A strong set of muscles and ligaments in the pelvis keep the uterus and vagina in their proper position in the pelvis. Pelvic organ prolapse (descensus or prolapse, depending on the complexity) is associated with a weakening of the connective tissue, leading to weakness of the supporting ligaments of the uterus and vagina. It refers to the static anomalies of the female genitalia, occurs mainly in menopause and is related to the greater number of births, massive ruptures of the pelvic floor, the birth of large fetuses and most often related obstetric interventions – episio- and perineotomies, forceps , vacuum extraction and others. In addition to natural (vaginal) childbirth, age and body mass index are predisposing factors for heavy physical work and chronic constipation. Nearly 50% of women who give birth normally develop genital prolapse to varying degrees. Sometimes prolapse occurs immediately after birth, most often as a result of a precipitous birth, as well as from obstetric intervention, but in general it occurs more often as women notice a significant advance in age. It is often noticed before menopause itself. Most women do not know that they have prolapse or prolapse, and during a random examination by a gynecologist, the condition is noticed. Another part of women feel slight discomfort. The fact that prolapse of the uterus or vagina can be a prerequisite for a bad sex life and disturbances during intercourse should not be neglected. Is it possible for young, nulliparous women to suffer from uterine and vaginal prolapse? Yes. Descensus of the vagina and uterus, although rare, also occurs in young and nulliparous women. Here, the cause is congenital weakness of the apparatus supporting and holding the uterus and vagina – connective tissue and smooth muscles. Thanks to the ligaments that attach the uterus to the pelvis, it is relatively mobile. The fixation is carried out by flat arranged tissue connections (ligaments), which are made of collagen and elastic coverings. The upper parts of the vaginal wall (and towards the cervix) also contain smooth muscle. Congenital defects of these tissues can lead to descensus. Pelvic floor defects, in addition to during and after childbirth, can also be the result of a car accident or accidental injury, such as during rough sex. Prevention and treatment are the same as for prolapse observed after vaginal delivery. Is there any way to avoid the risk of getting pulled over? The best approach is to limit the prolapse above all else. It is recommended to apply daily exercises to tighten the pelvic floor, as well as regular sports and training (regardless of the woman’s age). Regular Kegel exercises for the best way to train the muscles in the small pelvis, pelvic floor and vaginal canal. The stronger and more trained the muscles in this area, the lower the risk of prolapse. In addition to prevention,these exercises also help tighten the muscle fibers and tuck the sagging tissues back where they belong. In this way, the symptoms of prolapse are also reduced. In fact, these muscles that are involved in stopping the flow of urine are the ones that go into Kegel exercises. After emptying your bladder try to tighten them. Hold for a few seconds, relax and repeat. Never do the exercises with a full bladder! This is not only uncomfortable, but can also increase the risk of urinary tract infection. Train your pelvic floor muscles before and after birth! Move, exercise! Active participation, proper stretching and breathing during labor will save you many complications. Is surgical treatment necessary? Very often, surgical intervention and correction with the placement of special surgical rings (rings) is required. Surgical correction is most often performed with access through the vagina. The principle of the operation is to “hang” the vagina and uterus to certain structures in the pelvis, so as to resemble the natural connections of the female genital organs that have stretched over time, and to strengthen the front and back vaginal walls. (When we talk about rings and surgical prolapse correction, we’re most often talking about menopausal and postmenopausal women, of course).
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