Descent of the back wall moisture symptoms treatment. Causes, types, symptoms, diagnosis and treatment methods for prolapse of the vaginal walls Signs of prolapse of moisture in women

Hard physical labor.

The degree of vaginal prolapse.

Conservative therapy.

Exercises lying on your back.

Kegel exercises.

Postoperative period.

Symptoms of the disease

Surgical intervention

At this time, you cannot:

Conservative therapy

Exercise therapy and Kegel exercises

Non-surgical treatment

Vaginal prolapse, or prolapse of the vaginal walls, is a complex pathological process. It is most often observed in women who have given birth after 50 years. The prevalence between the ages of 30 and 45 is 40%, up to 30 years 10%. In some cases, the disease manifests itself at a young age, even in nulliparous women.

This pathology is possible due to the weakening of the pelvic floor muscles. As a result, both the anterior and posterior walls of the vagina can fall out. If the anterior wall descends, the urethra and bladder are displaced at the same time. With pathological prolapse of the posterior wall, there is a displacement, and in more severe cases, prolapse of the rectum.

Vaginal muscles are a must

The muscles and tendons of the vagina are involved in the period of conception, during gestation, and during childbirth. And the physiological course of pregnancy and the period of childbirth depends on the state in which they are.

When carrying a pregnancy, the muscle layer of the vagina is hypertrophied, and increased tissue hyperplasia occurs. This contributes to the transfer of special elasticity to the muscle fibers. This has a beneficial effect on the biomechanism of childbirth, in which the vagina acts as a birth canal.

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The passage of a newborn through the birth canal directly depends on the muscular state of the vaginal walls.

Reasons for prolapse of the vaginal walls

This pathological condition is not one-time, it develops over a long time. This is due to an increase in the pressure of internal organs (body of the uterus, bladder, rectum) on the pelvic area. The result of this long process is the prolapse of the walls of the vagina, sometimes their complete prolapse.

This disease can be accompanied by, and become the cause of the development, the following abnormal conditions:

Anatomically congenital connective tissue pathology, its inability to maintain constant muscle tone.
Daily bowel disorder accompanied by constipation.
Colds, in which a dry, hacking cough appears.
Pathology of the generic process. Prolonged labor, close-up birth, trauma to the perineum, improper use of obstetric forceps (incorrect application of obstetric forceps).
Sudden weight loss.
Daily hard work.
Surgery to remove the uterus.
Age-related changes after 60 years.
The number of births is more than 2 times.

Most often, the anterior wall descends. Falling or falling of both walls is rare.

Degree of development of prolapse of the vaginal walls

In the development of this process, it is customary to distinguish 3 degrees of the disease:

First degree characterized by a slight displacement of the anterior or posterior wall of the vagina. Sometimes their mutual displacement occurs. In the etiology of this process, there is an excessive pressure of internal organs.
In the second degree, the increased pressure can move the body of the uterus into the vaginal area, and its pharynx can be located on the eve of the vagina.
Third degree leads to severe pathologies, the walls of the vagina are everted, and looks like a prolapse of the uterus.

If pressure is carried out by the displaced bladder, it leads to cystocele disease. Less commonly, rectocele occurs, which leads to a displacement of the posterior wall of the vagina.

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Symptoms of prolapse of the vaginal wall

The development of this pathological process can occur over several decades. And only sometimes, due to difficult childbirth or improper obstetrics, the process can be more rapid.

The patient may feel the first symptoms in the form of pain during intercourse.

As the disease progresses, the following symptoms appear:

A feeling of discomfort, which can be characterized by heaviness and excessive pressure in the lower abdomen.
Swelling of the external genital organs.
Depending on the displaced wall, urinary or fecal incontinence occurs.
Constant pain, drawing pains of a aching character in the lumbar region. Sometimes it can give to the groin area.
Menstruation disorder occurs.
The vaginal mucosa can become covered with erosions and ulcers.

At an early stage, a woman does not go to a doctor because she is not worried about anything. However, with a vaginal examination, which is carried out during a prophylactic examination, the gynecologist may see a slight sagging of the vaginal wall.

Later periods lead to the development of a hernial protrusion. In this process, the vaginal wall is a hernial sac, and contains a portion of the bladder.

A similar clinical picture can develop with the back wall of the vagina. With such a development of pathology, a part of the rectum will appear in the hernial sac.

Diagnostics of the prolapse of the vaginal walls

To make the correct diagnosis, in most cases, the gynecologist only needs to make a preliminary examination using a vaginal speculum, as well as a palpation examination.

After carrying out these measures, the organs that have fallen out are repositioned, along the way, the condition of the muscles of the pelvic floor is assessed. Additional examination methods are prescribed by a doctor.

Colposcopy.
Cystoscopy.
Excretory urography.
Ultrasound examination (sometimes transvaginal ultrasound is prescribed).
Consultation with a urologist, followed by the appointment of a urodynamic study.
In case of prolapse of the posterior wall of the vagina, a mandatory consultation with a proctologist.

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Prolapsed vaginal walls pregnancy and childbirth

At the onset of pregnancy, even in a healthy woman, the musculo-ligamentous apparatus is subjected to great stress. This is due to the growth of the fetus. In the case when the patient is diagnosed with prolapse of the vaginal walls, a favorable pregnancy outcome is possible only at the initial stage.

At the same time, throughout the entire gestation period, it is necessary to use the Kegel complex of therapeutic gymnastics, be sure to wear a bandage, or use a pessary (this is a plastic ring that is inserted into the vagina and increases its muscle tone).

Treatment features:

If the patient has a 2 or 3 degree of prolapse of the vaginal steno to, it is necessary to plan pregnancy after surgery. This will allow you to bear and give birth to a healthy baby.
Surgical intervention for prolapse of the vaginal walls is usually performed at 2 or 3 stages of the disease, when conventional methods of treatment do not give positive dynamics. The patient is prescribed colporrhaphy or colpoperineorrhaphy. Such operations are performed using general anesthesia. When they are carried out, the stretched muscles are sutured, and part of the vaginal mucosa is removed.
In the postoperative period, wearing a bandage is mandatory... But it should be borne in mind that after an operable intervention, physiological childbirth becomes impossible. To give birth to a child, you will have to resort to the Caesarean section.

To avoid this pathology, it is enough to show up for an appointment with a gynecologist once every six months, and without his appointment to engage in therapeutic exercises every morning.

Treatment of prolapse of the vaginal walls

To choose the right tactics for treating this disease, its degree is established. This can only be done by a doctor.

If this pathology is at the first degree of the disease, then the patient can be treated with a conservative method of therapy. At the third or fourth degree, the main tactic of treatment is surgical intervention, followed by preventive measures.

Conservative method of treating prolapse of the vaginal walls

This technique involves a set of measures to increase muscle tone. For this purpose, it is appointed:

Physiotherapy.
Massage.
Wearing a bandage or pessary.
Application of methods of folk medicine.
The transition to dietary food.
In old age, with the onset of menopause, it is possible to use hormone therapy.

Physiotherapy

The complex of therapeutic exercises is selected individually, you need to do it daily, preferably in the morning before breakfast.

To carry it out, you can use the following exercises:

"A bike". It is performed while lying on the floor, the legs are raised at an angle of 45 degrees (in relation to the floor), and movements are performed that resemble pedaling while cycling. Such an exercise, for the first time, is performed within 1 minute, daily exercise time is increased by 10 or 15 seconds.
"Scissors". Starting position, lying on your back. Straight legs rise 45 degrees in relation to the floor surface. The lower limbs alternately perform movements reminiscent of cutting with scissors. Initially, this exercise is also performed for no more than 1 minute.
In the supine position, alternately raise the right and left leg, up to an angle of 90 degrees. Start with 10 reps.
Having taken a position, while lying down, simultaneously raise, to an angle of 90 degrees, both limbs... The initial number of times is 10.
In a standing position, put a chair in front of you, grab its back, lift one leg to the side and up. Perform circular movements with the limb, for 30 seconds. Then do the same exercise, changing your leg.
In this position, you can perform alternate leg swings..
It is very good for the pelvic floor muscles to use "swallow" exercises.

The entire set of exercises should begin with a minimum amount of time and repetitions, and the increase in load should be done gradually.

Massage

For its implementation, a gynecological chair is used. With one hand, the gynecologist performs massage actions, inserting two fingers into the lumen of the vagina, the other hand, performs massage movements along the anterior abdominal wall.

The number of sessions should be at least 10, after which a short break is taken and a second course of massage takes place.

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A prerequisite for the entire course, the patient should sleep only on her stomach. The session lasts no more than 15 minutes; when severe pain appears, it is no longer prescribed.

Wearing a bandage and pessary

Bandage is a special swimming trunks with a high waist. Highly elastic jersey is used in their manufacture. Modern versions of this product make it invisible under clothes. With the help of special hooks located on the side, the degree of its tension is adjusted.

With the correct choice of tension, it does not hinder movement, is comfortable to wear and hygienic.

A pessary can be used to prevent sagging of the vaginal walls. These products are made of plastic or silicone and come in various shapes, most often in the form of a ring. The shape and size is selected by the gynecologist, individually, taking into account the physiological characteristics of the patient.

It is very important that the gynecologist installs the pessary for the first time.

After 2 weeks of wearing the pessary, you need to see a specialist. It can be worn for no more than 1 month, after which a short break is taken. It is imperative to treat with an antiseptic with each subsequent introduction.

Correct use of the uterine ring will allow:

In some cases, refuse the operation.
Will prevent the vaginal walls from falling out.
Avoid the unpleasant symptom of urinary incontinence.
Save and carry the child.

Diet

Particular attention must be paid to the correct diet. The food consumed should not lead to increased gas production in the intestines. It is also necessary to avoid constipation.

This requires:

Diversify the diet with vegetables and fruits.
Foods should contain large amounts of coarse fiber.
Exclude legumes from the daily diet.
Do not eat fatty fried meat.
If possible, use boiled food, liquid soups and cereals.
Monitor the intestinal microflora, if necessary, use laxatives and prebiotics.

Application of methods of folk healing

Therapy with medicinal herbs, with the help of which infusions of decoctions are made, gives a positive effect only at the initial stage of this pathological process. The use of traditional medicine recipes cannot be the main type of treatment; it is used as an additional method. In this case, the use of medicinal herbs should be agreed with the gynecologist.

To raise muscle tone and strengthen ligaments, you can use:

Quince fruits. You can make homemade tinctures from them. For this, the crushed fruits of dried quince (300 grams) are poured with 1.5 liters of hot water. Boil for another 5 minutes, then filter through cheesecloth and take a glass 3 times a day.
Infusion of lily roots. Half a spoonful of ground roots are put in a thermos, and half a liter of hot water is poured, insisted for half a day, and half a glass is drunk before meals.
Dandelion leaves. 20 grams of crushed leaves are poured with boiling water in a volume of 2 liters. After 3 hours, add to the hot bath.
Chicory... The flowers and stems of the plant are used. They are placed in a half-liter jar and poured with red wine. The tincture is considered ready after 20 days. It is filtered and consumed in 20 ml before meals.
Astragalus root can be infused with vodka, or 40 degree alcohol. To do this, you need to take 1 part of the roots, add 9 parts of alcohol to them. Put the resulting solution in a dark place for 15 days. Take only 5 ml before meals. The treatment course should not exceed 1 month.
Datura. Can be used for taking baths. To do this, 20 grams of grass is poured with boiling water with a volume of 7 liters. Then, for another 15 minutes, steam in a water bath. After cooling to 38 degrees, you can add to the bath. The duration of the bath should not exceed 10 minutes.
Tincture of barberry rhizomes.100 grams of ground roots are poured with 0.5 vodka. It is infused for no more than 1 week, and is used one spoonful, once a day, before meals.
Pass the shell of 5 raw eggs through a meat grinder along with lemon(necessarily together with the peel), the resulting mixture is placed in a glass container and sent to the refrigerator for 4 days (stirring from time to time). After that, add 500 grams of medical alcohol and leave to infuse for another 10 days. The tincture is ready, it can be consumed in an amount of 50 ml half an hour before meals. Be sure to drink it with water.
Herbal collection. For its preparation, it is necessary to mix the ingredients of lemon balm herb 50 g, linden flower 70 g, lamina 10 grams. After that, the contents can be twisted in a meat grinder, and pour a glass of boiling water. Can be consumed half a glass before meals, or as tea.

Surgical treatment of prolapse of the vaginal walls

If conservative treatment has not led to the appearance of positive results, or this pathology is at the level of 3 or 4 stages of its development. This provides the basis for an operable treatment technique for this abnormal development.

Surgical intervention can be carried out using 2 methods:

Colporrhaphy. It is produced to remove overgrown tissues and hypertrophied vaginal walls. With the help of these manipulations, the pelvic floor muscles are strengthened, and the correct location of the organs is restored. In turn, it can be used for prolapse of the anterior and posterior walls of the vagina.
Colpoperineorrhaphy. It is mainly used for pathologies that developed in the postpartum period. The posterior wall of the vagina is truncated (its length is reduced, and the muscles of the perineum are tightened).

Surgical intervention can consist of two stages. With an additional stage, the internal organs are sutured, which exert excessive pressure (due to their prolapse) on the vaginal walls.

This makes it possible to restore the anatomical location of these organs, after which they will restore their physiological functions.

Anterior colporrhaphy

Front wall pulling is carried out through the lumen of the vagina, this avoids the incision of the abdominal wall. As a result, the surgical intervention becomes less traumatic, it brings a little psycho-emotional discomfort to the sick woman.

Before surgery, women of advanced age, especially during menopause, are prescribed hormones. They increase blood circulation and normalize the process of tissue repair after surgery.

During the rehabilitation period, antibiotic therapy is prescribed, drugs of the analgesic group. The patient is given recommendations, including warn her about abstaining from sexual intercourse.

Posterior colporrhaphy

Its main purpose is to restore the septum between the rectum and the vaginal wall. The group of muscles holding the anus is sutured. This leads to a strengthening of the rectovaginal septum. If necessary, the removal (if any) of hemorrhoids, polypous outgrowths, treatment of the fissure of the anus and the sphincter of the anus occurs.

Colpopexy

This type of operation is rarely used, since it removes the consequences of prolapse, only temporarily. But if it is used in combination with colporrhaphy, then it gives a good positive dynamics in the treatment of this pathology.

The essence of this operable treatment is that the weakened vaginal walls are sutured to the ligaments and fascia of the inner walls of the abdomen. This type of surgical intervention has received a "second life" due to the use of advanced technologies in medicine and the use of new materials (polypropylene mesh is used).

Rehabilitation period after surgery

The recovery period can last from 5 to 20 days. It depends on the technique used during the surgery.

Patients are assigned:

Regardless of the type of operation, the passage of a course of antibiotic therapy. It is set individually by the doctor.
To eliminate pain, non-narcotic analgesics and antispasmodics are prescribed.
In case of disorder of the act of defecation (constipation), an enema is prescribed and if no urine is passed, a catheter is placed.
If the operation was not performed laparoscopically, intravenous, drip infusion must be prescribed.

When discharged from the hospital, a woman is given a number of recommendations that she must follow in order to prevent the re-development of the pathological condition:

Avoid eating food that provokes increased gas production. In case of constipation, take a laxative, if it does not help, resort to setting an enema.
Monitor the condition of the external genital organs, observe intimate hygiene in order to prevent infection of the seams, and the development of inflammatory processes.
Prevent the appearance of dyspeptic disorders in the form of diarrhea... It causes infection of the mucous membranes of the vulva and vagina, which leads to the development of inflammatory diseases, and prolongs the rehabilitation period.
To heal the stitches within a week and a half, the patient is forbidden to sit and squat down. Even when traveling by car, she should resort to a semi-sitting position. This will avoid stress on the perineum.
Sexual activity is not allowed for 60 days after surgery.
Avoid any physical activity for the first weeks, this also applies to homework.
Any sport is prohibited. They will be possible only after a control examination by a gynecologist, approximately in 2-3 months.
Baths, solariums, saunas, swimming pools in the first months are prohibited.
During the first half of the year after surgery wear a bandage.
Be sure to visit a doctor on the dates indicated by him. If any alarming symptoms occur, do not self-medicate, but go to the clinic.

A set of therapeutic exercises

During the rehabilitation period, the use of physical activity is not allowed, but after 2 or 3 months, the doctor prescribes therapeutic exercises. It should be dosed, and you should start using it gradually (records are not needed in this case).

You can use different types of exercises, of which make up a complex that will be carried out daily in the morning.

To do this, you can use the following exercises on all fours:

In a standing position on all fours at the level of inhalation, the right arm and left leg are raised. Exhaling, the limbs lower. The same action is performed alternately with the other hand and foot. For the first time, it is enough to repeat this exercise no more than 6 times. 2. The head is lowered, the muscles of the perineum are drawn in parallel, while a deep breath is taken. Exhaling, the head rises, with a smooth bending in the lumbar region. No more than 10 repetitions.
Bend your arms at the elbows and alternately raise and straighten the lower limbs, you need to do 12 reps with each leg.

Exercises lying on your back:

Place your hands parallel to the body, at the depth of inhalation, raise the legs, followed by their spreading to the sides, and gradually lowering them, making them close and exhale. The minimum number of repetitions is 8 times.
Put your hands under your head, close your legs together. While pulling in the muscles of the anus, lift in the pelvic region. Exercises are done slowly, 10 times.
"A bike""Done" in slow motion for 20 revolutions.
Alternate raising of the right and left legs. 8 repetitions per limb are allowed.
Taking your legs off the floor, support the lumbar region with your hands, try to touch the floor with the tips of your socks. The exercise is performed no more than 6 times, at a slow pace.
Raising straight legs up to 45 degrees in relation to the floor... Runs slowly 8 times.
Exercise "scissors". Alternate crossing of the legs, at an angle of 45 degrees, in relation to the floor. Runs 10 or 12 times.

All exercises are performed in slow motion, with mandatory breathing control. This is best done 2 hours before meals (before breakfast).

Kegel exercises to strengthen the vaginal walls

The main Kegel exercises include:

Compression and extension of the muscles of the perineum(mentally stop the stream when urinating). You need to start this exercise from 3 seconds, gradually increasing the load.
Alternating tension and sharp relaxation of the groin muscles.
Exercise reminiscent of labor pains. There is a sharp tension of all the muscles of the groin area, with the same sharp relaxation.
Exercise "lift"... Starting position, lying, legs bend slightly at the knees. The vaginal tube is mentally divided into sections (“floors”) along which an imaginary lift moves. At each site, there is a tension of specific muscle groups, after their relaxation, tension of the following occurs. When performing this exercise, increased concentration of attention is required. The voltage needs to be brought up to 10 seconds, on each floor-site. You need to start with 5 seconds.
Exercise "bag". This is the most popular Kegel exercise. Starting position standing. Legs are wider than shoulder width apart. Imagination suggests that there is a bag with long handles between the legs. It is necessary to grip the imaginary handles with the vaginal muscles, a short distance from the floor surface. At the same time, hold it for 10 seconds, and then lower it into place. This exercise trains the walls of the vagina very well, increasing their elasticity and muscle tone.

Prevention of prolapse of the vaginal walls

Preventive measures to eliminate this pathology should be carried out upon reaching the age of 18 years. This will contribute to the normal course of pregnancy and the smooth passage of labor.

To do this, you must observe the following rules:

Be sure to engage in physical exercise or gymnastics before childbirth, during and after their onset.
Follow an active lifestyle, go to the gym.
Use a set of Kegel exercises (especially during pregnancy).
Learn, during urination several times, to interrupt the stream.
Avoid lifting weights.
Observe the diet, avoid constipation and diarrhea.
Control and monitor your posture.

Medical professionals play an important role in the prevention of this pathology.

Since it depends on them:

Correct healing of the perineum with postpartum ruptures.
Rational management of childbirth, and the correct application of obstetrics.
Competent elimination of perineal muscle tears.

This pathology can lead to the development of serious gynecological diseases. Therefore, in order to eliminate the prolapse of the vaginal walls, in the early stages, use all possible conservative methods of treatment.

In the event that the disease was recognized only at a later date, agree on the date of the operation with the doctor, and do not postpone its implementation.

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Obstetrician-gynecologist of the highest category and author of articles woman-centre.com. For more than 20 years she has been successfully helping women to get treatment for gynecological diseases.

Prolapse of the vaginal walls or vaginal prolapse is an abnormal condition in the female reproductive system that mainly occurs in women who have given birth after fifty years due to a weakening of the pelvic floor, but it can also occur in women aged 30 to 45 years (forty cases out of a hundred) , as well as up to thirty years (ten cases out of a hundred). Vaginal prolapse is not always associated with childbirth; in three percent of cases, an abnormal condition develops in young and nulliparous girls.

Causes or mechanism of vaginal prolapse. Prolapse of the vaginal walls (prolapse) is expressed in a change in the anatomical location of the pelvic organs against the background of weakening of the muscles of the abdominal region and pelvic floor. Why is this happening? Due to the increase in pressure inside the abdominal region, the elasticity of the ligaments is gradually lost, because of which they are unable to keep the internal organs (in particular, the bladder, uterus, rectum) in the required physiological position. Hence, an increase in organ pressure gradually leads to a loss of muscle tone in the perineum and prolapse of the tissues of the vagina.

Many factors can contribute to the development of such a condition, including:

Congenital malformation of the connective tissue.
Increased intra-abdominal pressure (chronic constipation, frequent acute respiratory viral infections, accompanied by a cough).
Development of complications during childbirth (long-term childbirth, perineal trauma, large fetus, use of obstetric forceps during childbirth).
Sudden weight loss with obesity.
Tumor changes in the genitals.
Hard physical labor.
Surgery to remove the uterus when the vaginal dome has not been fixed.
Changes in the body that occur with age (loss of tissue elasticity (after 60 years)).
The number of births (after the birth of the second child, the risk of prolapse of the vaginal walls increases significantly).

The process of the course of the disease is characterized by a slow pace at the beginning and rapid progression in the future, often accompanied by diseases of an inflammatory nature.

In the course of the development of the disease, either the anterior or the posterior wall of the vagina can undergo prolapse, or both can be simultaneously. In clinical practice, the prolapse of the anterior wall is most common, which is inevitably accompanied by a prolapse of the bladder and urethra. When the posterior wall of the vagina descends, there is a high risk of prolapse or prolapse of the rectum.

The degree of vaginal prolapse.

The first degree is the prolapse of the posterior, anterior or both walls of the vagina, while the vulva itself does not go beyond the boundaries of the entrance.
The second degree is a partial prolapse of the anterior wall of the vagina with a part of the bladder (cystocele) or the posterior wall with a part of the rectum (rectocele), accompanied by the bulging of the walls outward.
The third degree is the complete prolapse of the walls of the vagina, mainly accompanied by prolapse of the uterus.

Signs of prolapse and prolapse of the vaginal walls. In the early stages of development, the disease does not manifest itself in any way. The first alarm bells signaling the disease are pain during sexual intercourse and a weakening of sensations during this process. Further, heaviness and pressure in the vulva may be felt, as the progression, inflammation, swelling of the genital gap, discomfort during urination, incontinence (urine, stool and gas), pulling pains in the abdomen, lumbar region join.

The prolapse of the anterior wall of the vagina most often manifests itself in the form of the development of chronic cystitis against the background of stagnation of urine, the posterior wall - in the form of constipation and a feeling of the presence of a foreign object in the vulva.

A complication of the prolapse of any of the walls of the vagina is often prolapse, and then prolapse of the uterus, which manifests itself in the form of excessive blood or bloody discharge.

Diagnosis of prolapse and prolapse of the vaginal walls. Identifying the disease is not difficult; when examined in a gynecological chair, the walls of the vagina and cervix protruding from the genital tract are noticeable. The doctor adjusts them, and then evaluates the condition of the pelvic floor muscles. In this case, an additional consultation with a urologist and a proctologist is mandatory.

Prolapse of the vaginal walls and pregnancy. Pregnancy with this condition is possible, but the degree of development of the disease should be taken into account. The first degree of the disease allows you to give birth without a preliminary operation. In this case, exercises to strengthen the pelvic muscles and the press will help. With a progressive degree of the disease, surgery, recovery is necessary, only then can you become pregnant. Otherwise, prolapse of the vagina is fraught with prolapse of the uterus.

And one more nuance, after the operation you will no longer be able to give birth on your own, a cesarean section is shown.

Treatment of prolapse of the vaginal walls. The prolapse of the vaginal walls, subject to early diagnosis, can be eliminated conservatively; in more advanced and complicated cases, surgical intervention is performed. Timely treatment significantly reduces the risk of complications.

Conservative therapy. Therapy is indicated for insignificant prolapse of the vaginal walls and is expressed in the use of a set of exercises, the purpose of which is to increase the muscle tone of the pelvic floor, including Kegel exercises (compression and relaxation of the muscles of the perineum), physical therapy. At the same time, therapy is prescribed for the general strengthening of the body, while nutrition is not of the last importance (no heavy foods that can cause constipation and complicate the problem).

During menopause, women are shown hormone replacement therapy in order to improve blood circulation and strengthen the muscles and ligaments of the pelvic organs.

If an operation is contraindicated for a woman for any reason, to prevent complete prolapse of the uterus, the patient is fitted with uterine rings (pessaries) - a device to support the internal organs is inserted into the vulva. The pessary is selected for each patient individually, after which regular observation by the gynecologist is shown, in order to exclude the development of serious complications (processes of a purulent and ulcerative nature, irritation and swelling of the mucous membrane, ingrowth of the pessary into the cervix or vulva). To prevent these phenomena, the doctor prescribes douching and washing the vagina. If the weakness of the vaginal muscles does not allow the introduction of the pessary, then a hysterophore is used - a device that holds the uterus through a pessary connected to a bandage attached to the waist.

Gymnastics (a set of exercises) with the lowering of the walls of the vagina at an early stage (can be used as a prophylaxis of the disease).

Exercises on all fours:

While inhaling, we raise the straightened right arm and left leg, while exhaling, we lower it. Do six reps. Then the same thing, only this time with the left hand and right leg.
While inhaling, we lower our head and draw in the muscles of the perineum, relax at the exit, raise our head and bend in the lower back. Do ten repetitions.
Bending your arms at the elbows, we alternately raise the right and left legs. Do twelve repetitions with each leg.

Exercises lying on your back.

Arms along the body, legs straighten and join together. Slowly as we exhale, we raise our legs, while inhaling we spread them to the sides, as we exhale we close them, while inhaling we return to their original position. Do eight reps.
Hands under your head, feet together. Raise the pelvis while pulling in the muscles of the anus. Do ten repetitions slowly.
At an average pace, we make the "bike" twenty revolutions.
Raise straight legs one by one. Do eight times with each leg.
We tear off our legs from the floor, put them behind the head, stretch our toes to the floor. Do six sets at a slow pace.
Raise straight legs (together) at an angle of 45 ° to the floor and come back. Perform slowly eight times.
We bend our knees (foot on the floor, arms under the head) and slightly spread them. We raise the pelvis from the floor, while spreading our knees wide and pulling the muscles of the anus inside. Do ten approaches.

Exercise should be done slowly and with control of your breathing. Do it two hours before meals or two hours later. The time for classes is not limited.

Kegel exercises.

We strain the pelvic muscles in steps, from low to maximum effort, each position should be fixed for a few seconds. We relax in the same way.
We delay urination for 10-20 seconds.
Moderate straining (as during childbirth).

Surgery for prolapse and prolapse of the vaginal walls (plastic of the vaginal walls). After examining the patient with the participation of a proctologist and urologist, the doctor prescribes treatment, taking into account the severity of the pathology, the degree of loss, the patient's age and the individual characteristics of her body. As a rule, surgical treatment with plastic elements is recommended. This is mainly colpoplasty, which involves suturing the vaginal walls. There are two types of colpoplasty:

Colporrhaphy - removal of "extra" tissues of the walls of the vagina and their stitching during prolapse and prolapse, the operation is aimed at restoring the anatomical location of organs by strengthening the muscles of the pelvic floor. It can be front and back.
Colpoperineorrhaphy is a contraction of the posterior wall of the vagina (against the background of hyperextension after childbirth) by suturing it and tightening the muscles of the perineum.

Surgical intervention is carried out using general anesthesia. The choice of the procedure for the operation is determined by the surgeon, taking into account the visual and video colposcopic examination, the analysis of the condition of the tissues of the walls of the vulva and the presence of concomitant diseases of the pelvic organs.

Postoperative period. After assessing the general condition of the patient after the intervention, the doctor discharges her, usually on the second day after the intervention. To prevent the development of complications and accelerate the recovery period, it is necessary to strictly follow all the doctor's recommendations, namely:

For the first five days, treat the perineum with an antiseptic.
Take antibiotics prescribed by your doctor.
For two weeks, to avoid overstrain of the operated muscles, do not sit.
In the first week, it is recommended to eat liquid or semi-liquid food in order to exclude the development of constipation.
Exclude physical, including sports activities for at least a month.
It is recommended to resume sexual activity no earlier than five weeks after the operation.

Modern equipment and microsurgery capabilities make it possible to carry out an operation with low trauma. After the intervention, there are no visible traces and scars on the body.

Prevention of prolapse of the vaginal walls.

Correct suturing of tears or incisions of the perineum during labor.
Compulsory physical education before childbirth, during and after.
Exercise to strengthen your pelvic floor muscles during gestation and after childbirth.
Learn to urinate in portions, squeezing the stream several times during one urination.
Protect yourself from carrying heavy loads.
Balanced nutrition, including during pregnancy.
Gentle conservative management of childbirth and prevention of maternal injury.
Learn to pull up the vulva while walking.

Treatment of prolapse of the vaginal walls with folk remedies. Treatment with traditional medicine can only have an effect at an early stage and in combination with other therapies prescribed by a doctor, including exercise.

Quince can be brewed and drunk in the form of tea, it gives tone to the muscles of the uterus. For 100 g of dried fruits and a liter of water, brew in a water bath.

Alcohol tincture of astragalus root is also considered an effective traditional medicine against this ailment. For a part of the chopped roots, take nine parts of vodka. Keep the mixture in a cool, dark place for two weeks. Then strain. Take three times before the main meal (breakfast, lunch, dinner) with plenty of water. The treatment course includes thirty days, if necessary, the course can be repeated after two weeks.

Mix 50 g of lime blossom and lemon balm each, add 70 g of white ash and 10 g of alder root. Grind the mixture. Take two tablespoons, boil 200 ml of boiling water and insist until it cools completely. Take half a glass three times daily before meals. The course of treatment is twenty-one days, after two weeks of a break, the course can be repeated.

Datura is effective as a sitz bath for partial drooping. Pour 20 g of grass with seven liters of boiling water and keep in a water bath for fifteen minutes. After that, the infusion should be cooled to 38 degrees. Use for a sitz bath, which lasts no more than ten minutes.

What to do with vaginal prolapse?

What to do with vaginal prolapse? At the first degree of pathology, it is possible to use conservative methods of treatment. These include: exercise, gynecological massage, and herbs. All of these methods are needed to increase the tone of the pelvic muscles and reduce the likelihood of vaginal prolapse.

There is another method of dealing with vaginal prolapse - a pessary, or otherwise - the uterine ring. It is located in the vagina, which helps to keep the cervix in a physiological position.

As a result, the uterus is in a slightly elevated state, since the pessary covers the cervix and holds the entire organ. It is rational to use such a ring with slight omission or in old age, with the expectation that age-related changes contribute to a decrease in organs in size and mass.

The disadvantage of a pessary is the need for frequent washing, as well as individual selection in volume. In addition, the use of a bandage is considered mandatory, which also supports the pelvic organs.

Vaginal prolapse treatment

The tactics of treatment are determined by the degree of development of the pathology, the age of the woman and the presence of concomitant diseases. It is customary to distinguish two directions in treatment - the conservative way and the operative one.

Conservative treatment of vaginal prolapse is used for the 1st degree of prolapse, when the structures of the vagina do not cross the border of the genital slit. It consists in limiting physical activity, lifting weights, conducting a course of gynecological massage, as well as performing special physical exercises.

Vaginal prolapse treatment focuses on strengthening the pelvic muscles, supporting structures and abdominal muscles, which keep the internal organs in their physiological position. In addition, in the process of massage and exercise, blood circulation in the pelvis is activated, which is also necessary for treatment.

Vaginal prolapse surgery

A method of treating pathology - an operation for prolapse of the vagina consists in carrying out colpoplasty, the essence of which is based on suturing the walls of the vagina. This type of surgical intervention is of two types: colporrhaphy and colpoperineorrhaphy.

The first form of surgery involves resection (excision) of the tissues of the vaginal walls, which are "stretched" with further stitching of the remaining structures. In the process of colpoperineorrhaphy, a decrease in the size of the posterior wall is carried out by suturing it, as well as a tightening of the pelvic muscles.

Vaginal prolapse surgery may involve an additional step involving the surrounding internal organs such as the bladder, urethra and rectum. To reduce the manifestation of symptoms of dysfunction of these organs, it is necessary to restore their physiological location.

Plastic surgery can take place with your own tissues or using implants. Surgery is performed under general or epidural anesthesia. The choice is based on the scope of the proposed operation, its duration and the state of health of the woman.

Surgery for lowering the anterior vaginal wall

In order to tighten the organs, ensuring their physiological location, and prevent the formation of new defects that can provoke a relapse, an operation is used when the anterior vaginal wall is pushed down.

In addition, surgery improves a woman's sexual performance and is used to treat urinary incontinence.

Surgery for lowering the anterior vaginal wall is called anterior colporrhaphy. Modern equipment provides the use of vaginal access, which is less traumatic than laparoscopy and access through the abdominal cavity.

The preparatory period before surgery includes the use of hormonal agents, especially for women in menopause. They are necessary to improve local blood circulation, which has a positive effect on the postoperative recovery period.

After surgery, it is necessary to use antibacterial drugs to prevent infection of the operated lesion, as well as pain relievers, with the exception of aspirin. In addition, it is recommended to abstain from sexual activity for at least a month.

Surgery for lowering the posterior wall of the vagina

An operation is performed when the posterior wall of the vagina is lowered to resect the intestine, which protrudes towards the vagina and exerts pressure on its posterior wall, and in order to restore the rectovaginal septum.

Surgical intervention consists in eliminating intestinal protrusion, strengthening the wall (anterior) of the rectum, the septum between the intestine and the vagina, as well as in normalizing the function of the sphincter of the anus.

Surgery for lowering the posterior wall of the vagina involves suturing the intestinal wall with a group of muscles that raise the anus, which helps to strengthen the septum between the organs.

In the presence of concomitant pathology and involvement of the surrounding organs in the pathological process, the volume of surgical intervention increases to eliminate the physiological location of the structures.

So, a combination of the main direction of the operation with the treatment of prolapse of the anterior vaginal wall, hemorrhoids, polyposis formations or anus fissures is possible. As a result, the time of surgical intervention is increased. In addition, in some cases, endoscopic treatment with a mesh implant is allowed.

Exercises for lowering the vagina

The close connection of the vagina with the uterus predisposes to their joint prolapse, first the vagina, and then the uterus. Exercises for lowering the vagina have a strengthening effect on the muscles, with the help of which the organs maintain their physiological position.

The maximum result can be obtained when using these exercises at the initial stage of vaginal prolapse, since in addition to it, the surrounding structures are not yet involved in the pathological process.

The simplest exercise to exercise is to stop urinating by tightening the muscles. Stopping the jet from time to time during urination will help strengthen the muscles and combat urinary incontinence.

Vaginal prolapse exercises should be done at different rates throughout the day. Of course, you should not constantly train, but 3-4 times a day, several exercises will help to normalize muscle tone soon.

The workout can be done while sitting at the computer, standing at a bus stop, or at home in the "lying" and "standing on all fours" positions.

Kegel exercises for lowering the vagina

Before you start doing the exercises, you need to determine which muscles will have to work and where they are. To do this, during urination, try to stop the stream and remember how this is done. These muscles will have to be trained in the future.

Kegel exercises for lowering the vagina include 3 types of performance. Firstly, this is the contraction of those very detected muscles. However, the execution should be slow, squeezing the muscles you need to count to 3 and slowly relax them.

After that, you need to do the same thing, only quickly. And, finally, "pushing out" is performed by tension of the abdominal muscles, as in childbirth, but much weaker.

In order to control the correctness of the exercise, it is recommended to insert a finger into the vagina and monitor the contractions.

First, you need to start with 10 times of each exercise, performing 5 times a day, and then gradually increase the load. After a week, add 5 repetitions to each exercise, and so on until you get 30 times. To maintain the effect, you can stop at this load and perform these 3 exercises 30 times 5 times a day.

Bandage for lowering the vagina

The prolapse of organs occurs due to the loss of the muscular frame that supports them. So, after pregnancy and childbirth, muscle relaxation is most often observed to such an extent that vaginal prolapse is possible.

The bandage for lowering the vagina is necessary in order to maintain constant intra-abdominal pressure without lifting, which affects the location of the uterus and vagina. The bandage gives the muscles time to restore their tone and strengthen the organs in physiological positions.

Although effective, the vaginal lowering band should not be used continuously as the organs need rest. So, at night it is not rational to use it, since neither gravity nor pressure contribute to the prolapse of the vagina.

During even little physical activity (walking, doing housework), you must wear a bandage to support the organs. In addition, it is mandatory after operations on the uterus and vagina, since the muscles in the postoperative period are the weakest and are not able to perform the main function.

Folk remedies for vaginal prolapse

For the purpose of treating a pathological condition, it is recommended to simultaneously use physical exercises and folk remedies for prolapse of the vagina. For this, a collection of herbs is used, taken orally, in the form of baths or douching.

For the broth, you need to take lemon balm and linden flowers - a quarter of a glass each, white lamb - 70 g and alder root - 1 dessert spoon. After thorough grinding, you need to select 30 g of the mixture and pour boiling water in a volume of one glass.

The broth should be infused for about 1 hour, after which it should be filtered and taken in 100 ml three times a day before meals for half an hour. The duration of the course is 20 days, and then a break is needed - half a month.

For douching, you will need to prepare a solution from quince, which must be crushed and filled with water, the volume of which is 10 times the quince. After boiling for 25 minutes, the broth should be filtered and cooled to a warm comfortable temperature. Douching with this solution helps to increase muscle tone.

Exercise therapy for vaginal prolapse

Exercises should be repeated every morning before meals, starting with the minimum load and gradually increasing it. Exercise therapy during vaginal prolapse helps to restore the previous muscle tone and strengthen them for a longer time.

"Bicycle" is an exercise that has been familiar to everyone for a long time. To perform it, it is enough to lie down and pedal an imaginary bicycle for about a minute, raising your legs 45 °. In the same way, "scissors" are performed, but with straight legs.

Lie on the floor, put a twisted roller under the buttocks, while the back remains on the floor. The left leg must be lifted straight up to 90 °, and then lowered and changed to another. Repeat up to 8-12 times.

The exercise becomes more difficult, removing the roller, you should simultaneously raise both legs to an angle perpendicular to the floor. Standing near a chair, you need to stick to it and take your leg to the side in order to perform circular movements for 30 seconds. Then change direction and then leg. Also, while standing, you need to swing your leg up to 7 times each, stand in the "swallow" pose - for about a minute.

Vaginal prolapse can bother women at any age, but there is an effective way to prevent muscle weakening - this is physical exercise, so if you want to, you can independently reduce the chances of developing pathology.

Feelings of an unpleasant nature in the vagina during physical exertion, compression of the pelvic floor muscles, and intimate life are a reason for a woman to consult a specialist. The problem may lie in the displacement of the body of the uterus and fraught with serious consequences and a threat to the health of a woman.

Symptoms of the disease

The body of the uterus is displaced unevenly, the back or front surface descends downward. The process of lowering the posterior wall of the vagina, in which there is pressure on the rectum, is called rectocele. The early stage of this disease is almost asymptomatic.

The first thing that a woman begins to feel is pain during sex. For the disease in later stages, the following symptoms are characteristic:

At the last stage, a woman can no longer have sex. Simultaneously with the prolapse of the body of the uterus, erosion and other inflammatory processes occur.

Methods for treating vaginal prolapse

The method of treating rectocele depends on the degree of prolapse; for this, ultrasound studies, urography, colposcopy are prescribed, laboratory tests are taken, smears and feces are examined.

Prolapse of the uterus is a serious disease, ignoring which always leads to irreversible consequences.

Early diagnosis will allow you to get rid of this problem at the first stage and avoid unpleasant consequences. What to do if a descent of the back wall is diagnosed with moisture, this disease is treated with an operative method, laser correction or conservative treatment.

Laser correction is a modern non-surgical method using modern technologies. This is the safest and most effective treatment for rejuvenating and restoring the turgor of the vaginal walls.

Surgical intervention is performed at 2 and 3 stages of displacement. During a surgical operation, surfaces are tightened and sutured, implants are implanted to fix organs. In addition to the above methods of treatment for vaginal prolapse, drug therapy is prescribed, as well as a gymnastic complex.

Surgical intervention

If the treatment of prolapse was not started on time, with advanced stages, the only way to eliminate organ prolapse is to use a surgical scalpel. Modern surgery offers women diagnosed with prolapse of the back wall moisture to perform an operation and at the same time plastic surgery. This type of colpoplasty is called posterior colporrhaphy.

The purpose of the operation is to remove excess tissue, narrow the vaginal opening, and restore the anatomical location of organs.

This surgery has its own characteristics. The surgeon needs to remove the extra tissue flap on the vaginal wall adjacent to the perineum. The size of the cut fabric should be such that the seams do not come apart after overstraining.

The first 3 - 4 days, patients are assigned to bed rest, the woman is under the supervision of a doctor in a hospital. The rehabilitation period after colporrhaphy lasts 1.5 months. At this time, you cannot:

lift weights;
do sport;
have a sex life;
consume foods that contribute to constipation.

Among the contraindications for colporrhaphy are venereal diseases, heart disease, acute stages of thrombophlebitis.

Conservative therapy

In milder forms of prolapse, the following help to restore the anatomical location of organs:

introduction of supporting devices (pessary);
physiotherapy;
diet;
wearing a bandage;
drug therapy;
folk remedies.

A woman who uses corrective rings must wear a bandage, observe the strictest hygiene and see a doctor.

A strict diet of plant fiber also helps. Foods with a high percentage of fiber help the easy passage of feces through the intestines. It is recommended to take laxatives and eubiotics that restore the intestinal microflora.

Along with diet, pharmaceuticals and physical therapy, it is recommended to use recipes from traditional medicine to help increase muscle tone. These are douching and baths with quince solution, decoctions inside from lemon balm, alder, linden color, white ash.

It is necessary to wear a supportive bandage for rectocele, especially for women after childbirth, when muscle tone is weakened. You cannot wear the device all the time, the body must get rest.

Exercise therapy and Kegel exercises

Physiotherapy exercises and special Kegel exercises will help restore the anatomical positions of organs and strengthen muscle tone. Exercise therapy is carried out at the first stage under the supervision of an instructor; in the future, a woman can perform a simple gymnastic complex on her own.

Exercises allow you to get the greatest therapeutic effect:

"A bike". It is performed lying down, at a slow pace, 20 times.
Raising the legs from a lying position. 8 times.
Raising the pelvis with squeezing the muscles of the anus and vagina. The legs are bent at the knees, the knees are together, the arms are either along the body or under the head.
"Birch". Raising straight legs up, hands support the back.
Institution of the legs behind the head, lying on the back.
Simultaneous raising of the right arm and left leg from the "on all fours" position. 6 times, then change arms and legs.
"Cat". The position "on all fours", slow breathing, alternate deflections in the lower back. 8 times.
"Plank". It is performed on straight arms or elbows. 15 - 20 seconds.

The Kegel complex is effective for genital prolapse. These are three simple but effective exercises: stepped tension and such relaxation of the pelvic muscles, delaying the stream during urination for a few seconds and moderate attempts, as in labor.

Non-surgical treatment

Specialists in aesthetic gynecology are successfully dealing with the problem of restoring the tone of the muscular structures of the vagina. Laser correction is performed using special medical equipment and takes up to 30 minutes. This non-invasive treatment is performed with a laser beam. With the help of a laser, excess tissue is heated and evaporated. Such technologies contribute to better regeneration, increased blood circulation, and the production of collagen fibers.

After the laser procedure, normal turgor is restored, the tissues acquire elasticity, and the volume of the vagina decreases. Discomfort disappears, the normal process of urination is restored.

The cost of laser therapy in aesthetic gynecology clinics depends on the degree of wall prolapse:

The prolapse of internal organs is a serious pathology, it is dangerous with unique consequences. The sooner the disease is diagnosed, the faster it can be cured.

Treatment of prolapse of the vaginal walls according to the recipes of the newspaper "Vestnik HLS".

Kegel exercises can help you do without surgery
A 47-year-old woman turned to the newspaper: she was diagnosed with prolapse of the vaginal walls, and an operation was proposed. But she is afraid to go under the knife. I heard that exercises help to cope with this problem. Asks for information on these exercises.

The doctor-gynecologist A. I. Shashina is in charge. The main reasons for the prolapse of the vaginal walls are prolonged leg work or work associated with lifting weights. These two reasons in 99% of cases will lead to the development of this disease. Therefore, first of all, a woman needs to reconsider her lifestyle, change her job.

The exercises that the reader writes about were developed by the German gynecologist Arnold Kegel. They strengthen the pelvic floor very well.

These are the exercises.
1. First you need to learn how to compress and unclench the muscles of the perineum. Tighten them as if you are trying to stop urination. Hold the muscles in this state for 3 seconds. Relax.
2. The same exercise, but at a fast pace - quickly contract and relax these muscles.
3. Squeeze the muscles of the perineum and stay in this position as long as possible - 1-1.5 minutes.
4. Imagine that you need to push something out of the muscles of the perineum. Tighten your muscles (push) with medium strength. Try to hold this position longer.
Kegel exercises can be performed in any position, it does not matter of fundamental importance, even sitting, even lying down, even standing. If only the woman herself was comfortable doing them.
For the first week, do each exercise 10 times, 3-5 sets per day.
In the second week - 15 repetitions.
In the third week - 20 repetitions.
So keep increasing the number of repetitions until you get to 100 times. Gradually, the pelvic floor muscles will become so strong that no surgery is needed for the prolapse of the vaginal walls.
(HLS 2015, No. 8, p. 22).

Discomfort in the vagina with tension or contraction of the anterior abdominal wall, forcing a woman to consult a gynecologist. Sometimes it can occur at rest, as well as during sexual intercourse.

Similar unpleasant symptoms can be caused by prolapse of the vaginal walls (vaginal prolapse). This is a serious disease that requires careful diagnosis and comprehensive treatment.

Reasons for the prolapse of the anterior (posterior) wall of the vagina

There are a lot of factors that can contribute to the onset of this pathology, and these include:

prolapse of the back (front) wall of the vagina after a difficult birth, or as a result of ruptures and other injuries received during the birth process;
pathology of the processes of microcirculation of lymph and blood in the pelvic region;
dysplasia (systemic insufficiency) of connective tissue;
systematic lifting by a woman of significant weights;
obesity;
physical inactivity, insufficiently mobile lifestyle;
violation or decrease in the production of estrogen;
bronchial asthma, bronchitis or constipation - these diseases contribute to an increase in intra-abdominal pressure.

The degree of development of pathology

Experts divide vaginal prolapse into three degrees, which differ in the severity of the pathology:

the first degree - a moderate prolapse of the walls (both or one), caused by the pressure of the organs displaced downward;
with the omission of the walls of the vagina of the 2nd degree, the pressure on them from the side of the uterus or other internal organs increases several times. Often this is accompanied by the presence of the body of the uterus in the vagina, and the cervical pharynx - almost on the eve;
the third degree of prolapse, the most severe - eversion of the walls of the vagina outward and even prolapse of the uterus.

In addition, vaginal prolapse can be caused by the displacement of specific pelvic organs. So, share:

cystocele - prolapse of the anterior wall of the vagina, under the pressure of a pathologically displaced bladder. It is due to weakened muscles or stretched ligaments that hold it;
rectocele - prolapse of the back wall of the vagina, experiencing intestinal pressure.

Symptoms of vaginal prolapse

The prolapse of the walls of the vagina does not occur by itself - it is a symptom of a general change in the location of other internal organs in this area - they create pressure on the walls of the vagina.

Some of the symptoms of this pathology are felt by the woman herself, but the exact diagnosis is made by a specialist doctor during a detailed examination.

Often this is accompanied by uterine hypertrophy, polyps of the cervical canal, pseudo-erosion. As a result of what is happening, dryness of the vaginal mucosa, its thickening or thinning, is manifested.

In the study, it often turns out that microcirculation is impaired due to sclerotic changes in the lymphatic and blood vessels.

Already in the first stages of the disease, women feel painful impulses in the lower back, lower abdomen, experience difficulty with active movements, and her ability to work is noticeably reduced.

There is tissue irritation, itching, severe dryness of the mucous membrane. This often leads to the appearance of erosions (ulcers) in the vaginal area. Sex with vaginal prolapse is painful.

The prolapse of organs provokes frequent urination, urinary incontinence, sometimes the opposite reaction occurs - urinary retention.

Almost always, vaginal prolapse is accompanied by intestinal dysfunction - constipation occurs, uncontrolled gas separation, hemorrhoids appear, and there are cases of fecal incontinence.

Treatment

In the treatment of prolapse of the vaginal walls, both surgical and conservative methods can be used.

Conservative methods

These include the establishment of a pessary. Made of silicone or plastic, this internal organ support device is inserted into the vagina. Such a procedure is rarely resorted to, only when urgently needed.

The device is selected individually for each patient. Women who have it installed are under the constant supervision of a specialist, since complications are possible:

irritation and swelling of the vaginal mucosa;
ulcerative and purulent processes;
ingrowth of the installed pessary into the tissue of the cervix or vagina.

To prevent these phenomena, the doctor prescribes douching, rinsing, it is possible to change the model of the device.

Such treatment is allowed only with moderate prolapse of the vaginal walls. If it is not possible due to weakness of the vaginal muscles, a hysterophore is used. This device helps to hold the uterus with a pessary tied to a band that is attached to the waist.

Such methods are a typical palliative, which almost never leads to a complete recovery. Therefore, most often the most effective is surgical intervention, unless it is clearly contraindicated.

Surgical methods

The technique of surgical intervention is chosen by a specialist depending on the degree of development of the pathology, the patient's age and the individual characteristics of her body.

colpoperineorrhaphy - this operation is performed on the back wall of the vagina, with prolapse of the rectum into the vagina. It is sutured and levatoroplasty is performed, which ensures the retention of organs in the pelvic cavity;
on the front wall of the vagina, an operation is performed to raise and fix the bladder when it descends, and to release the vagina from its excessive pressure;
median colporrhaphy is performed with vaginal prolapse. Such an operation is recommended for women beyond reproductive age, when the use of other radical methods is not recommended. The operation is easily tolerated and in most cases has favorable results;
colpoperineocleisis (incomplete closure of the vagina) is also performed in elderly patients. The operation narrows the vaginal cavity, forming a dense septum that absorbs excess pressure from the abdominal cavity;
the method of vaginal-vesical interposition is used for combined prolapse of the anterior wall of the vagina, uterus and bladder. During the operation, the round ligaments are shortened and fixed, which will create support for the organs fixed in their normal position. After this operation, pregnancy is excluded. In general, the technique gives good results without complications;
If the prolapse of the vagina is directly related to the displacement of the uterus, then, depending on the indications, operations are performed to fix this organ in the abdominal cavity (ventrosuspension or ventrofixation), partial resection followed by plastic surgery ("Manchester" operation) or even complete amputation.

Gymnastics or Kegel exercises for lowering the vagina

Gymnastic exercises give a good effect in lowering the vagina. Performing them, you must definitely monitor your breathing.

The exercises are performed while lying on their backs or standing on all fours.

Lying on your back exercises

Standing on all fours

while inhaling, you need to lower your head, stretch your right arm up, and raise your left leg and stretch it back, lower your leg and arm as you exhale. The same is done with the right leg and left arm. Repeat the exercise 6 times;
the head is lowered down on inhalation with a simultaneous contraction of the muscles of the perineum. Then the muscles are relaxed on exhalation, the head is raised and the spine is flexed. You need to do this exercise 10 times;
lean on your elbows, take turns to raise your left and right legs up. The exercise is repeated 12-14 times.

Kegel exercises

There is a well-known set of Kegel exercises that allows you to strengthen the muscle walls of the pelvic region. They are simple and accessible to every woman at any time of the day:

the so-called "lift" of Kegel. The pelvic muscles are strained in steps, from small to maximum efforts, always fixing each position for a few seconds. Relaxation is done in the same manner;
a delay in urination for 10-20 seconds - this will not bring harm, but it will help to strengthen the muscles and ligaments;
moderate straining, as in labor;
regular performance of such exercises will become a reliable assistant for a woman in resisting the extremely unpleasant syndrome of prolapse of the vaginal walls.

It is therapeutic gymnastics that becomes the main tool that helps to completely get rid of such a pathology without resorting to surgical intervention.

Vaginal prolapse is positioned as a pathological condition of the female genital organs. The main cause of this disease is the weakness of the pelvic floor muscles.

Recently, this disease has rejuvenated. So, ten out of a hundred patients with such problems are not even thirty years old. About twenty percent of all cases are women aged 30 to 45 years. Moreover, not in every case the reason lies in the fact that a woman has recently given birth to a child. So, there are isolated cases when the disease affected young girls and even virgins.

Why does prolapse occur?

Looks like a visual and physiological change in the normal placement of internal intimate organs. At the same time, the muscles of the abdominal region and the pelvic floor are weakened. This is because too much pressure was recorded inside the abdominal region, which led to a deterioration in the elasticity of the ligaments. It turns out that they can no longer keep internal organs in their normal placement. This means that the woman loses muscle tone, and the tissues of the vagina begin to sink down.

There are many reasons for the development of pathology:

Anomalies in the development of connective tissues may well be congenital,
Intra-abdominal pressure was excessively increased (respiratory viral diseases, constipation),
Birth complications (too long labor, trauma to the vagina, the baby was large enough, obstetricians were forced to use forceps),
A sharp drop in body weight,
Surgical intervention to remove the uterus without subsequent fixation of the vaginal dome,
Age-related changes. After sixty years, the prolapse of the vaginal walls affects a lot of women, because at this age the elasticity of the tissues gradually deteriorates.
Several genera. If a woman gives birth two or more times, then the risks of prolapse of the vaginal walls become much higher.

How does the disease develop?

The disease is characterized by a rather slow rate of development at the very beginning and active progression, provided that it is not treated in time. Plus, it can lead to inflammation.

The disease affects either the anterior or posterior wall of the vagina. However, it also happens that both walls go down at once. Practice shows that it is the lowering of the front wall that is the most frequent. At the same time, in addition to everything, the woman's bladder with the urethra also begins to descend. If the back wall of the vagina falls, parallel prolapse or even prolapse of the rectum begins. For this reason, the patient should be ready for a full examination by several specialists of different profiles at once, because this is the only way to achieve complete recovery.

How to know about prolapse and prolapse of the vaginal walls?

In the early stages, this disease does not manifest itself at all. The only thing a woman can pay attention to is painful sensations during intercourse. In addition, some heaviness and a feeling of increased pressure in the vulva may begin, after which inflammation, swelling of the vaginal opening, and unpleasant urination begins. Incontinence of urine, gas and feces can also be recorded. In the abdomen, pulling pains begin, the lumbar region experiences increased stress.

The prolapse of the anterior vaginal wall is often accompanied by chronic cystitis due to urinary stagnation. The back wall brings the feeling of a foreign object (fullness) to the vulva.

Diagnosis of the disease

Only a gynecologist can detect a disease in the early stages during an examination on a gynecological chair. The doctor can easily notice the walls protruding from the vagina. First, the gynecologist carefully adjusts them, and then assesses the condition of the pelvic floor muscles. After that, the patient is referred for additional examinations to determine if there are additional problems.

Is it possible to get pregnant with drooping vaginal walls?

- this is not a sentence for women who want to feel the joy of motherhood. There are many examples when both young and older women, after such cases, could still give birth to a child. However, it is necessary to focus on the stage of development of the disease. So, if the disease is in the first stage, it is possible to become pregnant and give birth to children, even without prior surgery. If the disease is at the second or more stage, an appropriate operation must be performed. Only under this condition can a woman become a mother. Otherwise, the risk of prolapse of the uterus cannot be avoided.

It is also important that after an operation to restore the muscles of the vagina, a woman will not be able to give birth on her own: the child will be born exclusively by cesarean section.

Vaginal prolapse treatment

Such a disease, depending on the stage, can be treated both conservatively and promptly. The risk of complications with any of these approaches will be minimal.

Conservative therapy consists of specific exercises that work to develop and strengthen the pelvic floor muscles. In addition, the doctor prescribes a specific diet, which must be strictly followed.

The operation is prescribed in difficult stages that conservative therapy cannot cope with. It is carried out mainly under general anesthesia, but local anesthesia is also possible at the second stage. Recovery after surgery takes several days.

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Prolapse of the vaginal walls (vaginal prolapse) is an anatomical abnormality resulting from weakening of the pelvic floor tissues. The walls are displaced towards the perineum.

Pathology is common among women after 30 years of age.

The Center for Gynecology, Reproductive and Aesthetic Medicine www.ginekologi.pro employs specialists with extensive experience. They individually select the method of treatment for each woman in accordance with the features of the anatomical structure.

The structure of the vagina

The vagina is an extensible organ that is about 7-12 centimeters long. It connects the cervix and the entrance to the genital opening. Consists of inner, middle and outer tissue layers.

According to the physiological structure, the vagina is divided into anterior and posterior walls, which are connected to each other.

The anterior wall joins the cervix and borders the bladder and urethra. The posterior wall in the upper part is bordered by the abdominal cavity, located next to the rectum.

The organ is held by the musculo-ligamentous system. The upper and middle part of the organ is attached to the pelvic bones and the lower part of the uterus. The muscles are responsible for holding the vagina in the lower part of the pelvic floor and closing it.

With the development of prolapse of the walls of the vagina, the functioning of the surrounding organs is disrupted.

Causes of pathology

The following factors can provoke the prolapse of the vaginal walls:

Complicated childbirth (delivery lasted more than 16 hours, in the process were used obstetric forceps, divergence of sutures and their incorrect imposition, natural childbirth of a large child).

The birth of two or more children, multiple pregnancies.

Connective tissue diseases.

Chronic daily constipation.

Frequent hacking cough, which strains the abdominal cavity.

Difficult working conditions requiring great endurance.

Surgery to remove the uterus.

Failure to comply with the prescriptions of the gynecologist in the period after childbirth.

Weakness of ligaments and muscles, inherited.

Operations on the uterus.

Tumors of the pelvic organs.

Age-related changes after entering menopause.

Violation of the anatomy of the rectovaginal septum.

It should be noted that the violation develops gradually over a long time.

Degrees and types of prolapse of the vaginal walls

The classification of vaginal prolapse divides pathology into the following types:

Descent of the front wall. It is diagnosed often. Symptoms increase gradually. First, there is aching pain in the lower abdomen, radiating to the lower back. Then discomfort is felt near the perineum, it seems that there is a foreign body in the genital slit. After a while, the functioning of the bladder changes - urination becomes more frequent, with the release of urine pain appears.

Lowering the back wall. Revealed less often. It is a consequence of a decrease in the elasticity of the muscles of the posterior fornix. The fascia is destroyed in whole or in part. The back wall is pressed inward and increases in size. There is a sensation of a foreign body in the vagina, as a result of squeezing the rectum, the woman experiences difficulty in defecating. There is pain when straining.

There are three degrees of omission:

1. Only the front or back wall is displaced by a few centimeters, while being located within the vulva. There is an incomplete closure of the labia due to the pressure of the uterus. The woman notes pain similar to discomfort in the premenstrual period, discomfort.
2. Displacement provokes displacement of the bladder and / or rectum. The muscles relax a lot, the walls protrude outward a little. The cervix changes its position, the uterine pharynx descends. The woman experiences signs of cystitis or constipation, pain with prolonged walking and sitting.
3. The vagina does not keep within the pelvic floor and completely falls out of the genital slit. The walls are turned outward. The mucous membrane dries up, and ulcers, erosion, cracks appear. A woman cannot sit and walk.

Pregnancy and childbirth with prolapse

Throughout the entire period of gestation, the risk of infection of the genital tract is increased. In addition, partial drooping of the walls affects the ability to conceive. If pregnancy has occurred, it may end in premature birth or miscarriage due to the weakness of the ligamentous apparatus.

Experts recommend that pregnant women do Kegel exercises. They not only strengthen the tissues of the genital organs, but also stimulate the relief of labor. To reduce the stress on the vagina, a rubber pessary is inserted. A woman must wear a bandage for all 9 months.

When the walls of the vagina descend, the process of delivery changes. The likelihood of injury to the muscular structures of the pelvis increases. The risk of developing ligamentous insufficiency increases.

Often, a perineal incision is made to prevent vaginal prolapse, which is most often not properly stitched.

If the episiotomy is not performed when the muscle tissue is weakened, then during childbirth, not only the walls of the vagina can fall out, but also the entire organ.

Often, childbirth is a provoking factor in the development of a severe degree of prolapse of the uterus due to a decrease in muscle and ligamentous tone, non-observance of proper nutrition and the occurrence of constipation, and heavy lifting in the early postpartum period.

To avoid the above problems, it is necessary to eliminate the violation of physiology before planning pregnancy. The initial stage allows you to bear the fetus without surgical treatment, but with the strengthening of the muscles of the intimate area and abdominal muscles.

Diagnostics

Early degrees of prolapse are often similar to diseases of the urinary system. Vaginal prolapse is detected by:

Gynecological examination. The doctor determines the degree of displacement and opening of the perineum, the state of the cervix, the formation of hernial protrusion.

Ultrasound of the small pelvis. The state and position of the internal organs is being investigated.

General urine analysis. The inflammatory process is determined.

Bacterial urine culture.

Urogenital smear. The likelihood of infectious diseases and the cleanliness of the vagina are determined.

Excretory urography.

MRI. Tomography shows the size, position of the organs of the reproductive system.

At an advanced stage, a urologist, a surgeon and a proctologist are involved in the diagnostic process to determine the degree of complications. As a rule, pathology is visible with the naked eye.

Treatment methods

Based on the degree of omission, the specialist chooses different tactics for eliminating the disease.

Conservative treatment
Optimal at the first stage, when the organ is within the pelvis.

Often, a pessary is installed - a rubber ring that supports a woman's genitals. The size is selected individually. The structure is inserted diagonally, then straightens, resting against the bottom of the pelvis.

Surgery

The operation is prescribed when diagnosing the second and third degree of vaginal prolapse.

It is assumed that measures are taken to correct the intestinal cavity, restore the functions of the sphincters, and strengthen the wall bordering the intestine.

The surgery is called colporrhaphy. The procedure consists of suturing excess tissues of the posterior wall of the vagina to the muscle structures of the perineum and strengthening the septum. Suturing is necessary to remove the compression of the surrounding organs. It is carried out transvaginally.

Another operation is called colpoperineorrhaphy. It involves resection of excess vaginal walls and tightening of the muscular structures of the perineum.

In some cases, a mesh implant is sutured to prevent re-displacement.

Postoperative period

After the operation, antibacterial drugs are prescribed, the use of suppositories against inflammation, the use of local ointments and antiseptics.

During the rehabilitation period, it is important to observe the following recommendations:

Abstain from intercourse for one month.

You can't sit for 21 days.

You should eat liquid food.

It is necessary not to lift weights over three kilograms.

With the first and second degrees of vaginal prolapse, the prognosis of treatment is favorable. The anatomical position of the vagina is completely restored. In the third degree of pathology, in order to avoid relapses, it is necessary to strengthen the intimate muscles.

Gymnastics and Exercise

Exercise is effective as an adjunct to medication. Kegel gymnastics consists in alternating tension and relaxation of the genital tract muscles.

Exercises to strengthen the press and back are also prescribed.

Prophylaxis

Every woman wants to prevent pathology, not cure it. To this end, it is recommended:

Prevent constipation.

Strengthen the muscles of the intimate area, back, abdominal muscles.

Do not engage in weightlifting.

Follow the rules of recovery after childbirth.

Do not lift weights.

Perform gynecological massage after childbirth to improve blood supply.

The reason for the prolapse or omission of the walls of the vagina and uterus is the weakening of the structures and muscles of the pelvic floor, which leads to a violation of the physiology of the relative position of the pelvic organs - the uterus, rectum and bladder.

This disease is one of the most common among diseases of the female genital area: it is observed in a third of women who have reached the age of 45, and a tenth of women by the age of 80 undergo surgery to eliminate this phenomenon. What are the nuances of treatment for this phenomenon - we read further.

Causes

The prolapse of the vaginal walls is triggered by stretching the ligaments that hold the internal organs, and their subsequent pressure on the perineum. All this is exacerbated by dysfunction of the smooth muscles of the vagina and its strong stretching, as well as a weak tone of the pelvic floor muscles.

As a result, the back or front wall, or both at once, under the pressure of the uterus, bladder or intestines, move and can fall outside the genital slit. Prolapse of the walls in most cases is accompanied by prolapse of the uterus (its displacement, partial or complete exit beyond the genital slit).

Often, an ailment becomes a consequence of the following phenomena:

the birth of a large child;
traumatic or difficult childbirth;
multiple or prolonged childbirth;
removal of the uterus without simultaneous fixation of the vaginal dome;
obesity;
connective tissue diseases, dysplasia;
chronic cough.

Unfortunately, not a single woman can be one hundred percent safe and sure that this ailment will not affect her personally.

Varieties of pathology

Modern gynecology defines two main types of prolapse and prolapse of the vaginal walls in women, namely cystocele (prolapse or prolapse of the anterior wall) and rectocele (pathology of the posterior wall), as well as three main degrees of development of the disease.

Prolapse of the anterior vaginal wall

Cystocele is characterized by the prolapse or prolapse of the anterior wall and the prolapse of the bladder, which presses on the weakened muscular septum and the vaginal wall and squeezes it out until it completely falls out of the genital slit.

All this happens due to the weakness of the intimate muscles, as well as a rupture or severe sprain of the ligaments that hold the bladder in an anatomical position.

In the early stages, cystocele is usually detected during intense physical activity or a routine examination by a gynecologist. In more advanced cases, women feel like a foreign body inside the vagina, experience dryness or burning in this area, and feel it during washing as something protruding from the vagina.

Not infrequently, a tumor appears on the walls of the vagina, one of which is called a tumor-like formation on the wall of the vagina, which increases due to the accumulation of fluid in its cavity. If you notice the appearance of milk in your breast for no apparent reason - this is an obvious hormonal imbalance in the body, ...

In most cases, prolapse of the anterior wall is accompanied by partial urinary incontinence, especially during exercise, as well as prolapse of the bladder. In this case, the bladder is not completely emptied, urine stagnates in it, which easily becomes a breeding ground for infectious pathogens. Therefore, cystocele is also fraught with cystitis.

Descent of the back of the vagina

Rectocele occurs when the functions of the muscles of the pelvic floor of the posterior fornix are impaired, while the endotasic fascia is almost always disturbed or destroyed. The degree of development of the disease depends on the degree of failure of the latter.

Weakening of the muscles leads to prolapse of the vaginal walls

With rectocele, the woman also feels a foreign body in the vagina, which interferes with walking and sitting. Unpleasant sensations are accompanied by problematic stools. A kind of pocket is formed in the rectum, in which a large amount of feces accumulates. Therefore, in order to free the intestines, the patient has to push hard, and with an advanced form of rectocele, even help the intestines to empty out with a finger.

If the disease is not treated: the consequences

In the initial stages, the disease practically does not cause discomfort. As it develops further, it begins to disrupt the quality of a woman's life. However, most of them do not consider it necessary to go to a doctor for help and gradually get used to living with it. But this is fraught with a lot of complications:

Due to the kink of the ureters in the residual urine, infections can develop that lead to cystitis and pyelonephritis.

The prolapse of the walls of the vagina is accompanied by a displacement of the pelvic organs, a violation of their functions. As a result, patients are haunted by constant constipation and urinary incontinence.

The walls of the vagina and the uterus that protrude beyond the genital slit can easily get injured, for example, from friction against underwear. In addition, their significant displacement may be accompanied by impaired blood circulation. Subsequently, the tissues can swell and even die off.

If the disease is completely started, it will most likely lead to a complete prolapse and eversion of the uterus with all the attendant: infections, ulcers and others.

In addition, untreated pathology is a serious obstacle to normal pregnancy and successful childbirth. So, for example, the disease of the second and third stages is fraught with spontaneous abortion. A disease of any stage can cause rapid childbirth, which is dangerous for the mother with severe tears and bleeding, while the child simply does not have time to adapt to the new environment.

Postpartum weakness and stretching of the birth canal, supported by genital prolapse, is the cause of the lengthening of the postpartum period, which not only causes some inconvenience, but also is fraught with infection of the genitals.

Vaginal prolapse treatment

There are three radically different treatments. Treatment is almost always started with physiotherapy exercises, which can give excellent results and completely cure the patient. If physical education and the masses do not help, the doctor recommends to restore the physiological location of the pelvic organs by surgery. If it is impossible to carry out the operation, the pathology is eliminated by installing pessaries.

Intimate gymnastics: Kegel exercises

The set of exercises was developed by an American gynecologist about half a century ago. Having reached the present day, it has slightly changed, but the essence of the exercises remains the same.

The convenience of the complex lies in the fact that training is absolutely invisible to others, so you can practice literally everywhere and almost always.

The convenience of the complex lies in the fact that training is absolutely invisible to others

At home, exercises can be performed without a simulator, but training under the supervision of a specialist and using simulators gives much more significant results. Exercises should take place in stages.

Stage one: slow compressions

Tighten the muscles that are used to stop urination, you need to slowly, for a count of 3, then relax the muscles for three seconds. Over time, it is necessary to keep the muscles in a tense position, increasing this time to 20-30 seconds.

Stage two: dynamic contractions

The same muscles need to be tense and relaxed as quickly as possible. Start 20 times, gradually increasing the number of repetitions to 100 or more.

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