetal membranes.
Unless the uterus is replaced correctly and fully inverted to its normal position within the abdomen, the ewe will continue to strain and re-prolapse. A uterine prolapse is best replaced by a veterinary surgeon under appropriate epidural anaesthesia.
Figure 17: Successful replacement of the uterine prolapse featured in the image above.
A Buhner suture of 5mm nylon tape is the best way to ensure the uterus remains in place (see method for retention of vaginal prolapse above). Antibiotics should be administered after replacement of the uterine prolapse to limit bacterial infection of the traumatised tissues. Your vet will prescribe the most appropriate antibiotics and anti-inflammatory drugs to use.
The ewe’s milk yield might be reduced for several days after replacement of the uterine prolapse and her lambs may require supplementary feeding. Unlike vaginal prolapse, it is unusual for a ewe to prolapse the uterus the following year and there is no indication to prematurely cull such ewes.
Evisceration through vaginal tear
In rare cases evisceration of intestines through a tear in the vaginal wall occurs spontaneously in heavily pregnant ewes during the last month of gestation.
Figure 18: Evisceration of intestines through a tear in the dorsal vaginal wall.
There is usually no history of prior vaginal prolapse or straining. The incidence may reach 1-2 per cent in some housed flocks. Excessive body condition, triplet pregnancy, and high fibre diets are thought to be risk factors, but the precise mechanism is not known.
Ensure all ewes, particularly the fecund breeds, are in the correct condition at tupping to reduce the number of high multiple births and lower the risk of vaginal wall rupture. Reverse flushing could be considered for ewes with the Inverdale gene.
There is no treatment and affected ewes must be euthanased immediately.
Prolapsed uterus | healthdirect
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What is a prolapsed uterus?
Prolapsed uterus (also called uterine prolapse or pelvic organ prolapse) is when the uterus drops down towards the vaginal opening. It may protrude outside of the vagina.
Doctors use a grading system to describe how much of the uterus has pushed down into the vagina:
- Stage 1 is when the uterus protrudes a little way into the vagina
- Stage 2 is when the uterus protrudes close to the vaginal opening
- Stage 3 is when the uterus protrudes outside of the vagina
In some women, the bladder and bowel can also prolapse. If the bladder bulges into the front wall of the vagina, it is called a cystocoele. If the bowel bulges through the back wall, it is called a rectocele.
Prolapse usually worsens without any treatment, so it’s important to seek medical help.
A prolapsed uterus occurs when the uterus falls down towards the vaginal opening. This can happen if the pelvic floor muscles are stretched or weakened.
What are the symptoms of a prolapsed uterus?
Women who have a prolapsed uterus may :
- a sensation of fullness or pressure inside the vagina
- a lump or bulge in, or out of, the vagina
- a sensation of heaviness or dragging in the pelvis or vagina
- an inability to completely empty the bladder or the bowel when going to the toilet
- straining to get urine flow started, or to empty the bowel
- bowel or bladder urgency (needing to go very suddenly) or incontinence
- pain during sex or less sensation during sex
- lower back pain
- urinary tract infections that keep coming back
What causes a prolapsed uterus?
A prolapse occurs when the ligaments that hold the pelvic organs in place are stretched or weakened. This can happen when something puts pressure on the pelvic floor, for example due to:
- pregnancy and childbirth
- prolonged constipation, or regularly straining on the toilet
- repetitive heavy lifting (for example, of children or grandchildren, or weights)
- being overweight
- chronic coughing
Women are more likely to have a prolapse after menopause due to a lack of oestrogen, a hormone that keeps the vagina healthy
How is a prolapsed uterus diagnosed?
If you think you might have a prolapse, your doctor will talk to you and examine you. You will need to have an internal examination. You may also be asked to have tests like ultrasounds and urine tests.
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How is a prolapsed uterus treated?
The treatment suggested will depend on the type and extent of the prolapse. Whatever the course of action, it is important that you do something about the prolapse or your symptoms are likely to get worse.
In some women, strengthening the pelvic floor muscles and changing their daily activities may be all that is needed. You may be recommended to see a pelvic floor physiotherapist or a continence nurse to help with this.
Some women may be offered a ring pessary, which is a small disc put high in the vagina as a support.
In severe cases, women will be advised to have surgery to repair weakened tissues, insert synthetic mesh to replace damaged tissues, or remove the uterus entirely (hysterectomy).
You can make some changes to manage the prolapse through:
- regular pelvic floor exercises
- regular physical activity
- avoiding heavy lifting
- avoiding high impact exercise
- eating high fibre foods and drinking plenty of fluid (to prevent constipation)
- achieving and maintaining a healthy weight
- not smoking
Can a prolapsed uterus be prevented?
The best thing you can do to prevent a prolapsed uterus is to keep the pelvic floor muscles strong. You can do this with pelvic floor exercises:
Visit the Continence Foundation’s Pelvic Floor First website for more information about the pelvic floor and how to keep it strong.
90,000 Help with prolapse of the uterus and vaginal walls, consultation with a gynecologist
The doctor interviews the patient, then conducts a gynecological examination. Often, the disease in the initial stage, when there are no symptoms yet, is detected during a routine gynecological examination. The doctor may need the results of a Pap test.
Depending on the stage of prolapse, gynecologists sometimes ask patients to push, cough (to estimate how much urine comes out at the same time).To obtain the most complete picture, an ultrasound of the pelvic organs is prescribed.
Treatment of prolapse of the uterus and vaginal walls is especially effective in the first and at the beginning of the second stage. In such cases, doctors use conservative techniques:
- medical gymnastics;
- stimulation of the pelvic floor muscles with electricity;
- water procedures;
- gynecological massage;
- correction of hormonal imbalance;
- wearing special bandages, installing pessaries (vaginal rings made of plastic or rubber).
The patient is advised to avoid strenuous physical activity and avoid some exercise. It is required to eat well, to include foods rich in vitamins and microelements in the diet. To combat constipation, you need to drink plenty of water, eat foods containing fiber.
Conservative treatment is also used in cases where the operation is contraindicated due to pregnancy or illness of the patient. Only if the prolapse is at the third or fourth stage, and conservative therapy does not give the desired effect, we recommend surgical intervention.
The type of surgical intervention depends on the age, condition of the patient, her plans for intimate life. As a rule, operations are performed in two ways:
- vaginal, with the preservation of the uterus or with its removal (hysterectomy). At the same time, plastic surgery of the vagina is performed: with your own tissues or with the installation of a mesh prosthesis.
- laparoscopic, with uterine amputation and cervical fixation with a mesh prosthesis.
To avoid omission, loss, and then removal
uterus, you must regularly undergo gynecological examinations.
▶ ▷ ▶ ▷ uterine prolapse course work
▶ ▷ ▶ ▷ uterine prolapse course work
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added on 07/16/2014. Often, uterine prolapse is a complication of the retention of the placenta
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Quite often, uterine prolapse is noted when the placenta is retained as a complication in case of strong attempts in an animal.Coursework: Prolapse of the uterus in a cow.
Abstracts Medicine Uterine prolapse in a cow. Secrets of the ideal introduction of a term paper (as well as an essay and a diploma) from professional authors of the largest abstract agencies in Russia.
Often, prolapse of the uterus is noted when the placenta is retained as a complication with strong attempts in an animal. Coursework: Prolapse of the uterus in a cow.
Signs by which you can determine the age of the embryo and fetus. test 441.3 K, added 07.16.2014. Often, prolapse of the uterus is a complication of the retention of the placenta, especially when tying up heavy objects …
2.2 Information about the animal since the moment of illness (Anamnesis morbi) 6 hours after delivery, the uterus prolapsed. Coursework: Prolapse of the uterus in a cow.
2.2 Information about the animal since the moment of illness (Anamnesis morbi) 6 hours after delivery, the uterus prolapsed. Course work Prolapse of the uterus in a cow.
Strong pushing was the immediate cause of the prolapse of the uterus.The prolapsed uterus soon became very edematous, loose. 2011 Bank of abstracts, theses and term papers.
Inversion and prolapse of the uterus after childbirth. Assisting animals to remove the placenta from the uterus. term paper 488.9 K, added 12/26/2013.
Practice Report: Principles of Veterinary Hospital Operation. Strong pushing was the immediate cause of the prolapse of the uterus. The prolapsed uterus soon became very edematous, loose.
The text of this free term paper is not unique and cannot be tested in the Antiplagiat system by a teacher without additional revision.Pathological childbirth, prolapse of the uterus and retention of the placenta are the main causes of the disease. Course subinvolution of the uterus in cows.
Operative gynecology at the GENESIS clinic DNEPR
Endoscopic and abdominal surgery
Endoscopic surgery is a field of surgery that allows performing radical operations or diagnostic procedures without a wide dissection of the integument, either through punctured tissue punctures or through natural physiological openings.The advantages of endosurgery in comparison with traditional operations are undeniable: low trauma, short rehabilitation period, reduced period of disability, cosmetic effect, economic efficiency.
Abdominal surgery is the general name for all types of surgical intervention on all internal organs located in the abdominal cavity. The need for such operations, as a rule, arises after serious injuries or as a result of the development of chronic diseases of internal organs.
Operations on the ovary:
• Partial removal of the ovary
• Removal of the ovary
• Removal of the ovary from adhesions
• Removal of ovarian cysts
• Hulling of the ovarian cyst
• Hatching of the fetal egg during pregnancy
• Ovarian biopsy
Operations on the fallopian tubes:
• Salpingolysis (release of the fallopian tubes and ovaries from adhesions)
• Partial or complete removal of the fallopian tube
• Restoration of patency of the fallopian tube
• Hatching fallopian tube
• Surgical sterilization
• Removal of the uterine appendages
• Exfoliation of the paraovarial cyst
Operations on the uterus (laparotomic, vaginal and laparoscopic access):
• Diagnostic hysteroscopy
or angle 9000 ki
• Removal of the uterus with and without appendages
• Suturing of old ruptures of the cervix
• Manchester operation
• Removal of the rudimentary horn of the uterus
• Removal of myoma nodes
Vaginal surgery (vaginal access):
• Removal of the longitudinal vaginal septum
• Creation of an artificial vagina
• Reconstruction of the vagina with partial closure of the fistula-rectum
• Treatment of vaginal-cystic fistulas
• Obliteration of the vagina
• Suspension of the dome of the vaginal stump and cervix
• Treatment of recurrent forms of prolapse of the uterus and vagina.
• Endoprosthetics of fascia and ligaments of the small pelvis in case of prolapse and prolapse of the uterus
• Installation of synthetic mesh prostheses “PROLIFT”, “AMS”, “PROSIMA”, “TVT-o”.
Operations on the vulva and perineum:
• Opening of abscesses of the gland of the labia majora
• Removal of glands of the labia majora
• Resection of the labia minora
For its patients the most modern diagnostics and effective treatment of various diseases in a comfortable and friendly environment.
You can make an appointment with a specialist or ask your question by calling the phones indicated on the website. You can also make an appointment online, right on the clinic’s website. It is convenient and more economical – 20% discount.
The clinic is open every day, without days off and holidays.
Uterine prolapse: self-medication is unacceptable
Uterine prolapse (prolapse) means an abnormal position of the uterus and its displacement below the normal border. This is due to the muscles and ligaments in the pelvis weakening and unable to keep the organs in the correct position.In most cases, the vagina descends with the uterus.
Moving the uterus downward also often leads to displacement of the rectum and bladder, which leads to disruption of these organs: constipation, colitis, incontinence of urine, feces, gases and other equally serious problems.
Stages of prolapse and prolapse of the uterus
The prolapse of the uterus develops gradually, moving from a slight displacement to a complete prolapse.
The disease occurs in four stages:
- the cervix is located above the entrance to the vagina, but the uterus is not visible from the outside;
- any straining, including sneezing, coughing and lifting weights, leads to the fact that the cervix briefly exits into the genital slit;
- incomplete prolapse of the uterus, regardless of straining;
- complete prolapse of the uterus with the inability to set it back.
Who has prolapse and prolapse of the uterus?
For most of us, prolapse of the uterus is associated with extreme old age, when the work of all organs deteriorates. But in fact, the displacement of the internal genital organs is found even in young and nulliparous girls.
According to statistics, prolapse and prolapse of the uterus is observed in almost 10% of women under thirty. At forty years old, this disease is observed in 35-40% of women, and after fifty years, more than half of women know firsthand what uterine prolapse and the associated problems are.
Reasons for prolapse of the uterus
Among the main reasons that can lead to prolapse and prolapse of the uterus:
- congenital malformations of the pelvic region;
- birth trauma, difficult labor, perineal tears, multiple births;
- history of genital surgery;
- hard physical labor, frequent weight lifting, including overly active fitness;
- estrogen deficiency;
- increased pressure in the abdominal cavity;
- atrophic changes, weakening of the muscles and ligaments of the pelvic floor;
- chronic constipation;
- Frequent strained cough;
- neoplasms developing in the abdominal area.
When to see a doctor
Prolapse and prolapse of the uterus in the initial stages is manifested by the following symptoms:
- pulling pains in the lower abdomen and lower back, which intensify towards the end of the day;
- sensation of a foreign body in the vagina;
- pain during intercourse;
- whitish or bloody vaginal discharge outside the menstrual cycle;
- menstrual irregularities.
If a woman ignores the first precursors of prolapse and does not go to the gynecologist, the disease will progress, and in the future she can independently detect prolapse of the uterus protruding from the genital fissure.Complete prolapse of the body of the uterus leads to constant discomfort and severe pain.
Without treatment, prolapse of the uterus causes the development of cystitis, pyelonephritis, kidney stones. A woman begins to be tormented by frequent, or, conversely, difficulty urinating, involuntary leakage of urine and urinary incontinence, when it becomes difficult to run to the toilet in time at the urge. All this entails the appearance of an unpleasant odor, which is not so easy to get rid of.
Dislocation of the rectum may cause problems with bowel movements, severe constipation and hemorrhoids.
In many cases, complex treatment of prolapse and prolapse of the uterus is carried out with the involvement of not only a gynecologist, but also a urologist with a proctologist.
Danger of self-medication with prolapse and prolapse of the uterus
Performing any physical exercises, popular Kegel exercises, taking medications, tinctures and decoctions of medicinal herbs must be coordinated with a gynecologist. The fact that during the prolapse of the uterus helped your friend or the heroine of an article read somewhere, it may not help you, or worsen the situation.Remember: neglected prolapse of the uterus is treated only surgically.
Self-medication of uterine prolapse can lead to malfunction of internal organs, injuries to the uterus, the formation of deep bleeding ulcers and constant discomfort. With such problems, it is difficult, and sometimes even impossible, to lead a normal sex life, to feel like a happy woman and mother.
- Axt-Gadermann M., Chudomirova K., Noll M. [Probiotic baths for atopic dermatitis]. // Hautarzt – 2021 – Vol – NNULL – p.; PMID: 33730257
- Konya I., Nishiya K., Yano R. Effectiveness of bed bath methods for skin integrity, skin cleanliness and comfort enhancement in adults: A systematic review. // Nurs Open – 2021 – Vol – NNULL – p .; PMID: 33724709
- Spielvogel I., Spałek K., Badora K., Proćków J. Traditional knowledge and practice of the Triassic variegated clay from Silesia (Krasiejów), Poland, in human medicine. // J Ethnobiol Ethnomed – 2021 – Vol17 – N1 – p.10; PMID: 33596953
- Kanlioz M., Ekici U., Tatli F., Karatas T. Pilonidal Sinus Disease: An Analysis of the Factors Affecting Recurrence. // Adv Skin Wound Care – 2021 – Vol34 – N2 – p.81-85; PMID: 33443913
- Habek D., Cerovac A., Kamerić L., Nevačinović E., Šerak A. Balneogynaecology in the 21st century: increasingly recommended primary and complementary treatment of chronic gynaecological diseases. // Med Glas (Zenica) – 2021 – Vol18 – N1 – p. 1-6; PMID: 33219638
- Barnat N., Grisey A., Gerold B., Yon S., Anquez J., Aubry JF. Vein wall shrinkage induced by thermal coagulation with high-intensity-focused ultrasound: numerical modeling and in vivo experiments in sheep. // Int J Hyperthermia – 2020 – Vol37 – N1 – p.1238-1247; PMID: 33164625
- Uyanaeva AI., Pogonchenkova IV., Tupitsyna YY., Maksimova GA., Turova EA., Lvova NV., Lyamina NP., Kharisov NF. [Modern medical and meteorological assessment of Moscow weather and the effectiveness of non-drug methods of increased meteosensitivity correction in patients with joint diseases].// Vopr Kurortol Fizioter Lech Fiz Kult – 2020 – Vol97 – N5 – p.60-69; PMID: 33054010
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Cervix before and after childbirth: what it looks like, what it should be. Uterus photo before and after childbirth
Cervix before and after childbirth: size, condition that comes out
During the birth of a baby, your body is under stress.The woman in labor does not return to normal immediately – this takes a lot of time. In this case, the sexual function suffers most of all.
The entire course of events through which a woman passes can be divided into prenatal (before birth), natal (birth) and postnatal (postpartum). Let’s figure out what the cervix, uterus and the entire reproductive system look like after childbirth.
Divided into three stages:
- Contractions. Begins when contractions are observed every 15-20 minutes.After the discharge of amniotic fluid and the complete opening of the cervix, the second stage begins.
- Expulsion of the fetus. During this period, attempts are observed – contractions of the muscles of the anterior abdominal wall. Everything is aimed at the birth of a baby. After birth, the baby is applied to the stomach. Body contact is made with the mother.
- Serial. The afterbirth is the placenta, or “baby’s place”. After the second stage, the obstetrician again offers to push and get rid of the “child’s place” – the placenta. It is carefully examined for integrity.Not a single piece should remain inside, in order to avoid complications. Blood clots should come out and normal muscle contraction should occur.
- Early. The first 2 hours. The first thing that happens at this moment is an examination by an obstetrician-gynecologist to determine the presence of injuries. The medical staff monitors the state of the uterus: is spasm good, what kind of discharge, in what condition it is. At this time, the risk of bleeding is very high.That is why at this time the woman is under the close supervision of an obstetrician or doctor. They measure her temperature, measure her blood pressure. If no complications arise, they are transferred to the gynecological department.
- Late. The patient lies down for 8-12 hours, since the very process that she underwent is energy-consuming. It takes time to recover strength and energy. After resting, the young mother is asked to first sit on the edge of the bed. Monitor her reaction. Then she is advised to get up, then walk.During this time, the uterine cavity decreases in size. There is a redistribution of blood pressure. Fainting, dizziness are possible. What’s happening? Reverse organ development, which lasts up to 8 weeks. The young mother has lochia.
For 42 days, the lochia should change their color. Initially, the discharge is red (it turns out that 80% is blood and 20% of the fluid of the uterine glands). After that, they change and acquire a brown tint, and outwardly look like a ichor. Further, their color turns to yellow.Before the twentieth day, the discharge should be of a light shade. Normally, they end after two months.
If you have pubic stitches, it is imperative to adhere to the rules of hygiene. Be especially careful with the cesarean section stitches. Watch how the scar heals. Suppuration is unacceptable. After each trip to the toilet, wash yourself.
If the lochia does not stop, this is a reason to contact a specialist.
Causes of long discharge:
- Bending of the genitals.
- Disorders of the coagulation mechanism (hemophilia).
- Scar inflammation.
- Weak spasm.
To identify this or that pathology, the patient needs to consult an obstetrician-gynecologist. The examination is carried out on a gynecological chair, smears, general blood tests, general urine tests are being collected, and an ultrasound examination is prescribed.
What changes occur
After childbirth, significant changes have occurred in reproductive function.But what does the uterus look like after childbirth? Consider how the organs look before and after.
In nulliparous women, it has an inverted pear-shaped shape. If you do not have children, you have it about 5-6 cm long and 2-3 cm wide.
After the conception of the child, the cavity will gradually stretch. By the end of pregnancy, its length will be 35-38 cm, width 24-26 cm. It increases not only in volume, but also in weight. In a woman in labor, she weighs about 1 kilogram.If a girl has polyhydramnios, then her weight may be more. At this time, it is at the level of the diaphragm.
In the postnatal period there is an involution – renewal. The muscle tissue begins to contract. During breastfeeding, the hormone oxytocin is released. It promotes speedy involution due to muscle spasm.
The size of the uterus is then reduced. Sizes: in length they decrease from 15 to 25 cm, in width from 12 to 15 cm. Weight decreases gradually.Immediately after the appearance of the baby, she is in the region of one kilogram. Within seven days, it decreases to 500 grams. After 14 days – 300 – 350 gr. By the end, it weighs about 100 grams.
For better spasm, ice is placed on the lower abdomen immediately after childbirth.
Initially, the fetus is at the level of the diaphragm. After birth, due to compression, the uterus drops by one centimeter every day. In normal condition, it should be at the level of the pubis.
The cervix after childbirth is restored more slowly.The pharynx gradually closes. The internal one closes first, this will happen by the third week. The outer one will be formed only after the second month. The muscles do not return to their original form because they are severely stretched. It is on this basis that gynecologists can determine the one giving birth.
The pharynx of a nulliparous woman has a round shape, and due to the birth of a child it is transverse and has the shape of a cylinder.
What happens to the uterus after childbirth? After delivery, the system regenerates.While at home, you must definitely monitor your well-being.
- Over temperature. Even a slight increase can indicate complications and disorders.
- If you have had a cesarean section, the scar should be monitored. If suppurative processes occur or the very appearance of the scar is alarming, consult a specialist.
- If the lochia does not stop after two to three weeks, they have a red color, an unpleasant odor. See your doctor immediately.
Rules to follow
- Do not take a bath. Obstetricians-gynecologists strongly advise against taking a bath. In this case, there is a high risk of uterine bleeding and infections of the urinary system. It is only possible to shower with medium temperature water.
- Moderate loads. Heavy loads can cause large blood loss and worsen health. Seams may come apart. Going in for sports after the expiration of time is possible. Exercise should be moderate.You can feel free to practice Pilates or stretching. Lifting weights, engaging in heavy sports is unacceptable. The largest weight you can lift is the weight of the baby.
- It is forbidden to visit public water bodies and swimming pools. Reservoirs are a repository of a variety of infections. There is a high risk of infection.
- It is undesirable to sunbathe in the sun. A very high risk of deterioration of the tone. Possible development of cancer cells.
- The initiation of early sexual activity is prohibited.Physiologically, there was no recovery. After being discharged from the hospital within two months, intercourse threatens with bleeding and poor scarring. When the penis is inserted, your reproductive function suffers. In addition, the risk of getting sexually transmitted diseases is much higher.
Very often complications and pathologies can occur. The most common ones are:
- Subinvolution (poor muscle contraction). The reasons for this may be: remnants of the placenta, ruptures, poorly applied sutures, residual clots.In this case, the patient is injected with special drugs that promote muscle contraction. The gynecologist prescribes antibiotics as needed. In rare cases, vacuum cleaning is carried out.
- Endometritis (inflammation of the endometrium). The reasons may be: impaired venous outflow, early abortions, irresponsible examination by a gynecologist. In case of a severe stage of the disease, inpatient treatment is prescribed. Vacuum cleaning may be prescribed. Mandatory prescription of antibiotics. Self-treatment can harm your health
- Bleeding.The norm is the cessation of lochia for 7-10 days. The reasons may be: strong physical activity, lowering blood pressure, early recovery of sexual activity, red discharge from the uterus.
If you suddenly have bleeding, call an ambulance immediately.
In order to avoid pathologies, you should regularly visit your gynecologist.
If you are experiencing poor health or persistent ailments, you should contact your gynecologist.Timely treatment will help avoid problems.
The cervix after childbirth is normal and with deviations
Hello, dear subscribers and guests of the blog. Let’s touch on an interesting but rather serious topic today. Have women, especially those who have given birth not long ago, wondered how their cervix looks after childbirth?
I mean the cervix. It may be normal, but it may not. Recently, according to doctors, the number of pathologies associated with this organ has increased significantly.So what is the normal state of the cervix after childbirth?
In one of the medical programs I listened to a “medical luminary”, he talked about the changes in the body associated with childbirth, and showed photographs for clarity. It was from him that I learned about the frequent cases of cervical pathologies after childbirth.
I was surprised to what extent the uterus and cervix can stretch during childbirth.
Before pregnancy, the uterus is only 5 centimeters long, the cervix is 2.5 centimeters, can you imagine? And after childbirth, the uterus is about 20 cm long, the cervix is about 12 cm!
Who gave birth, remember the cold ice on the belly? This is to help the uterus contract faster.Recovery of the cervix is slower than that of the uterus.
By the way, do you know how doctors determine whether a woman has given birth or not? Along the cervix: in those who have not given birth, the cervical pharynx has a round opening, and after childbirth, a gap remains on the pharynx located across.
The tissue is too stretched by childbirth, so the pharynx will not return to its original shape. For the same reason, before pregnancy, the neck has the shape of a cone, and after childbirth, it is a cylinder.
How is the recovery going?
Recovery is divided into two main periods: early – after the birth of the placenta, two hours pass and late – ending two months after birth.
Immediately after childbirth, the cervix is open by about 12 cm, after a week and a half it should close, and after three weeks the external pharynx should close and take the form of a gap.
What pathologies can lie in wait for a woman during postpartum recovery?
- Cervical erosion is one of the most common. Doctors often cauterize it with liquid nitrogen. Often, erosion is found in women who have not yet given birth.
If the erosion is not large, then, as a rule, it is not touched, but only observed.Cauterization is tried to be postponed until the postpartum period.
Why? You ask. The fact is that after cauterization, a scar remains, which will prevent the neck from opening for the birth of a baby.
They also look at the smear results, if the doctor is not worried about anything, then again, erosion is only observed.
- Prolapse of the cervix is also quite common. If you do not pay attention to the problem, then the case may end with the prolapse of the uterus.What could be the reason for this condition?
This pathology is caused by the weakening of the muscles supporting the uterus. There may be several reasons for this. Lack of moderate physical activity – weak muscles. Or, on the contrary, they lifted something heavy and the muscles strained.
And maybe a feature of the female body. After all, pregnancy and childbirth place a tremendous strain on the body. So he rebelled in this way …
Knowing about this problem before pregnancy, a woman usually prepares for conception in advance.Doctors prescribe various exercises, cycling, the Kegel technique has proven itself perfectly.
In general, everything that will give the muscles elasticity, and subsequently, the ability to carry the baby without problems. Well, if the doctor is still worried about the condition of the woman during pregnancy, then she is put on the preservation of the fetus.
There are women who spend their entire pregnancy in the hospital, the threat of miscarriage is so strong.
- Inversion of the cervix – less common than the above cases.The inner layer of the cervix looks into the vagina, it is not closed, as it should be, and suffers from the acidic environment that lives in the vagina, which leads to disruption of the cervical mucosa.
Violation is detected only by a doctor when examining with the help of special mirrors. How could this happen?
Basically, this problem is again associated with childbirth. A large fetus could tear the cervical canal when walking along the birth canal; the sutures were incorrectly applied after the rupture of the cervical tissue; or careless actions of doctors who help a child to be born with forceps.
With this pathology, surgery is generally indicated.
- Prolapse of the cervix – this pathology is very dangerous. It is characterized by partial or complete displacement of the lower part of the uterus into the vagina, sometimes with an exit to the outside.
Worst case if the vaginal wall and rectum are attached to the cervix.
This happens with very long childbirth, the fetus was large, numerous births of women who are already over forty years old, hereditary muscle weakness, or an acquired disease of muscles and ligaments.
And nevertheless, the process does not begin suddenly, it is preceded by a gradual descent, which many do not notice at the initial stages. Very sorry. Indeed, if this disease is detected in time, it is possible to do without surgical intervention.
It is enough to do the famous Kegel exercises, gymnastics for the muscle press, without fanaticism, of course, physio procedures and the problem is solved. However, in the last stages, you cannot do without a scalpel. Therefore, dear women, visit the female doctor more often, and you will avoid many problems.
- Rupture of the cervix – and again childbirth is to blame. Either they were too fast, or the intervention of doctors was required to safely resolve the birth, as well as the consequences of prenatal abortions.
Treatment consists in correct suturing. If they are not applied as needed, then the cervical inversion described above may occur. After suturing, certain safety measures must be observed so that they do not disperse and become inflamed.
And it is imperative to see a doctor in a month for examination in order to avoid improper fusion and the formation of terrible scars.The presence of which can lead to not carrying a pregnancy.
- The cervix has not closed – such cases are quite common. The reason for not closing is cervical injury during childbirth, also described above. However, many doctors believe that incomplete cervical closure is a normal situation for a woman who has given birth, especially if the birth is not the first.
Free passage of one finger is allowed. However, if a woman is worried about something, you should consult a doctor, self-treatment can be harmful.
Traditional methods will help
It is by no means possible to completely replace the examination by a doctor, medicines and prescribed procedures. Life threatening!!! But for additional help, folk methods can be used, and sometimes even necessary.
Let’s discuss the methods used by our great-, great-, great-grandmothers?
- Stinging nettle helps very well to reduce the cervix. Take 3 tablespoons of the plant, pour half a liter of boiling water and let it brew until it cools completely.Take half a glass 3 times a day.
- Water pepper tincture is highly praised. You can find it at the pharmacy.
- The grass and flowers of the white ash-tree are very helpful in the restoration of the generic apparatus. This broth can be used even with hypertension, it does not increase blood pressure.
- Birch leaves collected in May help to heal and cleanse the generic organs faster. 3 tablespoons pour 600 ml of boiling water. Cool slightly, add a little baking soda and take a glass 3 times a day.This remedy works best if you start taking it three weeks after giving birth.
At the end of our conversation, I would like to emphasize one more method that will help to avoid problems. There is absolutely no harm, one continuous benefit and pleasure.
Intrigued? Have you ever wondered why southern peoples do not have problems with childbirth? There are many children, they do not complain about their health, and the children are all healthy.
This is his fault – belly dance. When performing the movements of this dance, all the muscles involved in childbirth are involved.And they study it almost from the cradle. A reason to think. And it is better to adopt, and beauty and health.
Well, if you don’t like oriental notes, you can study the elements of such a dance, with modern notes. Just look at what this girl is up to! )))
Health to you and your children, dear subscribers and guests. Subscribe to blog updates.
Best regards, Yulia Zorkaltseva
P / S: Let’s move on to the blog tradition… I will not offer you a good course on belly dancing yet – even in search of one, for the recommendation of which it would not be a shame. Quality is above all)))
But the course on preserving women’s health is easy, I’ll even tell you about two.
The first is a comprehensive one, to preserve women’s health in the postnatal period + the subtleties of a caring mother
The second is for those who have heard the diagnosis “Erosion” addressed to them.
I warn you that the courses are not free, but I can help you with discounts.Write in a personal, through the feedback form
Photo of the cervix by days of the cycle (the faint of heart, DO NOT watch eating)
This project was led by a 25-year-old woman. She has never given birth and has no history of STDs. Each photo was taken at approximately 10:00 pm, starting on the first day of the menstrual cycle. Throughout this project, she used condoms as a contraceptive method, and also so that there was no seminal fluid at the time of the photo session. She did not use tampons during her period.
This cycle is 33 days, which is normal. The follicular phase of her cycle lasts until about 20–21 days. Favorable days for fertilization last several days from the 13th to the 21st day with ovulation on the 20th day. The luteal phase is 13 days (12-16 days is normal).
The above is http://www.my-bt.ru/gr/207975 for this cycle. As you can see, after ovulation on about the 20th day, her temperature began to rise due to increased progesterone, which in turn is produced by the corpus luteum.This temperature shift means that ovulation has already occurred.
She also monitored the position of the cervix throughout the cycle. Since the photo does not show a hard or soft, high or low cervix. All this is clearly visible with self-probing. The uterus is tilted back (retroflexion), you can notice in several photos that the cervix is pointing up. These are anatomical changes that are present in 20-30% of women, and most often a genetic trait.
Blood – red, there are small cramps in the lower abdomen.The chest is slightly swollen.
Feelings are very sexual.
Blood – dark red.
The chest is normal.
Blood – brown, sometimes watery dark red.
Pay attention to fresh blood.
Very light brown discharge.
Neck in low, closed position.There is sticky liquid on the neck.
Neck low and closed.
The cervical fluid is white and sticky.
The neck is low and closed.
The neck is low and closed.
Note the drop of blood and a brown lump near the cervix (right). Perhaps from stormy communication on the same day, but later was diagnosed with an endometrial polyp.
Creamy cervical fluid.
Cervical fluid white milky. Feeling of phlegm.
I feel especially sexy.
Profuse watery discharge.
Neck softened and move up.
White, transparent watery cervical fluid, stains laundry.
The cervical fluid changes to a discharge resembling egg white.
The neck is soft, open and high.
Cervical fluid in the form of egg white, very wet.
The neck is soft and high.
Cervical fluid is very thin, with whitish-yellow streaks. Sensual breasts, but not painful.
The fluid stretches between the fingers when stretched.
Egg white with a white tint.
Slight back pain and cramps on the left side.Suspected ovulation.
Feeling of strong sexuality.
Cervical fluid, like gelatinous egg white.
Cervical fluid, like glue.
The nipples are very sensitive and painful.
The neck is in the middle position and slightly open.
Basal body temperature begins to rise.
Very sensitive nipples.
Very sensitive nipples.
The neck is firm and high.
Headache and fatigue.
The cervical fluid is dry / sticky.
Day twenty six
The breasts are swollen.
The cervical fluid is sticky.
Basal body temperature is now noticeably higher, by about 1 degree.
Painful nipples, swollen breasts.The cervical fluid is sticky.
The chest is heavy.
Dry, (note, fresh blood, a sign of impending menstruation).
Feelings of emotional instability.
Light brown spots.The neck is low and open.
Pain in the lower back.
Menstruation will start tomorrow after waking up, 13 days after ovulation.
The article is taken from the Internet! Who is not interested not fu … kat!
Before and after childbirth uterus. horoshayaberemennost.ru
Prolapse or prolapse of the genitals is a violation of the normal position of the uterus and the walls of the vagina, which is manifested by their displacement to the vaginal opening or prolapse outside of it.Approximately every eleventh woman undergoes surgery due to prolapse or prolapse of internal genital organs, so it is recommended to know why such a pathology occurs and how it can be prevented.
The photographs show various visible prolapse of the uterus of 3 and 4 degrees.
We recommend watching a video about uterine prolapse:
We recommend reading the article of women who have had their uterus removed – life after surgery
Uterine prolapse of the 3rd degree or incomplete prolapse is characterized by the cervix and uterine body, showing from the vagina without tension
Early signs of pelvic organ prolapse are pulling pains in the lower abdomen, radiating to the lumbar region, prolonged absence of stool and frequent urge to urinate.Often, a woman is worried about the constant sensation of a foreign body in the vagina, and an increase in the amount of discharge also attracts attention. Menstruation becomes very painful and so profuse that anemia can develop due to blood loss. During intercourse, difficulties and pain arise, in the case of a prolapse of the 2nd degree, it becomes impossible.
Preventive measures aimed at preventing the prolapse of the pelvic organs include performing special gymnastics, refusing to lift objects weighing more than 15 kg, careful management of childbirth.Since the prolapse of the pelvic organs progresses in most cases, the pathology can only be eliminated surgically.
Prolapse of the uterus in women – photo Prolapse of the uterus in women – photo and general description of the disease. This disease is characterized by an abnormal position of the uterus, its bottom may shift, or the cervix shifts below the normal level due to weakness of the pelvic floor muscles and ligaments. In this case, the woman experiences unpleasant sensations: pressure, a feeling of discomfort, pulling pains in the vaginal area.Problems with urination may appear, vaginal discharge may be observed.
As a rule, a similar pathology is observed in women during menopause or menopause. Muscles and ligaments at this time lose their elasticity, and the level of hormones decreases significantly. However, young and elderly women are also at risk of getting this disease. Often this is facilitated by:
inconveniences during intercourse.
How can uterine prolapse be treated?
- Medication often includes anti-inflammatory and hormonal medications that increase female hormone levels and prevent ligaments from stretching and sagging further.A prolapsed uterus bandage is used to temporarily correct the position of the uterus in relation to other organs. A pessary is also often used (that is, the uterine ring in case of prolapse of the uterus), which is inserted into the vagina. It is made of elastic, soft material and provides a positive effect.
- The operation is prescribed after the immediate prolapse of the uterus. As a rule, in women at a fairly mature age, the uterus is removed, since neither hormonal therapy nor strengthening exercises can prevent a relapse of the disease.For childbearing girls, the uterus is fixed in its normal position by means of an incision in the abdomen or through the vagina. The rehabilitation period does not last long, you only need to follow the medical recommendations.
- Some women continue to believe that folk remedies can stop the process of lowering and prolapse of the uterus. But they are only prevention. In the initial stages of prolapse, this can still help, but in case of loss, you should immediately go to the doctor. This is the only way to preserve women’s health.
Uterine prolapse after childbirth
Many women are concerned about such a sensitive issue as the prolapse of the uterus after childbirth. What is this pathology, and how to identify it? It turns out that this disease affects about 10% of women under the age of 30, 40% of women aged 30-40 and 50% of women after 40. During this disease, prolapse of the uterus occurs, and sometimes its prolapse.
All of a woman’s reproductive organs, including the ovaries, vagina, uterus, and bladder, are supported by the pelvic floor.It is the pelvic floor muscles that keep the internal organs in a normal state. When these muscles are damaged, the organs are displaced and, accordingly, the uterus prolapses.
Reasons for prolapse of the uterus after childbirth:
- During pregnancy, the pelvic muscles are under strong pressure from above and gradually begin to weaken.
- During childbirth, it is not uncommon for the weakened muscles of the vagina and perineum to rupture, especially if it was a difficult childbirth using medical forceps.
- If a woman lifts weights, the uterus may sink several years after childbirth.
- Constipation, in which you have to push and strain, can also lead to prolapse of the uterus.
- The disease is hereditary and can be transmitted through the female line. If your mother or grandmother had a prolapse of the uterus after childbirth, you should contact your gynecologist to prevent the possible development of pathology.
Symptoms of prolapse of the uterus:
- At the initial stage, pulling pain in the lower abdomen.Many attribute this pain to ovulation, the approach of menstruation or inflammation of the appendages, but this symptom should alert a woman.
- Pain in the vagina and lower back. This pain is sharper, more prolonged and strong enough.
- Vaginal discomfort. The woman has the impression of the presence of a foreign body, especially when walking.
- Urinary incontinence.
- Unpleasant sensations during intercourse.
Methods for the treatment of prolapse of the uterus after childbirth
This disease can be treated both conservatively and surgically.It all depends on the degree of development of the disease.
When the uterus begins to descend, but has not yet reached the genital slit, conservative treatment can be used, which includes:
- Physiotherapy, which strengthens the pelvic floor muscles and press.
- Introducing ointments into the vagina that contain estrogen.
- Gynecological massage.
- Decrease in physical activity.
Elderly patients are shown the use of pessaries and vaginal tampons. A pessary is a rubber ring with air inside, giving it elasticity and resilience. It is inserted into the vagina to support the displaced uterus. When using pessaries, it is necessary to carry out vaginal douching with chamomile every day and change it every 3-4 weeks, with a break of 2 weeks.
To more radical methods of treating prolapse of the uterus, include surgical intervention.The indication for this type of treatment is a more severe degree of organ displacement.
There are several types of operations in the treatment of prolapse of the uterus:
- Plastic surgery aimed at strengthening the muscles of the pelvic floor.
- Operations involving the shortening and strengthening of the round ligaments that support the uterus. However, such operations are not as effective as the round ligaments tend to stretch over time.
- Another type of surgery is the strengthening of the uterus by stitching the ligaments together.Such operations can make it impossible for a woman to have children in the future.
- Operations with the use of alloplastic materials, which are used to strengthen the ligaments of the uterus.
- Surgical intervention for this pathology, which is a partial narrowing of the vaginal lumen.
- The last type of surgery, the most radical one, is the removal of the uterus. It is used only in extreme cases, when there is no need to maintain the reproductive function of the body.
Prolapse of the uterus after childbirth is a rather serious disease.Therefore, every woman needs to be examined by a gynecologist at least once a year.
Uterus after childbirth
How the body and cervix change after childbirth
The uterus after childbirth undergoes numerous changes. Let us consider what exactly these changes are, what is considered normal, and what may be pathology.
Immediately after the birth of the baby, the uterus weighs about 1 kilogram. Its bottom is approximately at the level of the navel. That is, a woman in the first days of her motherhood looks like she has not yet given birth.During the postpartum period, and it lasts up to 40 days, the uterus contracts after childbirth, and as a result, it acquires its previous, “non-pregnant” dimensions, ”and weighs about 50 grams.
The cervix is also undergoing changes. Immediately after the birth of the child, it is open by 10-12 cm, but gradually by the 10th day it completely closes, by about the 21st day the external pharynx closes and acquires a slit-like shape (a distinctive gynecological feature of all women giving birth). This is what the uterus looks like after childbirth from the point of view of a gynecologist.
What the woman feels and notes is normal
Severe pain goes away immediately after childbirth. But in the coming days, spasms of the uterus can still be felt, as a result of its contractions. This is especially noticeable for women who are injected with Oxytocin to improve the contractility of the uterus.
In the first 3-7 days, there is a fairly strong uterine bleeding. But every day the discharge becomes less and less, they brighten and turn into a “daub”. Normally, the discharge completely disappears no later than the end of the postpartum period.The name of these secretions is lochia. But before they end, some women are worried about the bleeding that has begun again, but this is no longer lochia, but ordinary menstruation. In non-breastfeeding women, as well as in some lactating women, menstruation occurs as early as 6-8 weeks after the birth of the baby.
1. Increased uterine bleeding after childbirth. This can happen for 2 reasons: either placenta particles remain in the uterus, or the uterus does not contract well.The first pathology can be diagnosed using ultrasound. Surgical treatment – curettage of the uterine cavity. The second pathology should also not be ignored, since a large loss of blood is possible and endometritis – inflammation of the endometrium of the uterus. Treatment consists in taking drugs that reduce the uterus, if necessary, hemostatic and antibiotics. This pathology is called subinvolution of the uterus. This is a characteristic complication after preeclampsia, multiple pregnancy, and polyhydramnios.
2.Erosion of the cervix after childbirth may occur, but treatment is not required in all cases. A small ectopia, with normal smear and colposcopy results, needs only observation. Whereas the ectropion of the cervix – its eversion, necessarily requires surgical treatment.
3. And one more unpleasant pathology – prolapse of the uterus after childbirth. The cause is pelvic floor injuries resulting from severe and / or multiple births. Symptoms appear depending on the neglect of the process.With a slight drop, the woman feels good. She is advised to do specific exercises to strengthen her pelvic floor muscles. With a significant prolapse of the uterus, women complain of pain in the lower abdomen, urinary incontinence. With the second and third degrees of prolapse of the uterus, only surgical treatment is effective.
In order to identify possible pathologies in time or to make sure that you are in good health, visit a doctor 6-8 weeks after giving birth. Even if you have no complaints.
Uterus after childbirth
During the postpartum period, all organs and systems of the young mother return to their original, prenatal state. Typically, this period takes 6-8 weeks.
All organs that have been taking care of the well-being of the baby and mother for 9 months undergo reverse development. After childbirth, the uterus also undergoes a process of involution.
The size of the uterus after childbirth
Approximately 5-50 minutes after the birth of the child, the placenta and fetal membranes (afterbirth) emerge from the reproductive tract of the woman in labor.This is followed by a reverse contraction of the uterus – it takes on the shape of a ball.
If it were possible to weigh this important female organ immediately after delivery, one would have to agree that the size of the uterus after childbirth is quite large, because its weight is about 1 kg. After a week, the weight of the uterus is halved, and after two it is no more than 350 g.
In case of violations of uterine contraction, these indicators may differ slightly. In case of discrepancy in these important parameters, an urgent consultation with a gynecologist is necessary.
After childbirth, contraction of the uterine muscles occurs, part of the blood and lymph vessels dries up, and muscle cells formed during 9 months of pregnancy dissolve. Upon completion of this process, the uterus returns to its normal parameters. The normal size of the uterus after childbirth (after a month and a half) is about 50 g.
Uterine contractions after childbirth
Uterine contractions are felt by a woman after childbirth as aching pain in the lower abdomen. During feeding, when the nipple is stimulated, the hormone oxytocin is released into the blood, which has a reducing effect.Therefore, in breastfeeding women, involution occurs already by the end of 6 weeks, and in non-lactating women only at 8 weeks.
After childbirth, which took place through a cesarean section, the ability of the uterus to contract is much lower, therefore, doctors recommend that women who have undergone such an operation move more and more actively in order to accelerate the process of involution.
By the way the process of contraction of the uterus after childbirth proceeds, one can judge the condition of the woman. If the reverse development of the process occurs slowly, hormonal and immune disorders in the body of a young mother are possible.
Prolapse of the uterus after childbirth
Prolapse, or prolapse of the uterus after childbirth is a fairly common consequence of injury to the pelvic floor muscles, obtained during labor. The risk of such a complication increases in women who have undergone a difficult birth or in women who have given birth repeatedly.
Normally, after discharge of the placenta, the uterus is at the level of the navel. Further, after childbirth, the prolapse of the uterus occurs by about 1-2 cm per day. By the end of the first postpartum week, an organ height of 4-5 cm from the bosom is considered normal.Any deviation from this is considered a pathology and requires medical intervention.
With the prolapse of the uterus, the cervix is much lower than the normal level: it protrudes into the vagina or may even extend beyond the perineum. If the diagnosis reveals violations of its omission, the woman needs urgent surgical intervention. If you do not engage in treatment, not only sex life becomes difficult, but also a high risk of developing infectious diseases of the urinary tract, prolapse of internal organs and difficulties with urine outflow.
Causes of uterine contraction disorders
Causes of uterine contraction disorders after childbirth can be different.
First of all, the process of involution is affected by the lack of prolactin, which is produced reflexively when the nipples are irritated. With its lack, involution slows down.
A delay in uterine contraction can be triggered by the presence of remnants of the placenta attached to the walls of the uterus.
In addition, a woman’s infection can reduce the contractility of the uterus.
All these cases require specialist advice, self-medication in such situations aggravates the situation of the young mother.
Clots in the uterus after childbirth
The uterus after childbirth is a large wound. From the inside, it is badly damaged in the place where the placenta was attached. On its inner membrane are the remnants of the membranes and blood clots.
Clots from the uterus normally stand out only within 3-4 days. Thanks to the wound healing processes in the woman’s body, a wound secret – lochia – begins to stand out from the uterus.
Lochia in the first days bloody, similar to menstrual flow, on the 3rd day they acquire a serous-sacral character, and by the end of the 20th day after childbirth they become liquid and light. Lochia completely disappear by the end of the 6th postpartum week.
When the involution slows down, lochia can stand out longer. However, if, after 2 weeks after delivery, clots still remain in the uterus, an urgent visit to a doctor is necessary. This can be guessed if the lochiae do not change their color and the intensity of their release does not decrease.This can happen because of an infection or when blood clots block the uterine pharynx.
If you do not resort to cleaning for violations of the discharge of lochia, the inflammatory process can flow outside the uterus, to the internal organs.
In healthy women, as a rule, problems with involution of the uterus do not arise. If you follow the doctor’s recommendations, monitor the state of the body, perform restorative gymnastics and adhere to breastfeeding, the process of uterine contraction will be painless.
Sources: http://jabudu-mamoj.ru/matka-pri-beremennosti/vypadenie-matki-foto-u-zhenshhin-posle-rodov.htmlhttp://www.missfit.ru/berem/matka-posle- rodov / http: //lady7.net/matka-posle-rodov.html
What happens to a woman after childbirth. Postpartum 90,083
Natural fears about when and how labor will start are left behind. Immediately after a woman gives birth, she is no longer called a parturient woman, but a parturient woman.From this moment on, the early postpartum period begins. Its duration in comparison with the process of childbirth itself is quite insignificant – only two hours. And although the early postpartum period, again compared to the process of giving birth to a child, is considered relatively easy, you should still monitor the woman’s condition as responsibly as possible.
What happens to the postpartum uterus in the early postpartum period
Due to the fact that the uterine walls, both during and immediately after natural childbirth, are actively contracting, the uterus becomes much smaller than it was some time ago.Its walls become thicker, the shape of the uterus resembles a ball. Immediately after childbirth, due to the fact that the fixation apparatus of the uterus is very relaxed, it has an increased ability to displace. A full bladder is also capable of moving the uterus, so it is imperative to empty it. If it is not possible to do this on your own due to postpartum edema of soft tissues, then you need to use a special catheter. At the beginning of the early postpartum period, the mass of the uterus is approximately 1.1 kg.
How the early puerperium is handled
Immediately after the completion of the childbirth process, a woman feels severe fatigue, but her body is now producing a huge amount of tonic hormones, so she cannot fall asleep. And that’s okay. Moreover, the obstetrician-gynecologist deliberately does not allow the mother to sleep, since sleep can provoke uterine hypotonia. If after childbirth a woman suffers from vomiting and drowsiness, then there is a likelihood of developing cerebral hypoxia – a consequence of a large loss of blood.In this case, the woman is examined to exclude internal bleeding.
Due to the fact that the intra-abdominal pressure of a woman drops sharply after childbirth, and the uteroplacental circle of blood circulation ceases to exist, disturbances in the functioning of the heart and blood vessels are not excluded in the body. Therefore, experts constantly monitor the blood pressure indicators of the newly-made mother. Due to the colossal nervous and physical stress, the body temperature in the early postpartum period may slightly increase.
Throughout the early postpartum period (two hours), a woman who has just given birth continues to be in the delivery room with an obstetrician who closely monitors changes in her body. Discharge during this period is abundant, with clots of clotted blood. According to the rules, a woman’s blood loss must be calculated. To do this, a special pelvis is placed under the hips of the postpartum woman, then at the end of the early postpartum period, that is, 2 hours after childbirth, the blood from the vessel is drained into a measuring container to assess blood loss.
Values from 0.25 to 0.3 liters are considered normal. If the discharge turned out to be significantly less than the norm, then there are suspicions of insufficiently active contractions of the uterus. In this case, the woman is injected with an uterotonic agent, most often it is oxytocin – a natural hormone responsible for uterine contractions. In parallel with the introduction of the drug, the obstetrician does a massage of the abdomen, stimulating the contractile activity of the uterus.
How is the soft birth canal viewed in the early postpartum period?
In the first hour after the birth of the child, the doctor examines the soft birth canal of the postpartum woman, which includes the labia minora and majora, the clitoris area, the vaginal entrance area – these parts are examined without additional instruments, only with the help of hands after preliminary processing of the perineum and the inner part woman’s thighs with disinfectant.
The lower part of the vagina is examined for damage using sterile swabs.
The cervix and the inner walls of the vagina are examined using special clamps and large gynecological mirrors.
If a doctor finds tears (and this is not uncommon for natural childbirth), then they are immediately sutured. If this is not done, then the risk of postpartum complications in the form of infection and bleeding increases significantly. In the future, not sutured ruptures of the soft birth canal in time lead to prolapse and even prolapse of the entire uterus.Suture material may or may not be self-absorbable. The first version of the threads does not need to be removed, they dissolve themselves within a week, the second option – the stitches will need to be removed after about five days. For the sake of fairness, it should be noted that today artificial threads for sewing crotch lacerations after childbirth are practically not used.
Late postpartum period. When does it start and how long does it last?
After suturing the tears, two hours after giving birth, the woman with the newborn is transferred to another department – the postpartum department.But before that, the obstetrician and doctor measure the height of the uterus, its consistency, a conclusion is made about the nature and abundance of vaginal discharge, the pulse rate, body temperature and blood pressure are measured. After all these procedures, the woman enters the late birth period, which is much longer and, in a sense, somewhat more difficult than the early one. The late postpartum period lasts up to one and a half months or six weeks.
The late postpartum period is characterized by involution of the organs of the reproductive system.Reverse development is called involution. That is, the genitals and all other organs that previously participated in the process of pregnancy and childbirth return to their natural size. If the baby is breastfed, the mammary glands will reverse development only after the end of the breastfeeding process. After the completion of lactation, ovarian-uterine cycles will be restored. Read about when the first menstruation comes after childbirth on our website.
How does the uterus change during the late postpartum period?
Due to the constant contractions of the walls of the uterus, every day it becomes smaller in size.In the first 10 days after childbirth, the bottom of the uterus becomes 1.5-2 cm lower (or 2 fingers). In the first 24 hours, the bottom of the uterus may not fall below the level of the navel. But starting from the second day, it drops lower and lower, and as a result, on the tenth day after childbirth, the uterus is already completely hidden behind the pubic bone.
Uterine contractions make its walls somewhat thicker, and the back and front are extremely close to each other. A week after giving birth, the uterus weighs no more than 0.6 kg. After 14 days – no more than 0.35 kg, after 21 days – up to 0.2 kg. At the end of the postpartum period, the main reproductive organ in the female body becomes almost the same as it was before pregnancy.
Before assessing the size of the uterus, a woman is advised to empty her bladder, since the uterus is still very mobile and, under the influence of the pressure of the filled bladder, may turn out to be higher than it actually is during examination.
What is the nature of the discharge in the late postpartum period?
The first few days after the completion of the process of natural childbirth, significant discharge comes out of the uterine cavity.Under the influence of uterine contractions, bloody clots, parts of the decidual membranes, as well as secretory fluid, which is secreted by wounds of the soft birth canal, appear from the vagina.
The discharge that appears after childbirth is called lochia. The first 72 hours after giving birth, the lochia contains the maximum amount of blood, from simply abundant to excessively abundant.
On the 4th-6th day, the lochia becomes less abundant, becoming more blurred. Experts call such secretions sacrificial.
A week after childbirth, the discharge becomes serous-serous. Now there are significantly fewer of them.
Then the discharge becomes smearing and gradually fade away. Normally, postpartum discharge stops about 40 days after delivery. But here everything is purely individual. Some women have no discharge after 3 weeks, while others may continue for a month and a half.
The involution of all organs involved in pregnancy and childbirth ends quite quickly, but the so-called signs of the past childbirth remain in the body forever.The uterus will still be slightly larger than it was before pregnancy, its neck is now not conical, but cylindrical. Stretch marks may appear on the abdomen, which cannot be removed with the help of cosmetics.
Breasts in the late postpartum period
The first couple of days after childbirth, the mammary glands do not secrete full-fledged breast milk, but colostrum – a thick substance with a huge amount of useful substances for the newborn. Only on the 3-4th day milk begins to be produced.A woman who recently gave birth feels the first milk flushes very well, her breasts become denser, larger, her palpation causes painful sensations. Lactation is fully established only 2-3 weeks after delivery. Before that, there may be problems in the form of an insufficient amount of milk produced, or vice versa – there is too much milk. Which of this is worse, no one will answer. With a lack of milk, the child often has to be fed with artificial breast milk substitutes, and this may result in his refusal to breastfeed.With an excess of milk, a woman has a high risk of milk stagnation, which is not only unpleasant, but can also lead to serious diseases like mastitis. In any case, lactation must be fought for. It is important to remember that breast size and the shape of the nipples do not make any difference for breastfeeding.
What examinations are carried out in the late postpartum period?
Before being discharged from the maternity hospital, a woman must be examined by a doctor.An ultrasound examination of the uterine cavity is also performed to exclude the presence of extra large clots in the uterine cavity. If a woman feels well, her discharge is normal, then she can be discharged from the hospital on the fifth day.
After the end of the postpartum discharge, the woman should come for examination and consultation with a gynecologist. The doctor will examine the cervix, palpate the abdomen, and examine the breasts. Also, without fail, the doctor will hold a conversation about contraception after childbirth.A smear is taken from the vagina to identify various kinds of infections. When the analysis is ready and in case of good results, the doctor gives the go-ahead for the resumption of sexual activity.
Diet after childbirth
The main task of a new mother is to establish breastfeeding. For this, food must be correct and varied. A nursing mother’s menu should not contain excessive amounts of sugary foods, as well as foods that lead to increased gas production.
If, for objective reasons, natural feeding turns out to be impossible, then a woman after childbirth can eat in her usual mode. But you need to know that after childbirth, problems with the digestive system are often manifested, in particular, there are often constipation, which, in turn, provokes the development of hemorrhoids. To eliminate constipation, you should eat less smoked, salty, sweet. Prevention of constipation consists in the inclusion in your diet of laxative foods such as beets, prunes, apples, fresh kefir.
If there is such a problem as hemorrhoids, then again constipation should be excluded. Today, the pharmaceutical market offers a large number of products that help to cope with hemorrhoids. You can use ointments, gels, or suppositories. But in most cases, postpartum hemorrhoids go away on their own.
Postpartum depression. How to fight?
Depressive state of a woman after childbirth is not uncommon. Mothers of first-borns are especially susceptible to postpartum depression.It `s naturally. The woman is now constantly attached to the child, she does not have the opportunity to devote all her free time only to herself. To get rid of obsessive and bad thoughts, one should resort to the help of loved ones. If this is not possible, then you just need to remember that this will not always be the case and now you have a child. Decoctions of medicinal herbs, as well as herbal medicine, help to relax.
Two months after giving birth, the woman’s body is almost completely restored and is already, theoretically, ready for a new pregnancy.
Uterine prolapse after childbirth – a photo, what to do, treatment, symptoms, after a cesarean section
During pregnancy and during childbirth, many complex physiological and biochemical processes occur in a woman’s body, which are triggered by hormonal changes. The organs and bones of the pelvis, the spine, the uterus and the muscles that support it are exposed to great stress. Often, young mothers for a short period after giving birth are faced with unpleasant symptoms in the lower abdomen.
Prolapse of the uterus after a cesarean section is a common pathology, because the female organs have experienced such a load. Many women are taken by surprise by this diagnosis. Sometimes pathology occurs after several years, which is facilitated not only by childbirth and the woman’s age, it is preceded by a long asymptomatic period. More often middle-aged and older women are susceptible to the disease.
Mechanism of pathology
According to medical terminology, prolapse of the uterus, its walls and cervix is called prolapse (prolapse, extension) of the genitals out of the vagina.In a healthy, physically fit woman, the pelvic muscles support the organs. Displacement of the uterus can occur before pregnancy, with its onset, during or after. In any case, it depends on the elasticity of the muscles, which are stressed and stretched. An important role in this is played by the physical fitness of a girl or a woman.
Genital prolapse is most often triggered by labor, when the muscles are injured, strongly stretched and do not fully return to their original position.The stretching process begins during pregnancy and ends with childbirth. Sometimes, when exposed to stress, they relax so much that they cannot keep the uterus in the correct position, which is why it does not easily fall, but falls out.
At the initial stage, the disease can be cured with moderate physical exertion and therapeutic exercises, and in more advanced stages, it becomes necessary for conservative and surgical intervention.
Basically, pregnancy and childbirth provoke the problem, but there are other factors that contribute to the prolapse of the uterus: women.This is preceded by a constant weakening of the supporting muscle function throughout pregnancy. Especially if the woman has a lot of weight or a large child, polyhydramnios.
Symptoms and first signs
Prolapse of the uterus, walls and cervix is characterized by weak or moderate clinical signs, which is quite tolerable by a woman, so she often does not attach importance to them:
- aching pains in the lower abdomen appear after childbirth. If this happens after a while, then it is also not a reason to consider them as an inflammatory process or the approach of menstruation;
- the appearance of sharp pain in the vagina and lower back indicates the development of an already begun disease.Significant discomfort can be observed when walking, this indicates that the uterus has moved from its usual place, and during intercourse;
- Urinary incontinence and painful urination are also not always a sign of cystitis or inflammation of the appendages, but indicates prolapse of the uterus and cervix;
- The advanced stage is characterized by severe pain during intercourse, a sensation of the cervix at the exit from the vagina, which can be determined by palpation during hygiene procedures.The photo clearly shows how the uterus is pushed out;
- White discharge may appear, sometimes bloody.
Degrees of prolapse
The disease has three stages of development, which are characterized by the main features.
The first stage is characterized by mild pulling pains in the lower abdomen, which is very similar to the approaching menstruation, a cold phenomenon, and therefore does not cause suspicion in the woman. Although the stomach can hurt constantly.
Usually, the pathology appears in women with mild trauma to the pelvic floor and favorable circumstances of labor. In this case, there is a slight downward displacement of the uterus, and the cervix continues to remain in the vagina. Usually, women are prescribed physical exercises that strengthen the ligaments and hold the genitals.
|Second and third degree||
After severe or multiple births, the cervix is almost at the exit from the vagina or the uterus is already leaving it.The risk of developing infections and inflammatory diseases that can seize not only the uterus, appendages, but also the urogenital sphere is sharply increased.
Pain in the lower abdomen increases and constantly bothers, a woman cannot lead a normal life, sexual intercourse is contraindicated. Signs of urinary incontinence are clearly expressed, along with the uterus, the kidneys and intestines can go down.
What to do in case of prolapse of the uterus after childbirth?
After examination and diagnosis, the doctor decides on the method of treating prolapse of the uterus.It depends on how quickly the woman asked for help after she identified negative symptoms. Treating the disease conservatively or using surgical methods will depend on the stage of development of the disease.
Radical intervention is already necessary if the cervix is at the exit from the vagina. In this case, doctors try to preserve the reproductive function and therefore:
- strengthen the pelvic floor muscles by plastic means;
- shorten and strengthen rounded ligaments, which is not always effective, they have the ability to stretch again;
- strengthen the ligaments with alloplastic materials;
- operatively narrow the vagina.
The most dangerous operation is considered to be ligament suturing, after which a woman may no longer tolerate pregnancy or the uterus may be damaged during surgery. When there is no need to preserve fertility or the uterus, a decision is made to remove it.
If the uterus prolapses, special rings and bandages are used that are able to support the organ for a certain time. Temporary relief cannot be permanent, therefore, the uterus is returned to its original place by surgery, and the muscles of the vagina and small pelvis are sutured.
For three weeks, a woman should not live sexually, physically work hard and lift weights, in the future she can do her usual things, but follow the doctor’s recommendations regarding the pathology of prolapse of the uterus and provoking factors.
At the initial stage of the development of the disease, the uterus moves down, but does not reach the vaginal slit. In this case, the treatment of prolapse of the uterus after childbirth is carried out by conservative methods, which include:
- special therapeutic gymnastics, with which the organ can be returned to its place, as well as to strengthen the pelvic muscles and abdominal muscles;
- the use of ointments and gels with estrogen, which is able to improve the condition of the ligaments and strengthen them.
Gynecological massage can be prescribed to strengthen the muscles. The course of treatment is several weeks.
Good muscle tone can be achieved through regular, simple exercise that helps a woman maintain her overall physical health. They should be carried out before planning a pregnancy, during a sparing regimen, and also after.
If the prolapse of the uterus has already occurred, then with the help of the same exercises, after consulting a doctor, the organ returns to its place.In the case of a hereditary predisposition after childbirth, gentle suturing of the pelvic floor is used.
A pregnant woman who has given birth should control her diet, preventing constipation. Immediately after childbirth, it is necessary to protect yourself as much as possible from heavy physical labor, lifting weights. Sometimes it is not recommended to keep the baby standing for a month, and it is necessary to feed only lying or sitting.
A woman should not only give birth to a child, but also try to maintain her health.Elementary preventive measures help to prevent the consequences. In the event of a pathology, a doctor’s consultation and treatment is necessary.
If the disease is not treated at an early stage, the uterus can fall out of the vagina, along with other organs of the small pelvis.
Due to relaxed muscles, prolapse of the rectum and intestines, bladder is possible. Inflammatory processes due to the penetration of infections into the uterine cavity lead to an abscess and removal of the organ, affect the appendages and ovaries.A timely visit to a gynecologist after childbirth will help avoid negative consequences.
Risk of prolapse
The uterus falls out only after a sharp descent downward, which can occur immediately after childbirth or over time. The organ falls out in whole or in part. During incomplete prolapse, part of the organ is outside the vagina. When the uterus is fully extended from the vagina, they speak of complete prolapse.
In the first case, surgical intervention is still applicable, in the second only removal of the uterus is recommended.
Sometimes it is impossible to detect a disease without visiting a doctor, because a slight discomfort is observed only during defecation, urination, this delays the moment of diagnosis, as a result, a woman may no longer give birth or be left without an organ. Due to prolapse, malignant tumors can develop.
causes, symptoms, treatment, possible consequences (with photo)
For women, pregnancy is not only great happiness, but also a responsible process for which the body needs to be prepared in advance.In the absence of sports and a healthy diet, the pregnancy process becomes more difficult, since the body needs reinforcement to overcome stress during the carrying of the fetus, the birth itself, and also after them. One of the serious postpartum diseases is uterine prolapse. Let’s find out more about him.
Displacement leads to damage to the muscles of the small pelvis – after childbirth, these muscles are not able to support the genitals, so the uterus shifts from its normal position down towards the vagina.
The photo clearly shows what a prolapse of the uterus looks like in women:
Important! To prevent the disease, after childbirth, it is necessary to exclude physical activity, specifically on the abdominal muscles.
Stages of development of the disease:
- Slight lowering.
- Periodic prolapse – under stress in the genital area and when sneezing, for example, the cervix is visible.
- Incomplete prolapse – the cervix and the uterus itself are visible from the vaginal area.
- Complete prolapse – the uterus completely falls out of the vagina.
Reasons for prolapse after childbirth
Displacement of the neck towards the genital gap occurs as a result of anatomical anomalies or violations:
- decrease in the strength of the pelvic floor muscles;
- as a result of injuries sustained during childbirth;
- after surgery in the genital area;
- due to congenital pelvic defects;
- estrogen deficiency developing during menopause;
- connective tissue dysplasia.
Did you know? The uterus is the most elastic organ, since during pregnancy it increases in size by 10-15 times, while at the end of the postpartum period it returns to its original size.
Recognizing the symptoms
Initial symptoms that should be addressed immediately include:
- pain in the lower abdomen;
- back pain;
- discomfort in the vagina;
- possible problems with intercourse;
- secretion of mucus and blood from the genital crevice.
This is followed by difficulties with urination, since in connection with an ailment, a woman begins to urinate frequently, which can be both difficult and frequent. Urinary incontinence is also possible, which indicates a downward displacement of the uterus. Naturally, with a protruding cervix and daily activity, the uterus is damaged and bleeds, since, being in the external environment, it does not have protection from any kind of damage (even simple touches can infect an organ). Sexual life in this case is absolutely impossible, since in addition to discomfort, there is an aggravation of the injury.
Important! With a prolonged state of prolapse, due to unstable and uncontrolled urination, kidney disease such as hydronephrosis can begin.
The main way is to visit your gynecologist regularly, who can determine your current condition and evaluate the change between visits in order to identify possible difficulties with or after childbirth. Women with an already developing ailment are put on dispensary registration.
Treatment of prolapse of the uterus
Of course, a woman with such a diagnosis immediately raises the question: what to do after childbirth when the uterus is prolapse.Since this problem is quite common, there is a method of treatment. The approach to this problem is determined by many factors, such as:
- how deeply the cervix has sunk, whether it is visible from the outside of the vagina;
- presence of gynecological diseases;
- the ability and need for fertility; 90 010
- age of the woman;
- the degree of damage to adjacent organs;
- degree of surgical risk.
Based on these criteria, as well as symptoms, doctors recommend how to treat prolapse of the uterus after childbirth.The type of treatment and further prevention depends on such a factor as age, quite strongly – over time, the muscles in the intimate area weaken and it is necessary to take measures directly to strengthen them. Also, with age, the question of fertility becomes more difficult, so doctors recommend thinking about childbirth in the period of 22-35 years, so that the complications that may arise with them do not affect the woman’s further ability to give birth.
You can do certain activities for the treatment of prolapse of the uterus at home yourself – according to the Kegel method.These activities are recommended by doctors, so they can be combined with your daily activities. Do not let the disease affect the established way of life, as it becomes more difficult for the body to adapt to changes with age.
Treatment without the use of surgical intervention allows you to give a result without interfering with the work of the body. To get rid of the disease at an early stage and not put yourself at risk, when the uterus prolapses, you need to do the following physical exercises:
- exercise “bike”;
- raising the legs up in the lateral position;
- tension and relaxation of the muscles of the walls of the vagina.
If the cervix does not reach the vagina, and the functions of neighboring organs have not been changed or impaired, conservative treatment is applied, namely:
- playing sports, where the main role is played by the muscles of the pelvis and lower abdomen;
- estrogen therapy to strengthen the organs;
- use of ointments and mixtures that contain estrogens;
- Significant decrease in the level of physical work.
Remember that during the prolapse of the uterus, it is gymnastics that helps to keep the muscles in good shape.
Important! Until the age of 45, the probability of getting an ailment is about 20-30%, while after menopause the probability of this reaches 80%.
The grounds for the use of surgical intervention are either a neglected and prolonged state of the disease, or the ineffectiveness of a conservative method. Let’s consider the main operations:
- Vaginoplasty is a corrective operation aimed at strengthening the muscles of the genital gap.
- Suturing ligaments – used to increase the strength of the ligaments of the walls of the uterus, but there is a chance of losing the ability to give birth to children.
- Application of alloplastics – strengthens the ligaments and fixes the position, but relapses are possible due to alloplastic materials.
- Hysterectomy – removal of the uterus, used if the woman does not plan to give birth in the future.
Lack of treatment and timely diagnosis will lead to complete loss, which should not be allowed in any case. Also, when treating an advanced disease, the sensitivity of the vagina is seriously affected, since the surgical operation inevitably affects it.
Cessation of the production of sex hormones leads to early menopause and many psychological problems. In general, here, too, the old truth is justified: it is better to prevent the onset of a disease than to cure it later.
Did you know? In the ninth month of pregnancy, the volume of the uterine cavity becomes 500 times larger than the original.
How to prevent prolapse
In addition to regular visits to gynecology for diagnosis, a woman should lead a certain lifestyle that avoids problems and improves female immunity:
- do not take part in difficult physical activities – do not lift more than 5-7 kg;
- to do artistic gymnastics;
- ensure yourself a healthy diet.
So, we found out what kind of danger a woman can face after giving birth. This anomaly will not be a special problem if diagnosed in time – modern medicine easily solves this issue. Do not be afraid to see a doctor at the first alarming symptoms. Happy childbirth and happy postpartum period!
Prolapse of the uterus and vagina (68 photos)
Open uterus in the vagina
Wife’s vagina after fisting
Prolapse of the rectum outward
Fisting 9033 vagina and vagina
Fisting 9033 vagina and vagina
Fisting the uterus of a pregnant woman
Female vagina inside
The uterus fell out of the vagina
Fuck in the vaginal prolapse
Penetration of the penis into the cervix
Vagina 3 vagina outwards
Hentai vagina from the inside
Huge inverted vagina
Old stretched vagina inside view
Vagina close-up inside
Vagina turned inside out
Huge vagina after physting
Female vagina before childbirth
Prolapse of the uterus and vagina
Anal prolapse vacuum
Uterus outward of pornography
Huge stretched vaginas
Vagina turned outward
Vagina turned outward
9000 Vagina turned out
Vaginal dilator inside
The largest clitoris suction
A woman experiences an orgasm after removal of the uterus
Vagina private objects
Objects in the female urethra
from the anus
from the anus
Vagina with a drooping uterus
Fisting the vagina and uterus
Vagina close-up inside
Vagina after first sex
The largest female vaginas
Vagina from the inside after childbirth
Huge inverted vagina
Fisting the vagina outward
Fucks in the inverted uterus
Vagina clitoris cervix
outside3000 mate women
Opened vagina after childbirth
Vaginal dilator inside
Large vaginal prolapse
Masturbation of a prolapsed vagina
Masturbation of the prolapsed vagina
Vagina turned outward
Woman’s vagina from the inside
Lesbian everts anal Raisa
Female vagina after childbirth
Vaginal prolapse (eversion) 90 003
Uterine prolapse fisting
Opened vagina uterus
Uterine prolapse from the vagina
Inserts into the female urethra
Protrusion in the perineum
Vaginal fist 9000 Vagina plate 9000 and vagina, uterine prolapse, price in St. Petersburg
The prolapse and prolapse of the pelvic organs (urethra, bladder, uterus, rectum) occurs with functional weakness of the ligaments and fascia of the pelvic floor, usually due to a genetic predisposition (systemic connective tissue dysplasia).
Department of urology – uroportal.ru
The organization of hospitalization for the purpose of surgical treatment is carried out according to the principle of “one window” .
Descent (prolapse) of the pelvic organs is one of the most common diagnoses in women of the middle and older age group.
To date, there have been extensive population studies that have established the true prevalence of pelvic organ prolapse (PTO). Thus, every tenth woman (10%) living to 50 years old needs surgical treatment of one or another form of prolapse. By the age of 80 in women, this figure reaches 20%.
Obviously, as the population ages, more and more women will need help with this disease.
In gynecological hospitals, in the structure of planned indications for surgical treatment, prolapse of the uterus and prolapse of the vaginal walls takes the third place after benign tumors (uterine myoma) and endometriosis.Such prevalence and wide variability of PTO have led to the fact that today a separate specialty is engaged in the treatment of pelvic floor pathology – pelvioperineology.
For several decades, specialized urogynecological clinics have been operating in the world, which are substantively dealing with all issues related to the prolapse of the pelvic organs, urinary incontinence, neurogenic urinary disorders, urogenital fistulas, etc.The North-West Center for Pelvioperineology has been operating in our clinic for 5 years already on the basis of the urological department.
Pelvic prolapse does not pose an immediate threat to life, but it significantly impairs its quality. The fact is that anatomical disorders, which are the result of damage to the structures of the pelvic floor, lead to numerous, sometimes painful, complaints. Among them: frequent urination, uncontrollable urge to go to the toilet up to loss of urine, difficulty urinating, recurrent cystitis, repeated night climbs to the toilet, difficulty in defecation, gas incontinence, feeling of a foreign body in the perineum, pain in the lower abdomen and sacrum.
Numerous studies have confirmed the fact that the prolapse of the pelvic organs is tolerated by patients worse than such serious diseases as diabetes mellitus and coronary heart disease. In advanced forms, prolapse of the pelvic organs (especially, prolapse of the bladder) can cause chronic urinary retention and, as a result, bilateral hydronephrosis with the subsequent development of chronic renal failure.
The prolapse of the pelvic organs is a consequence of the destruction of the ligaments and fascia of the pelvic floor.Therefore, the treatment of this pathology by training the pelvic floor muscles (Kegel exercises, Yunusov gymnastics, etc.) does not significantly improve the situation. This approach can only help with mild forms of urinary incontinence. In fact, the main method of non-surgical management of such patients is the installation of pessaries. This option can often be the best choice (elderly patient, high risks of surgery, unwillingness to be operated on, etc.). However, even modern pessaries (for example, Dr. Arabin’s pessaries) cause a reaction of the vaginal mucosa to a foreign body, which can lead to irritation, discharge, etc.NS.
In the initial stages of prolapse (1 and partly 2 tbsp.), As a rule, you can refrain from surgical intervention. Restriction of heavy lifting, combating constipation, refusal of certain types of physical exercises is permissible. For aesthetic purposes, at this stage of the disease, it is possible to use laser microperforation of the vaginal wall. The latter technique does not quite help the cure, however, cicatricial contraction of the laser-perforated vaginal wall leads to “wrinkling” of the latter and a decrease in the area, which visually reduces prolapse.
Operations for prolapse and prolapse of the uterus and vagina
The organization of hospitalization for the purpose of surgical treatment is carried out according to the principle of “one window” .
The main method of treatment of severe forms of prolapse and prolapse of the pelvic organs is surgery.To date, many methods of surgical treatment of prolapse of the pelvic organs (uterus, bladder, rectum) have been proposed. Each of them, along with certain advantages, has disadvantages, which is mainly expressed in relapses of the disease, pain syndrome, sexual disorders, disorders of the function of the pelvic organs. So, the isolated use of colporrhaphy (“filing of the vagina”, “plastics” with one’s own (native) tissues) with omissions of 3-4 degrees, leads to relapses in more than 40-50% of cases, which, of course, is unacceptable in modern conditions.The widespread belief that if “everything is cut off” (meaning the uterus), then “there will be nothing to fall out” is also a delusion. The uterus itself has no effect on prolapse, being the same “hostage” of the situation (defect of the pelvic floor ligaments), like other organs of the small pelvis. For some reason, no one suggests removing the latter … Removing a healthy uterus when using modern technologies is completely optional and has no (including oncological) grounds. At the same time, you need to understand that the removal of this organ can damage the nerve endings that regulate urination, disrupt the blood supply to all pelvic organs and, finally, lead to prolapse of the vaginal dome (when the uterus has already been removed) with a probability of 7 to 25% ( cm.Rice. 2.).
Back in the mid-80s of the XX century. the widespread use of endoprostheses (meshes) made of monofilament polypropylene in the surgical treatment of abdominal hernias began. This approach has transformed this area of surgery beyond recognition. The relapse rate has decreased almost tenfold. Today it is impossible to imagine this area of surgery without “meshes”.
This technology migrated to reconstructive urogynecology in the mid-90s of the XX century: the TVT technique or “synthetic suburethral sling without tension” was proposed.This approach turned out to be much simpler, safer and more effective than all technologies used at that time. Today sling surgery is “gold standard” in for stress urinary incontinence . In our clinic, not only this technique is widely used (more than 600 operations per year), but also modifications of the used implants and technologies for their application are being developed. Unfortunately, even the “gold standard” is not devoid of noticeable shortcomings.
In the early 2000s, an avalanche-like penetration of “meshes” into the methods of treating pelvic organ prolapse by vaginal access began. The main initiators of such an intensive process were venerable implant manufacturers, inspired by the commercial success of TVT technology and the like. Unfortunately, marketing in this area has far outstripped fundamental research and, especially, the knowledge and skills of specialists.
“Mesh” with vaginal access began to be put on a massive scale by those who often did not know the question at all: they did not understand the indications / contraindications, the nuances of technology, were not able to cope with “surprises” during the operation, etc., relying on the logo of a well-known company on the implant box. The result was not long in coming – there were quite numerous complications and side effects of the technology: erosion of the vaginal mucosa, damage to neighboring organs, pain syndrome, disorders of urination and sexual activity, etc.With a careful analysis of most of these problems, it becomes obvious that the cause of the patient’s suffering is not a grid, but an illiterate approach to its application. In the practice of our clinic (and we deal with the treatment of complications in patients from other hospitals), almost all the patients who had to get rid of the “net suffering” through complex surgical interventions, initially DIDN’T HAVE ANY INDICATIONS to use meshes or needed a completely different version of the implant (how to install it).Therefore, we have to agree with one of the leading specialists in the US in the reconstruction of the pelvic floor, Robert Moore, who wrote back in 2010: “What is needed is not so much the correct selection of patients for this surgery as the correct selection of surgeons …”. Be that as it may, the technology of using implants in the treatment of pelvic organ prolapse has suffered significant reputation losses, despite the outstanding, previously unattainable results that it provided (and provides) in the hands of competent specialists working in expert centers.But, at the same time, an impulse was received for further intensive improvement of the methodology, on the one hand, and for the “withdrawal from art” of the absolute majority of amateurs, on the other. Today’s technologies for pelvic floor reconstruction in leading clinics have a “patient-centered” approach, when, in fact, there is no standard technique, implant or technology. There is a set of internationally recognized approaches that are combined to achieve the best result for a particular patient.Thus, one of the most progressive methods is combined (hybrid) reconstruction of the pelvic floor , when modified techniques for restoring the pelvic floor with one’s own tissues are combined with selective endoprosthetics of individual ligaments using synthetics (Fig. 9 and 10).
With this approach, there is a summation of the pluses and leveling of the minuses of both methods.Our clinic is one of the pioneers in this area. In our practice, we most often use materials produced by the domestic enterprise “Lintex” (St. Petersburg), as we have already become convinced of the high quality of their implants and have the opportunity to directly influence the improvement of all elements of these products, thanks to long-term scientific and technical cooperation.
To date, North-West Center for Pelvioperineology on the basis of the urology department of the University Clinic of St.Data on all women who received help within our walls are entered into a single register, which allows you to reliably track the results of treatment at various times (1 month, 6 months, 1 year, and then – annually). There are already data on a 5-year follow-up period, indicating that, for example, the frequency of erosion when using “synthetics” in our country does not exceed 0.