Uterine Prolapse
Pelvic Organ Prolapse (POP) also known as uterine prolapse, is the bladder adjacent to the vaginal wall. It is the herniation of the large intestine and uterus parts by merging with the vaginal wall. Uterine prolapse, which is one of the common complaints, can cause problems that will affect the patient's daily life. It also causes sexual functions to be affected. If the condition in question is not treated, the body image will be damaged as well as some sexual problems will be encountered.
How Common Is Uterine Prolapse?
Those over 30 years of age and It is possible to see the complaint in 50% of individuals who give birth. In younger individuals, this condition can be seen at a rate of 3%. It is seen that 10% of all age groups have complaints about uterine prolapse.
“Uterine Prolapse can cause different types of complaints, and prolapse can be seen in different parts of the uterus.”
<Pelvic Support Anatomy
The support point of the pelvic organ is bones and muscles.Connective tissue It resists sagging by holding the interaction between the uterus and the pelvic floor muscles, pubococcigeus, and puborectalis ileococcigeus muscles. At this point, Fascia ensures that the organs remain together and in the correct position.
Pelvic Organ support is examined in 3 levels
What are the Causes of Uterine Prolapse?
It is possible to attribute the causes of uterine prolapse to several different factors. . When we take a look at these factors, we see that while births occurring at later ages are the priority, this class is followed by the obesity guru. Frequency of birth is also among the factors that cause uterine prolapse. 4/3 of uterine prolapse occurs due to birth and pregnancy. The type of birth will also be the main factor determining the risk of prolapse. When normal births are compared with cesarean births, it is seen that normal birth poses more risks.
“Births at later ages increase the rate of prolapse. Loosening of the ligaments holding the pelvic organ is more common after the age of 30.
It has been determined that this complaint is twice as common in individuals struggling with obesity and especially in patients in the BMI 25 group. It has been proven by clinical tests that weight loss reduces sagging. Considering racial data, when comparing African individuals and white individuals, it is seen that white individuals face sagging complaints on average 5 times more often. Individuals who have undergone hysterectomy have a high risk of herniation at the vegetal vertex. The patient's age and the conditions of the surgical method will be the main factors that determine sagging.
The likelihood of the disease being seen is higher in individuals who have had or have experienced connective tissue diseases, and in individuals who have had similar complaints in their family history. Additionally, individuals who have complaints of chronic cough and constipation due to heavy lifting are also included in this risk group.
How Can Uterine Prolapse Be Prevented?
There are many studies conducted in this field. However, it is not yet possible to talk about a direct solution that prevents sagging. However, if you are in the risky group, taking precautions at this point will undoubtedly make your job easier. Especially large Early cesarean section is performed for babies. In addition, continuing kegel exercises during birth and pregnancy will be one of the main elements that strengthen the pelvic muscles. Again, kegel exercise provides recovery in mild sagging.
As for obesity, it would be correct to mention that losing weight will reduce the risk on its own. Again, muscles can be strengthened by eating healthy and continuing kegel exercises. The best move to prevent sagging caused by chronic diseases such as cough and constipation is undoubtedly to receive treatment for these complaints. It is of great importance that employees, especially in heavy jobs and jobs where heavy lifting is required, improve the working conditions in question. Estrogen hormone, which should be used during menopause and quitting smoking to end the chronic cough seen in smokers, will greatly strengthen the vaginal connective tissue.
Symptoms and Complaints Caused by Uterine Prolapse
The feeling of fullness and pressure in the vagina are the most important symptoms of the disease in question. In addition to urinary incontinence, which is one of the biggest symptoms, it will be inevitable to feel pain during sexual intercourse. In many cases, sexual intercourse will not occur. Problems with defecation are also among the symptoms of this period. These effects may vary depending on the nature and size of the sagging. While sagging is felt much less in supine positions, it will be inevitable for complaints to increase in the morning after sleeping and after walking a little. There are no visible symptoms of vaginal prolapse. A visible symptom will occur only in cases where severe sagging occurs and extends outside the vagina. Hearing a sound during sexual intercourse can also be considered a sign of uterine prolapse.
“The hymen level is accepted as the threshold required for the symptoms to reach a visible level.”
How is Uterine Prolapse Diagnosed?
In order to make a definitive diagnosis of uterine prolapse, an examination by a specialist physician is required. Because it shows similar features to uterine prolapse. A few different disorders may come to the fore. Pelvic examination is required to make a definitive diagnosis.
How is Uterine Prolapse Treated?
If kidney function disorders occur, it would not be wrong to say that hydronephrosis findings occur. . Uterine prolapse is a disease that must be treated. Since it is a move that will directly disrupt the patient's life comfort and sexual function, waiting for it to recover on its own may lead to extremely negative consequences. When the disease occurs, each patient's treatment and condition depend on their own characteristics. Therefore, the decision is made after evaluating the patient's condition and individualization. If a pregnancy is expected soon and the current sagging has not extended outside the vagina, delivery can be waited for treatment.
"Surgical method or conservative treatment can be applied without the need for surgery for the treatment of the patient."
Non-Surgical (Conservative Treatment)
No surgical operation is performed in the treatment in question. Vaginal ring, Pelvic floor muscle exercise and estrogen treatment can be applied.
Vaginal Ring:This is the method used in cases of advanced age and in cases where surgical intervention would be difficult. In this method, a ring is placed in the cervix to keep the prolapse inside. This ring treatment, which needs to be removed and cleaned regularly, can be considered a troublesome operation.
Pelvic Floor Muscle Exercise:It is preferred in cases where uterine prolapse is at the initial level. Muscle sagging that occurs after birth can be corrected with the method also known as Kegal exercise.
Estrogen Treatment:While increasing the estrogen hormone may be sufficient for treatment in patients with low amounts of sagging, the method does not give results in advanced sagging. .
Treatment with surgical methods is a process in which a decision must be made by the doctor and the patient together, taking into account the patient's condition. Therefore, explanations regarding the method and details of surgical treatment can be made by taking into account the physical condition of the prolapse. Uterine prolapse with surgical method in our clinic In addition, uterine prolapse is treated with conservative methods. It would be beneficial for you to remember that a physical examination is essential for definitive diagnosis and initiation of treatment, and that the disease in question should be started without delay. Because the genital area, which is one of the most important parts of human life, creates both a negative psychological and physiological effect in case of the disease in question.
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