Uterine prolapse

What is uterine prolapse?

A combination of muscles and ligaments of the pelvis, called pelvic floor support the uterus and vagina, and keep these organs in their proper position within the pelvis.

Childbirth, and the process of normal aging and some diseases can weaken the pelvic floor and this can produce a prolapse (falling or output) of the uterus or the vaginal walls.

Prolapse of the uterus and the vagina becomes more common as women age and usually does not occur before menopause , except sometimes in some younger women with multiple births and very traumatic, or women with collagen diseases (fiber present in most tissues).

Prolapse of a woman is described in terms of the part or parts of the uterus and vagina that are involved:

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• If the front wall of the vagina (in the bladder) suffers prolapse, known as cystocele.
• Affected if the rear wall of the vagina (in front of the intestine), is known as rectocele.
• If the cervix undergoes a collapse that reaches beyond the entrance of the vagina (introitus), it is known as prolapse.
• Sometimes the prolapse only affect part of the vagina, or a combination can affect the vagina and uterus.

What kind of problems can cause uterine prolapse?

• Many women with prolapse do not suffer any symptoms and only discover they have it when they are examined internally for some reason. However, most women have symptoms and the most common is a feeling of "something is going down" or "package in their external genitalia."
• Sometimes a rectocele is associated with difficulty in passing stools, as well as a cystocele may be associated with loss of urine when coughing, laughing, or making any effort to exercise your abdominal muscles (urinary incontinence).
• Prolapse can also cause difficulty or discomfort in sex .
• It is likely to cough smoker make them more likely to develop prolapse, as the woman overweight and constipation .

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What is the treatment for uterine prolapse?

• The best option is to prevent prolapse first. It is recommended to do daily exercises to strengthen pelvic floor muscles. The exercises can be done anywhere and at any time simply by tensing the muscles of the pelvic floor, as if trying to stop the flow of urine or avoid deposition.
• Once the prolapse has already occurred, it is much more difficult to control the symptoms with exercise. A physical therapist will have the expertise and equipment to apply special techniques to stimulate and strengthen the pelvic floor muscles but often a pessary (a ring of celluloid or vinyl) or an operation will be necessary.
• In older women or those who do not want or can not undergo surgery, you can insert a pessary. This will keep the uterus and bladder in place without being noticed. The pessary is often changed or removed to wash it often and replace it every four to six months.

How is surgery performed?

The surgery is usually done through the vagina. The type of repair is determined by the type of prolapse present, but the idea is to unite with points weakened muscles of the pelvic floor to strengthen it being necessary to remove a portion of vaginal mucosa in most of these operations. Sometimes one is required hysterectomy (removal of the uterus) vaginally, but often can be removed only the cervix.

Repair operations often give very good results to eliminate the feeling of "something is going down" or "package", but is less likely to improve other symptoms that could have been blamed on prolapse as fatigue or back pain . If there is urinary incontinence, about two-thirds of women will have full control and have improved a lot after prolapse surgery including the front wall of the vagina near the bladder neck.

• Before the operation, the woman should try to lose weight if you are overweight and quitting smoking.
• The operation is very complex and usually has few complications, the duration is usually 30 to 60 minutes. Depending on the age of the woman and whether to have sex with vaginal intercourse, more or less close to the entrance to the vagina will be practiced.
• After surgery, women usually remain in the hospital three to five days. The subsequent recovery is rapid. Unfortunately, relapses are common.