Uterine prolapse means protrusion of the organ part that usually arises in the area of the natural anatomical orifices. Uterine descent and falling out represents more severe type of prolapse.
These pathologies are relatively common and count for 28% of all the gynecological diseases. Almost 15% of all gynaecological surgeries are carried out due to uterine prolapse.
Uterine prolapse is a pluricausal condition arising under the influence of several factors such as:
Uterine prolapses because of predisposing factors such as:
Impact of the predisposing factors causes a descending uterus and bladder into the vaginal cavity.
Clinical signs may be absent for a while. Depending on the degree of progression, a patient can feel the presence of the foreign object in the vagina.
When the uterus falls out the large labia its mucosa becomes rougher. It is covered with a keratinous epithelium and resembles the skin covered with cracks, abrasions or scratches.
The following pathologies accompany these changes:
Depending on the prolapse manifestations there are 4 stages of uterine prolapse:
Primary diagnostics of the uterine prolapse with its descending or falling out is based on the doctor's examination by a gynaecologist. A specialist performs palpation of the uterus directly in the vaginal cavity and through the front wall of the rectum. A doctor will necessarily assess the condition of the muscles and ligament apparatus of the pelvic cavity bottom.
Ultrasound, hysteroscopy, colposcopy is done to differentiate uterine prolapse from the developing tumour or other diseases.
Uterine prolapse treatment is comprehensive. Conservative therapy may be prescribed for the early stages of the disease including special exercise therapy.
Other cases demand radical treatment and a woman has to undergo surgery. The type of intervention is determined by the stage of illness.
Several basic surgical techniques are used in German hospitals:
Professionals in the modern European hospitals give preference to the laparoscopic interventions as they are better tolerated by the patients; have low risk of complications and help to shorten the time of rehabilitation period.
Prognosis is unfavourable for uterine prolapse if no adequate treatment course is provided. Prolapse might end up in the organ falling out in 97% of cases.
Timely and the correct radical intervention excludes any further complications and recurrence in the majority of cases.
Risk of recurrence in the medically advanced European states after the surgery doesn’t exceed 10-15%. Recurrence frequency is higher than 30% after the operation in the developing countries.
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