What are the treatments for uterine prolapse?

Uterine prolapse is a common disease among middle-aged women. It is mostly caused by uterine damage during childbirth without good care. In addition to the first time, it is also closely related to certain diseases in women, such as cervical erosion. Patients will obviously feel the abdomen falling when squatting or walking. Mild cases will not affect life, but severe cases require timely treatment. Let us learn about the treatments for uterine prolapse.

1. Causes

The main reasons are damage to the cervix, cardinal cervical ligament and uterosacral ligament caused by delivery and failure of supporting tissues to return to normal after delivery. In addition, most women in the postpartum period like to lie on their backs and are prone to chronic urinary retention. The uterus is prone to become posterior, with the axis of the uterus in the same direction as the axis of the vagina. When the abdominal pressure increases, the uterus will descend along the direction of the vagina and prolapse will occur. Postpartum squatting habits (such as washing diapers, washing vegetables, etc.) can increase abdominal pressure and cause uterine prolapse. Uterine prolapse in nulliparous women is caused by poor development of the supporting tissues of the reproductive organs.

2. Clinical manifestations

The patient feels that his abdomen is falling, and the pain is more obvious when he walks and squats. In severe cases, the dislocated mass cannot be put back, affecting his movement. Due to long-term exposure to the outside, the cervix may develop thickening and keratinization of the mucosal surface or erosion and ulceration. Patients experience increased leucorrhea, which is sometimes pus-like or bloody. Some also experience menstrual disorders and excessive menstrual bleeding.

Uterine prolapse is the downward displacement of the uterus along the vagina. It can be divided into three degrees according to the degree of prolapse: First degree means that the level of the external cervical os is lower than the level of the ischial spine, but the cervix and uterine body are still located in the vagina. This degree of uterine prolapse does not require treatment and can be recovered by resting. Grade II means that the cervix has protruded out of the vaginal opening, but the uterine body or part of the uterine body is still in the vagina. However, because the range involved is too large, in mild cases only the cervix may protrude from the vaginal opening, while in severe cases the cervix may be elongated, causing the entire elongated cervix and vaginal wall to protrude from the vaginal opening. Grade II uterine prolapse is divided into mild and severe types: ① Grade II mild type: the cervix and part of the anterior vaginal wall prolapse out of the vaginal opening. ② Severe Grade II: The cervix, part of the uterine body, and most or all of the anterior vaginal wall protrude from the vaginal opening. Grade III means that the entire uterine body and cervix, as well as the entire anterior vaginal wall and part of the posterior vaginal wall, are protruding out of the vaginal opening.

3. Inspection

During the examination, the patient is first asked to cough or exhale to increase abdominal pressure, and observe whether urine overflows from the urethra to determine whether there is stress urinary incontinence. The bladder is then emptied and a gynecological examination is performed. First, pay attention to vaginal wall prolapse and uterine prolapse without exerting force. And pay attention to the condition of the vulva and the degree of perineal laceration. Use a vaginal speculum to observe whether the vaginal wall and cervix are ulcerated, and whether there is rectouterine hernia. During internal examination, attention should be paid to the condition of the anal levator muscles on both sides, the width of the anal levator muscle fissure, the position of the cervix, and severe uterine prolapse. The uterus should be returned for examination to determine the size of the uterus, its position in the pelvic cavity, and whether there is inflammation or tumor in the appendages. Finally, the patient is advised to apply abdominal pressure and, if necessary, squat to make the uterus prolapse and then perform palpation to determine the extent of uterine prolapse.

4. Diagnosis

The diagnosis is based mainly on physical signs and examination. Because surgery has a certain impact on subsequent vaginal delivery, it is only suitable for severe cases and women who are no longer fertile. Pessary treatment Pessary indications Pessary has been used to treat uterine prolapse for a long time. It can be controlled by the patients themselves, but it is not suitable for patients with severe uterine prolapse and excessive vaginal relaxation. The size of the pessary should be slightly larger than the genital (pubococcygeus muscle) fissure. The horizontal diameter of the fissure is generally four centimeters at most, so medium-sized pessaries are often used. After a period of time, the pubococcygeus muscle gradually recovers its elasticity, the tissue edema disappears, the weight is reduced, and the uterus will no longer prolapse after the prolapsed part is restored. The time of use is generally to put it in the morning before work, take it out and wash it at night. It is best not to use during menstruation. The surface of the plastic tray is smooth, it is not easy to deteriorate when exposed to acids and alkalis, and it has little irritation to tissues. After wearing the support, the symptoms disappear and the patient can participate in various activities without pain.

5. Notes

Rest in bed, and raise your hips or feet to the height of two bricks when sleeping. Do not get out of bed and move around too early after giving birth, especially do not engage in heavy physical labor too early. Avoid long-term standing or squatting, holding your breath, and other actions that increase abdominal pressure. Keep bowel and bladder function unobstructed. Treat chronic bronchitis, diarrhea and other diseases that increase abdominal pressure promptly. Breastfeeding should not exceed two years to avoid atrophy of the uterus and its supporting tissues. Do appropriate physical exercise to improve your physical fitness. Increase nutrition and eat more foods that have the effect of replenishing qi and nourishing the kidneys, such as chicken, yam, lotus seeds, dates, etc. Be moderate in sexual intercourse.

The above are the treatments for uterine prolapse, which basically cover all treatment methods. In addition to medication and surgical treatment, your daily conditioning is also very important. For example, you can do more high-leg exercises when you are free, and don’t stand or walk too fast often. If conditions permit, you can choose to practice yoga. There are many yoga poses that can help restore uterine prolapse.