Cervical prolapse

Prolapse of the cervix in gynecological practice is called genital prolapse, this pathological condition of the female genital organs is associated with the displacement of the uterus as a result of weakening of the pelvic floor muscles that support the uterus. When prolapse occurs, a woman experiences discomfort in the lower abdomen, pain, difficulty urinating, and discharge.

Often, cervical pathology is associated with abnormal positioning of the genitals. When the uterus prolapses, the cervix is displaced downwards, at the initial stage the cervix is not visible from the vagina, but over time, in the absence of treatment, the uterus and other genitals can fall out of the genital slit, which poses an immediate threat to the woman's life. Cervical prolapse is often diagnosed in women who have given birth, since the muscles that support the uterus become weaker after pregnancy and childbirth.

Often, prolapse is observed in women over 40 years of age, however, recently this pathology has become more common among young girls.

The development of the disease is relatively slow and the symptoms that often appear are not a reason to contact a specialist and identify the causes.

Pregnancy and childbirth with prolapse cause many problems, but in this case, much depends on the degree of prolapse of the uterus. At the initial stage of the disease, for the normal course of pregnancy and childbirth, it will be enough to do some exercises that strengthen the abdominal muscles.

In some cases, young specialists confuse postpartum prolapse with uterine cancer, so it is important to undergo a complete examination and consult with several specialists.

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Causes of Cervical Prolapse

Cervical prolapse can be diagnosed in both young girls and older women, however, the likelihood of the disease increases with age in women.

The causes of prolapse are weakened muscles supporting the uterus, often the disease is accompanied by displacement of the bladder or rectum. Often, prolapse disrupts the functioning of internal organs.

The initial stage of prolapse can begin in youth, given the slow progression of the disease, with age the signs of the disease become more pronounced - discomfort and pain appear, which can lead to loss of working capacity.

One of the main causes of prolapse is the abnormal structure of internal organs, which leads to damage to muscle fibers.

The risk of developing the disease is increased by difficult childbirth, operations on the genitals, damage to the perineum, hormonal imbalances during menopause, and abnormal development of connective tissue.

Experts note some risk factors that can provoke the disease: heavy physical labor and lifting weights, frequent births, heredity, age, excess weight, severe cough, increased pressure in the inner part of the peritoneum, in some cases, severe cough can also cause prolapse. Often the disease occurs when several risk factors converge, weakening the muscle fibers in the pelvis.

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Symptoms of Cervical Prolapse

Prolapse of the cervix initially occurs with a feeling of heaviness and a foreign body in the vagina, nagging pain in the lower abdomen, sacrum, and lower back. During sex, a woman may experience bloody discharge, and sexual intercourse becomes painful. The nature of menstruation often changes - discharge becomes scanty or, on the contrary, abundant. With prolapse of the cervix at a young age, it is extremely difficult to get pregnant, but this possibility cannot be completely excluded.

As the disease progresses, problems with the urinary system appear (in about 50% of cases), stretching of the walls of the ureter, kidneys, and enuresis are also possible.

Every third patient experiences intestinal dysfunction: constipation, gas and fecal incontinence, colitis.

Prolapse of the cervix in the later stages is often diagnosed by the woman herself - the main symptom is the appearance of a formation from the vagina. The part of the uterus protruding from the genital slit is matte with cracks, itchy. When walking, as a result of friction, the prolapsed part of the uterus becomes covered with ulcers, bleeds, which increases the risk of infection.

When prolapse occurs, blood circulation in the pelvic organs is disrupted, congestion, swelling of adjacent tissues, and cyanosis appear.

The disease prevents a woman from living a full sexual life.

Prolapse of the cervical walls

Cervical prolapse is caused by the downward displacement of the entire organ or one wall. Doctors distinguish several stages of cervical prolapse:

• 1 – the external os of the cervix drops relative to the normal position
• 2 – the cervix falls out of the vagina
• 3 – the uterus falls out of the genital slit entirely

The disease is characterized by a slow progression. Often, with prolapse, the progression of the disease leads to complete prolapse of the organ, which is an extremely serious condition. Prolapse can also be provoked by heavy physical work or old age. Prolapse of the uterus also leads to prolapse of other internal organs.

With regular organ prolapse, the vaginal walls become coarse and lose elasticity. All this causes swelling, bedsores, bleeding ulcers and cracks. Infection often leads to severe inflammatory processes of the genitourinary system.

Cervical prolapse during pregnancy

Cervical prolapse complicates childbirth, so timely treatment is extremely important in such a situation. During pregnancy, this pathology is also dangerous; prolapse can be diagnosed by ultrasound and in the gynecologist's chair.

Prolapse can be caused by various reasons: congenital anomalies of internal organs, neoplasms, inflammation and adhesions in the pelvis, weakened muscles, difficult previous births, improper treatment of internal ruptures.

Usually prolapse develops after 40 years, but with weak or damaged abdominal muscles, prolapse can develop during pregnancy. When the ligaments are stretched, the muscles are not able to hold the growing uterus. The pressure of the uterus on the internal organs causes them to gradually descend. Prolapse leads to impaired blood circulation in the pelvis, swelling, inflammation, constipation, hemorrhoids appear.

If the prolapse of the cervix does not threaten the child, then treatment is not carried out. As a rule, in such a situation, the woman is recommended maximum rest, no physical activity, so as not to worsen the condition.

At the initial stage of prolapse, Kegel exercises (for intimate muscles) are very helpful; at the second stage, orthopedic treatment methods are prescribed; at the third stage, surgical intervention.

To prevent prolapse after childbirth, it is important for a woman to do gymnastics or, as a last resort, to pump up her abdominal muscles on her own.

Cervical prolapse after childbirth

Prolapse of the cervix after childbirth often develops due to a violation of the integrity of the pelvic muscles. The pathological condition may manifest itself with characteristic symptoms immediately after the birth of the child or only after several years.

Heavy and frequent childbirth increases the likelihood of prolapse. With minor muscle injuries, if a woman has given birth once and does not lift heavy objects, then the symptoms of prolapse are expressed only by nagging pains, which a woman can attribute to an imminent menstruation, a cold, etc. At this stage, special exercises for intimate muscles can help, which will help strengthen weakened ligaments.

Diagnosis of cervical prolapse

Diagnosis of cervical prolapse is not difficult, but the doctor must establish the extent of changes that led to the pathology. To establish a diagnosis, a biopsy, colposcopy, etc. are performed, which will help assess the condition of the genitourinary system. However, some conditions require special urological examinations. In case of cervical prolapse, an examination of the intestines, heart, blood vessels, nervous and endocrine systems is mandatory. Only after receiving a complete picture of the disease can the doctor prescribe effective treatment.

Cervical prolapse is diagnosed primarily during a gynecological examination. With tension, the doctor can determine the degree of prolapse of the woman's internal organs.

After the examination, the doctor prescribes a colposcopy (examination of the internal walls of the vagina and uterus using a special device - a colposcope). If necessary, other examination methods may be prescribed: ultrasound, smear, bacterial urine culture, computed tomography, excretory urography (X-ray of the urinary tract), hysterosalpingography (ultrasound examination of the uterus and patency of the fallopian tubes).

If the cervix is prolapsed, the woman is referred to other specialists (urologist, proctologist), who determine the existing prolapse of the intestine or vagina. The specialist also prescribes a study that will help assess the degree of damage to the sphincter of the rectum, urinary incontinence of gases, urine.

Once all the problems and the degree of cervical prolapse are identified, the doctor prescribes the necessary treatment.

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Treatment of cervical prolapse

Cervical prolapse comes in three stages, depending on which stage is diagnosed, the doctor prescribes treatment.

In case of such pathology, treatment can be conservative or surgical.

Conservative treatment is prescribed at the initial stages of prolapse. As a rule, at this stage, general strengthening therapy is prescribed, increasing the tone of the abdominal muscles and ligaments. The treatment is also supplemented by therapeutic exercise and water procedures.

Special exercises for minor cervical prolapse include a standard set of exercises to strengthen the buttocks. Elements of oriental dances or Kegel exercises, which have recently become increasingly popular, are also used.

If the vaginal walls prolapse and the uterus falls out of the genital slit, surgical intervention is prescribed.

During the recovery period or in old age, when for medical reasons it is not possible to perform surgical intervention, the doctor can use a ring pessary, which will prevent the uterus from falling out (provided that the uterus is in the vagina). The pessary is a plastic ring that is placed in the vagina and holds the uterus. This method of treatment after some time leads to the formation of bedsores and stretching of the pelvic muscles. Wearing a pessary should be done under regular medical supervision, in addition, it is necessary to douche daily.

Surgical treatment is used in the last stages of the disease. During the operation, the surgeon stitches the uterus closer to the base of the muscles that should hold it. In most cases, such an operation is effective, but after that the woman has a recovery period, during which she should be careful: do not lift heavy objects, avoid physical activity.

Cervical prolapse surgery

Cervical prolapse can be eliminated by surgery. Surgery is prescribed when conservative treatment has not led to positive dynamics. The most effective treatment for this pathology is a combined operation, which ensures fixation of the uterus in a normal position, vaginal plastic surgery, and muscle strengthening.

Simple surgeries that involve only tightening weakened muscles often result in relapse, especially before pregnancy. Elderly women or women who have given birth may undergo surgery to completely remove the uterus.

Exercises for cervical prolapse

Cervical prolapse is caused by weakened abdominal muscles, so special exercises are used to prevent organ prolapse, which help strengthen the muscles. The most effective exercises are Kegel exercises, which help get rid of a number of female diseases of internal organs, in particular prolapse and urinary incontinence caused by pathology.

The exercises are quite simple and can be mastered at home:

1. Long contraction of vaginal muscles (10-15 seconds) for 5 minutes
2. Rhythmic contractions of the vaginal muscles (5 seconds each – contraction/relaxation) for 2 minutes.

Regular Kegel exercises are recommended during pregnancy and after childbirth to prevent prolapse.

The founder of the intimate exercise complex was Arnold Kegel, a gynecologist who, in the course of his work, was able to establish that urological problems, prolapse of internal organs, and decreased sexual desire are provoked precisely by poorly developed and weakened intimate muscles of a woman.

The doctor noted that after performing the recommended exercises, the condition of his patients improved significantly. These exercises are especially effective in the early stages of cervical prolapse and urinary incontinence, which is caused by the pathological condition.

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Gymnastics for prolapse of the cervix

Gymnastics helps prevent cervical prolapse at the initial stage. The set of exercises is aimed at developing the abdominal muscles and improving blood circulation in the pelvis:

1. Exercise "bicycle" (recommended to be performed twice a day - morning and evening).
2. Lie on your back, arms along the body, knees bent. Raise the pelvis 10-20 cm from the surface (feet and shoulders remain pressed to the floor).
3. Lie on the floor, arms along the body, trying not to lift your heels off the floor, raise your upper body and sit down (do 10-15 times).
4. Lie on the floor, place your hands under your buttocks, knees bent. Bend your knees alternately to the sides (your back does not come off the floor). Do 7-10 bends to each side.
5. Exercise "Candle" for 45 seconds.
6. Lie on your stomach, place a rolled-up towel or cushion under your stomach, and stretch your arms up. Raise your upper body with your arms above the floor and hold this position for 20-25 seconds.
7. Get on your knees, rest your hands on the floor, arch your back up and down alternately, perform 7 bends.
8. Get on your knees, rest your hands on the floor, raise one leg to the maximum possible height (leg straight), lower it, then repeat the exercise for the other leg.
9. While standing, perform leg swings (10 times for each leg).
10. Standing, move your leg to the side and rotate it for 30 seconds, first in one direction, then in the other (repeat the exercise for the other leg).
11. Exercise "Swallow for 45 seconds.

It is recommended to do the exercises daily. If the exercises are difficult to do, you can reduce the number of repetitions at the beginning, but over time, be sure to increase the load.

Prevention of cervical prolapse

Cervical prolapse is a rather severe and common disease, therefore, in order to prevent the development of pathology, it is important to follow some preventive measures, especially for women at risk (over 40, those who have given birth frequently, etc.).

Regular exercise, especially that aimed at strengthening the abdominal muscles, will help prevent the development of prolapse.

During pregnancy and after childbirth, it is important to pay attention to a special set of exercises that will help strengthen the muscles and ligaments of the peritoneum.

After giving birth, it is not recommended to make sudden movements, try to avoid heavy physical activity, and do not lift weights (these recommendations are suitable not only after giving birth, but also at other times).

Prognosis of cervical prolapse

Cervical prolapse is a rather dangerous condition that can be life-threatening. The disease is easier to treat if it is diagnosed at the initial stage of the pathological process. In this case, conservative treatment can be used without resorting to surgery. Over time, the disease progresses, despite the fact that prolapse occurs rather slowly, the woman's condition worsens, which can ultimately lead to the uterus falling out of the vagina. In this case, surgery remains practically the only way to help the woman.

Cervical prolapse is the most common diagnosis in gynecological practice. The disease is often diagnosed at an advanced stage, when the woman's condition is critical.

In general, the disease progresses rather slowly, but there were cases when prolapse developed rapidly, and in a relatively short period of time the cervix descended into the vagina, which affected the quality of the woman's sexual life. However, medicine knows of cases when women with prolapse of the cervix live for several years without even suspecting their pathology.