Prolapse of the uterus and vagina
Last reviewed: 23.04.2024
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Uterine prolapse - the uterus is lowered to or beyond the entrance to the vagina. Vaginal prolapse - the descent of the walls of the vagina or vaginal cuff after a hysterectomy. Symptoms are pressure and incontinence. The diagnosis is based on clinical data. Treatment includes gymnastics, the use of pessaries and surgical correction.
The prolapse of the uterus is classified according to the degree of omission of the organ in degrees: below the vaginal canopy (1st degree), at the entrance to the vagina (2nd degree), beyond the entrance to the vagina (grade III, or complete prolapse of the uterus).
The prolapse of the vagina can be of the second or third degree.
[Symptoms of prolapse of the uterus and vagina
With the I degree of prolapse, symptoms can be minimal. At II and III degrees of uterine prolapse incontinence, feeling of pressure and sensation of fallen organs are characteristic.
Uterine prolapse III degree is characterized as protrusion of the cervix or vaginal cuff, which can self-correct. The mucous membrane of the vagina becomes dry, thickened, with signs of chronic inflammation, with secondary infection and ulceration. Ulcers can be painful, bleeding and resemble vaginal cancer. The cervix of the uterus can also ulcerate when the walls of the vagina are lowered.
Symptoms of prolapse of the vagina are similar. There is a cystocele or rectocele.
The diagnosis is confirmed by examination in mirrors and bimanual examination. If there are vaginal ulcers, a biopsy is performed to exclude cancer.
Treatment of prolapse of the uterus and vagina
Prolapse of the uterus I and II degree in the absence of symptoms does not require treatment. Prolaps I and II degrees with the presence of symptoms or prolapse of the uterus of the third degree can be treated conservatively by administering pessary for the purpose of structural support of the perineum. In case of severe or persistent symptoms of the disease, surgical treatment is recommended, usually a hysterectomy with surgical correction of the pelvic floor structures (colporaphy) and vaginal sewing (suturing the tip of the vagina to stable nearby structures) is performed. If there are ulcers, then surgical intervention is postponed. Vaginal prolapse is treated like uterine prolapse.