Tracheloplasty

Cervical plastic surgery is a surgical procedure that is performed after a definite surgical procedure on the cervix to correct the results of the operation. In most cases, it is carried out simultaneously with surgical intervention on the cervix. There are pathologies resulting in a disruption of the structure of the uterus and cervix, which also requires plastic surgery. The technique has its differences depending on the diagnosis and individual characteristics of the anatomical structure of the internal genitalia. The results of this intervention, as a rule, completely correct the pathology and allow in the future fully to become pregnant and continue the genus.

Indication and technique of conducting cervical plastic surgery

First, it is necessary to clarify the cases in which it is generally the question of surgical methods of treatment, and the plasticity of the cervix including. That is, it is necessary to establish the diagnosis accurately and determine the scope of the forthcoming operation. There are conditions in which the plasticity of the cervix is required, as anatomical disorders are very significant.

Indications for cervical plastic surgery are as follows:

1. ectropion of the cervix;
2. complete or incomplete loss of the vagina, which may be accompanied by the loss 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. omission of the cervix;
6. postpartum deformities of the birth canal, deformation after suturing, scar cervical deformities.

All these conditions are accompanied by a violation of the integrity or anatomical ratio of the cervix, body and vagina. Conditions such as, for example, cervical deformations, often occur over a long period of time, and therefore, plastic is not required immediately after surgery on the cervix, but only after a while, when the changes progress, it requires plastic interventions on the cervix. This nuance complicates the very technique of cervical plastic surgery, because the changes are very significant and cicatricial deformations may become worse with time. Therefore, it is important in such conditions, as well as with similar illnesses in the anamnesis, to monitor your own health and monitor any changes.

The ectropion of the cervix is a process that is accompanied by a "reversal" 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 because it does not respond to conservative treatment. With the long course of this disease, not only the function of the cervix in terms of normal ovario-menstrual cycle is disrupted, but also the histological picture of the endometrium structure is disturbed. That is, this condition for a long time can lead to different metaplasia and is considered a background disease with a high risk for malignancy. Therefore, the plastic of the cervix in the ectropion should be performed as early as possible.

Complete or incomplete uterine prolapse often occurs in older women, which occurs with age-related changes in female genital organs. In this case, there is a state of weakness in the muscles of the pelvic floor, the anterior abdominal wall, which is accompanied by a gradual omission or prolapse of the uterus. Such a condition is also treated only by the surgical method, by correcting the uterine cavity and by combining with the cervix uteri. Plasticity of the cervix during uterine dysfunction is carried out in a planned manner and complex postoperative therapy aimed at strengthening the muscles of the pelvic floor and the abdominal press should be carried out in order to prevent other similar complications.

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

Deformations of the cervix most often occur in the postpartum period, when there are ruptures of internal organs that have been sutured, as well as scar formation at the site of these ruptures. It can be a narrowing of the cervix, which can have a degree that already requires plastic. Operative methods of treatment are of high priority in case of significant deformations of the cervix, as it is possible to correct such deformations. They use different methods of surgical treatment, which depends on the type of pathology. Often, minimally invasive interventions for certain indications are made, as they are less traumatic, especially if pregnancy is also planned. In case of violations of the structure of the cervix due to deformities, such as constriction or obstruction of the cervical canal, a special procedure is performed - bougiezing of the cervical canal. Cervical plastic surgery after childbirth implies correction of such conditions that caused such deformations, and the earlier this plastic is performed, the better the effect and the result of treatment, which in turn allows planning for the next pregnancies with normal bearing and the birth of a healthy child.

Preparation for neck plastic includes general clinical moments - this is, first and foremost, an exactly established diagnosis. Before deciding on such an intervention, it is necessary to undergo a comprehensive examination of the doctor using instrumental and laboratory methods of investigation. To begin with, you need to undergo colposcopy, which allows you to accurately visualize the changes that need to be corrected, as well as the presence of concomitant pathologies. An important point of preoperative preparation for the forthcoming plasticity of the cervix in the case of its deformations is hysterography - a study that allows filling the uterine cavity and neck with contrast medium, and then examine the uterine cavity and the presence of all deformities. In this case, you can accurately determine their nature, localization, structure, which allows more accurate diagnosis.

The preparation of a woman for surgery is no different from usual surgery and is performed on an empty stomach. Other features of cervical plastic surgery depend on the technique.

The technique of carrying out the plasty of the cervix depends on the type of deformation and the peculiarities of using a certain technique. First, the plasticity of the cervix can be performed by the vaginal method, by open laparotomy and by laparoscopy. The laparoscopic method is the most minimally invasive, but it does not allow for revision, and is limited in application for extensive cervical deformities. Laparotomy allows you to inspect all changes in surrounding tissues. As for the vaginal method, it is used most widely because it makes it possible to examine the cervix, the degree of its deformation and access the most accessible and simple.

According to the method of using the leading method, several types of this intervention are distinguished:

1. A simple surgical method is the use of a simple scalpel;
2. ultrasonic method - used for minor defects, which can be scaled with a high-power ultrasonic wave;
3. laser method - the use of a laser scalpel for the plasticity of small neck defects. The most progressive and new method, which allows a bloodless way to correct deformation with further fixation of tissues with virtually no seams.

Cervical plastic surgery by the laser is used mainly in narrowing the cervix, ectropion, when it is possible to remove excess tissues and in parallel to carry out the plastic of the cervix.

The plasticity of the walls of the cervix can be carried out using alotransplants, which are used for significant defects, when it is possible to replace the cervical tissue with another tissue. At the same time, an extended operation is used in which the plastic of the neck and its walls are simultaneously carried out with the cervical canal sutured in such a way as to avoid changing the dimensions.

Cervical plastic surgery in Sturmdorf is a plastic technique that is combined with amputation. It is described by this doctor and is in a circular section above the site of the lesion with further overlapping of the seams from the beginning of the incision that pass through all layers of the neck. This method of plastic allows you to maintain the integrity and anatomical structure of the cervix.

Cervical plastic surgery by Emmett is one of the ways of surgical intervention, in which seams are superimposed from the edge towards the external throat, and the mucous membrane of the cervical canal is not affected. Such operations are performed with ruptures of the cervix, when the cervical canal is not retracted into the process.

Rehabilitation period

The rehabilitation period lasts a month, when all the damaged tissues are renewed and the wound channel and the place of the sutures are healed. During this time, complete epithelization and regeneration takes place, which allows new cells to function normally. In the rehabilitation period it is recommended not to live a sexual life. A month later, you need to undergo a second examination to evaluate the outcome of the treatment. Also, preventive antibacterial therapy should be given systemically or locally, which is decided on an individual basis.

Hospital after plastic 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 hospital sheet is issued by the attending doctor.

Cervical plastic surgery is an operation that in some cases is the second stage of surgical interventions on the cervix, and in some cases it is necessary stages of primary treatment of diseases. Often pathologies that occur after traumatic births or cervical deformities of cicatricial nature, subsequently cause clinical symptoms that require any kind of treatment. Therefore, you need to protect your health and not delay with timely treatment of diseases.

Consequences and complications of cervical plastic surgery

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

One of the consequences of this procedure can be stenosis of the cervical canal of the cervix. This can be when the plastic is held in such a way that the cervical canal is sutured and the sutures are applied to its mucosa, and after healing it forms a scar, which helps to narrow the lumen. Such a narrowing can be clinically insignificant, but if it is of considerable size, then later the cervical canalization may be necessary.

Complications of plastics of the cervix are found during surgery or in the early postoperative period in the form of a bleeding that occurs when the vessels are injured. In this bleeding can be very massive, which requires significant measures. The cause of this bleeding may be the inability of stitches, so you need to check their condition. In case of any suspicion of bleeding, a thorough examination is necessary to check not only the uterine cavity, but also the extrauterine space. It is also necessary to examine the postoperative wound for the injury of neighboring organs.

Allocations after plasty of the cervix may be some time after surgery because of increased secretion of glands during their intensive proliferation. At the same time, mucous membranes are clear, light in a small amount, and then you should not worry, because this is a normal phenomenon of such interference. 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 arises from infection of the cervical cavity and it is necessary to consult a doctor for the treatment of the infectious process.

[1], [2], [3], [4]