Surgical treatment of uterine prolapse in Kharkiv

Uterine prolapse (womb descent) is a pathological process characterized by the displacement of an organ below its anatomical boundaries. With prolapse, the cervix does not go beyond the labia. Pathology progresses over time and, in the absence of therapy, leads to prolapse of the uterus: partial (when part of the uterus protrudes from the vagina) or complete.

Uterine prolapse is a common gynecological pathology diagnosed in about half of women after menopause. The displacement of the uterus and vagina is facilitated by age-related weakening of the muscles and ligaments of the pelvic floor, which hold the organs in a normal position, as well as other unfavorable factors.

There are four stages of uterine prolapse:

1. Descent of cervix when it does not go beyond the vagina.
2. The cervix extends beyond the labia only when the abdominal muscles are straining (during coughing, sneezing, lifting weights).
3. Exceeding of the anterior or posterior uterine wall beyond the labia.
4. Falling of the uterus due to prolapse of the vagina walls.

The prolapse of vagina, in turn, leads to displacement of other pelvic organs and the occurrence of related complications. With prolapse of the anterior vaginal wall, it is difficult to urinate or there is urinary incontinence, and the protrusion of the posterior wall provokes constipation and gas incontinence.

At the initial stage, signs of uterine prolapse may be absent. Clinical manifestations of pathology appear as it progresses. The main symptoms of uterine prolapse include the following:

• pains in the lower abdomen, radiating to the lower back;
• sensation of a foreign body in the vagina;
• pain during intercourse;
• lack of orgasms;
• feeling of fullness in the bladder;
• urinary incontinence when laughing, sneezing;
• difficulty urinating;
• getting air into the vagina during intercourse or exercise;
• more painful and prolonged periods than usual;
• vaginal bleeding. 

Causes of uterine prolapse 

The prolapse of uterine walls occurs due to several causes:

• congenital weakness of the pelvic floor muscles;
• gynecological operations;
• dysplasia - a pathology of connective tissue (affects the strength of the pelvic floor ligaments);
• increased intra-abdominal pressure (as a result of intense physical exertion, frequent constipation, hard physical labor);
• damage to the nerve structures of the urogenital diaphragm;
• obesity (due to increased pressure on the abdominal and pelvic muscles);
• estrogen deficiency (due to the onset of menopause, removal or early depletion of the ovaries);
• old age.

Prolapse of the uterus after childbirth is usually caused by pelvic floor injuries, perineal tears during childbirth, and the use of forceps. Uterine prolapse can also result from multiple pregnancies.

Diagnosis of genital prolapse 

Diagnosis of genital prolapse begins with examination by a gynecologist. During it, the doctor asks the patient to strain to assess the degree of displacement of the vaginal walls and uterus. Then the doctor issues a referral for laboratory and instrumental diagnostics to determine the cause of the pathology development and eliminate it.

The list of necessary examinations for prolapse of uterine walls includes:

• ultrasound of pelvic organs;
• vaginal smear for microflora;
• diagnostic curettage of the uterus and cervical canal;
• ultrasound of uterus and tubal patency;
• urography (X-ray of kidneys and ureters). 

Surgical treatment of uterine prolapse “ON Clinic Kharkiv”

Treatment of uterine prolapse can be conservative and surgical. Conservative therapy is indicated at an early stage of the pathology and consists in training the pelvic floor muscles using Kegel exercises or using vaginal balls. Menopausal women may be prescribed with local estrogen medications to maintain the elasticity of the pelvic ligaments. If the uterus is lowered so that its cervix reaches the vagina, then surgical treatment is indicated.

Open surgery is performed through the vagina, without incisions on the body, and has a short recovery time. During the surgical treatment of uterine prolapse, general inhalation or only spinal anesthesia is used (after an injection of anesthetic drug into the back, the patient is awake, but the lower body is not sensitive).

The essence of the operation is to return the uterus to its normal anatomical position or remove it through the vagina. The uterus is removed if it is prolapsed or otherwise indicated. The operation takes 1-2 hours on average. After its completion, the patient is transferred to the ward, where she is under the supervision of the medical staff for 1 to 3 days.

Preparation for uterine prolapse surgery

The first stage of preparation for uterine prolapse surgery is a consultation by gynecologist and a medical examination to rule out the presence of contraindications to surgery. During the next appointment, the doctor will appoint the date of the operation. The patient should not eat the night before and on the day of the operation, and not drink anything two hours before the operation.

Make appointment for a consultation with a gynecologist regarding the surgical treatment of uterine prolapse at the medical center “ON Clinic Kharkiv”. Call the specified phone number or leave your request on the website at any convenient time.