Cervical plasty

Cervical plastic surgery is a surgical intervention that is performed after a certain surgical procedure on the cervix in order to correct the results of the operation. In most cases, it is performed simultaneously with surgical intervention on the cervix. There are pathologies that result in a violation of the structure of the uterus and cervix, which also requires plastic surgery. The technique has its own differences depending on the diagnosis and individual features of the anatomical structure of the internal genital organs. The results of this intervention, as a rule, completely correct the pathology and allow you to fully become pregnant and continue the family in the future.

Indications and technique for performing cervical plastic surgery

First, it is necessary to find out the cases in which we are talking about surgical methods of treatment, including cervical plastic surgery. That is, it is necessary to establish an accurate diagnosis and determine the scope of the upcoming operation. There are conditions in which cervical plastic surgery is required without fail, since the anatomical disorders are quite significant.

Indications for cervical plastic surgery are as follows:

1. cervical ectropion;
2. complete or partial vaginal prolapse, which may be accompanied by prolapse of the uterus or cervix, as well as these conditions in isolated cases;
3. deformation of the cervix of various etiologies;
4. elongated cervix;
5. cervical prolapse;
6. postpartum deformations of the birth canal, deformations after suturing, cicatricial deformations of the cervix.

All these conditions are accompanied by a violation of the integrity or anatomical relationship of the cervix, body and vagina. Conditions such as, for example, cervical deformities often occur over a long period of time, and therefore plastic surgery is not required immediately after surgery on the cervix, but only after some time, when the changes progress, plastic interventions on the cervix are required. This nuance complicates the technique of cervical plastic surgery itself, since the changes are quite significant and cicatricial deformities can worsen over time. Therefore, it is important in such conditions, as well as in similar diseases in the anamnesis, to monitor your own health and control any changes.

Cervical ectropion is a process that is accompanied by the "eversion" of the mucous membrane of the cervix outward, that is, into the vaginal cavity, with the formation of a significant defect. This pathology requires surgical treatment, since it does not respond to conservative treatment. With a long course of this disease, not only the function of the cervix in terms of the normal ovariomenstrual cycle is disrupted, but also the histological picture of the structure of the endometrium is disrupted. That is, such a condition for a long time can lead to various metaplasias and is considered a background disease with a high risk of malignancy. Therefore, plastic surgery of the cervix in ectropion should be performed as early as possible.

Complete or partial prolapse of the uterus often occurs in older women, which occurs with age-related changes in the female genital organs. In this case, a state of weakness of the pelvic floor muscles, anterior abdominal wall occurs, which is accompanied by a gradual prolapse or prolapse of the uterus. This condition is also treated only by surgery, by correcting the uterine cavity and combining it with cervical plastic surgery. Cervical plastic surgery for uterine prolapse is performed on a planned basis and complex postoperative therapy should be carried out, aimed at strengthening the pelvic floor muscles and abdominal press in order to prevent other similar complications.

An elongated cervix is a pathology that occurs when the structure of the cervix is disrupted, in which its length increases and is more than 45 millimeters. This pathology is asymptomatic, but serious complications often arise in the form of infertility, dyspareunia, problems during childbirth and pregnancy. Therefore, it is necessary to correct this pathology. There are conservative methods of treating an elongated cervix, which are widely used directly during childbirth. Surgical treatment of an elongated cervix in the form of cervical plastic surgery is carried out when planning a pregnancy, when a woman knows the possible complications and purposefully treats this pathology.

Cervical deformities most often occur in the postpartum period, when there are ruptures of internal organs that were sutured, as well as the formation of scars at the site of these ruptures. There may be a narrowing of the cervix, which may be of such a degree that it already requires plastic surgery. Surgical treatment methods are a priority in the case of significant deformations of the cervix, since it is possible to correct such deformations. Different methods of surgical treatment are used, which depends on the type of pathology. Minimally invasive interventions are often carried out for certain indications, since they are less traumatic, especially if pregnancy is also planned. In case of violations of the structure of the cervix due to deformations, such as narrowing or obstruction of the cervical canal, a special procedure is carried out - bougienage of the cervical canal. Cervical plastic surgery after childbirth involves the correction of conditions that caused such deformations, and the earlier such plastic surgery is performed, the better the effect and result of treatment, which in turn allows planning subsequent pregnancies with normal gestation and birth of a healthy child.

Preparation for cervical plastic surgery includes general clinical aspects - first of all, an accurately established diagnosis. Before deciding on such an intervention, it is necessary to undergo a comprehensive examination by a doctor using instrumental and laboratory research methods. First, it is necessary to undergo a colposcopy, which allows you to accurately visualize the changes that will need to be corrected, as well as the presence of concomitant pathologies. An important point in preoperative preparation for the upcoming cervical plastic surgery in case of its deformations is hysterography - this is a study that allows you to fill the uterine cavity and cervix with a contrast agent, and then examine the uterine cavity and the presence of all deformations. In this case, you can accurately determine their nature, localization, structure, which allows you to more accurately diagnose.

The woman's preparation for the operation is no different from a regular surgical intervention and is performed on an empty stomach. Other features of cervical plastic surgery depend on the technique.

The technique of performing cervical plastic surgery depends on the type of deformation and the specifics of using a certain method. Firstly, cervical plastic surgery can be performed vaginally, by open laparotomy and laparoscopically. The laparoscopic method is the least invasive, but it does not allow for revision and is limited in use for extensive deformations of the cervix. Laparotomy allows for examination of all changes in the surrounding tissues. As for the vaginal method, it is used most widely, since it allows for examination of the cervix, the degree of its deformation and the most accessible and simple access.

Depending on the method of using the leading method, there are several types of this intervention:

1. a simple surgical method is the use of a simple scalpel;
2. ultrasonic method – used for minor defects that can be corrected using high-power ultrasonic waves;
3. laser method – using a laser scalpel for plastic surgery of small defects of the cervix. The most progressive and new method, which allows for a bloodless way to correct the deformation with subsequent fixation of tissues practically without sutures.

Laser cervical plastic surgery is used mainly in cases of cervical narrowing, ectropion, when it is possible to remove excess tissue and simultaneously perform cervical plastic surgery.

Cervical wall plastic surgery can be performed using allografts, which are used for significant defects when the cervical tissue can be replaced with another tissue. In this case, an extended operation is used, in which plastic surgery of the cervix and its walls is performed simultaneously with suturing of the cervical canal in such a way as to avoid changes in size.

Sturmdorf's cervical plastic surgery is a plastic surgery technique that is combined with amputation. It is described by this doctor and consists of a circular incision over the site of the lesion with subsequent stitching from the beginning of the incision, which pass through all layers of the cervix. This method of plastic surgery allows preserving the integrity and anatomical structure of the cervix.

Emmett's cervical plastic surgery is one of the surgical intervention methods, in which the sutures are applied from the edge towards the external os, and the mucous membrane of the cervical canal is not affected. Such operations are performed in case of cervical ruptures, when the cervical canal is not involved in the process.

Rehabilitation period

The rehabilitation period lasts a month, when all damaged tissues are restored and the wound channel and suture site heal. During this time, complete epithelialization and regeneration occurs, which allows new cells to function normally. During the rehabilitation period, it is recommended not to have sex. After a month, it is necessary to undergo a follow-up examination to assess the treatment result. It is also necessary to carry out prophylactic antibacterial therapy, systemic or local, which is decided on an individual basis.

Sick leave after plastic surgery on the cervix is issued, as with any other disease, even if it is a planned surgical intervention, then for the entire period of the disease. The sick leave is issued by the attending physician.

Cervical plastic surgery is an operation that in some cases is the second stage of surgical interventions on the cervix, and in some cases is a necessary stage of primary treatment of diseases. Often, pathologies that occur after traumatic childbirth or cicatricial deformations of the cervix subsequently cause clinical symptoms that require any treatment measures. Therefore, it is necessary to take care of your health and not delay timely treatment of diseases.

Consequences and complications of cervical plastic surgery

Cervical plastic surgery is a surgical intervention, so preoperative preparation and special management of the postoperative period are necessary to avoid possible complications. Complications can occur directly during the operation and in the postoperative period.

One of the consequences of such a procedure may be stenosis of the cervical canal of the cervix. This may happen when the plastic surgery is performed in such a way that the cervical canal is sutured and sutures are applied to its mucous membrane, and after healing, a scar is formed, which contributes to the narrowing of the lumen. Such a narrowing may be clinically insignificant, but if it is of significant size, then in the future, bougienage of the cervical canal may be required.

Complications of cervical plastic surgery occur during surgery or in the early postoperative period in the form of bleeding, which occurs when blood vessels are injured. In this case, the bleeding can be quite massive, which requires significant measures. The cause of such bleeding may be the failure of the sutures, so it is necessary to check their condition. In case of any suspicion of bleeding, it is necessary to conduct a thorough examination in order to revise not only the uterine cavity, but also the extrauterine space. It is also necessary to examine the postoperative wound for injury to adjacent organs.

Discharge after cervical plastic surgery may be for some time after the operation due to increased secretion of glands during their intensive proliferation. In this case, the discharge is normally mucous, light in small quantities, and then you should not worry, since this is a normal phenomenon of such an intervention. In the case of green purulent discharge with an unpleasant odor, it should be remembered that such discharge can be one of the consequences that occurs due to infection of the cervical cavity and it is necessary to consult a doctor for treatment of the infectious process.

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