In total in places! Omission of genitals after the delivery of
Omission of genitals - a problem which women after the delivery quite often face pregnancy is serious “test“ for muscles of a pelvic bottom. How struggle with this disease which causes to young mother essential discomfort?
A little physiology
the Problem of omission of genitals arises when muscles of a pelvic bottom lost ability to reduction so that separate bodies or their parts do not get to a projection of the supporting device. The whole body or any of its walls can be displaced.the Pelvic bottom represents
powerful myshechno - fastsialny layer (a fastion (Latin of fascia - a bandage, a strip) - the soyedinitelnotkanny cover covering bodies, vessels, nerves and forming cases for muscles of the person) which closes from below basin bones. The part of a pelvic bottom which is settling down between back soldering of vulvar lips and a tailbone is called a crotch.
the Pelvic bottom is a support for internal genitals (a uterus, a vagina, ovaries and uterine tubes, and also a bladder, an urethra and a rectum), promotes saving their normal provision. The muscles lifting back pass have special value. At reduction of these muscles there is a short circuit of a sexual crack, narrowing of a gleam of a rectum and vagina. Injury of muscles of a pelvic bottom leads to omission and loss of genitals.
the Pelvic bottom represents a support not only for genitals, but also for interiors. Muscles of a pelvic bottom participate in regulation of intra belly pressure together with a grudobryushny barrier (diaphragm) and muscles of a belly wall.disease Symptoms
of Manifestation of loss of genitals (walls of a vagina, neck of a uterus, uterus body) are various
. At full loss of a uterus of the woman complain of feeling of a raspiraniye or foreign matter to a vagina, a nagging pain or feeling of weight in lumbar area. Symptoms, as a rule, disappear in a prone position, are absent or are less expressed in the morning and accrue during the day, especially, if the patient walks a lot of time. Is more often than
into the forefront symptoms of dysfunction of a bladder and/or rectum act. From an urinary system the complicated urination, stagnation in an urinary system with possible infection (in the beginning - the lower departments (an urethra, a bladder) can be observed, and then, when progressing process, and top - kidneys). This phenomenon can serve as the beginning of development of such disease as pyelonephritis - an inflammation of kidneys. In this case pyelonephritis is more often shown by a slow current, is followed by dull aches in lumbar area, slight increase of body temperature, weakness, fast fatigue, the lack of appetite, nausea, vomiting, anemia which is speeded up, a painful urination, urine change (urine becomes muddy because contains bacteria, leukocytes).
Also a symptom of dysfunction of a bladder is the urine incontience at a tension (at cough, sneezing, strong laughter). From intestines of complication consist in malfunction of a thick gut in the form of development of locks and colitis (the inflammatory disease of a thick gut which is characterized by the belly-aches having skhvatkoobrazny character; the ponosa alternating with locks; release of slime; weakness and loss of appetite). The most burdensome complication which meets extremely seldom is the incontience of gases and a calla.
Omission of genitals can be shown by weak feelings during sexual intercourse, impossibility of a vagina to densely capture a penis, hit of air during sexual intercourse and its exit with characteristic sounds.
menstrual function which is characterized by emergence of pains during periods (the uterus changes situation at the expense of what outflow of menstrual blood is at a loss) and increase in amount of menstrual blood Changes. Quite often such women have infertility though approach of pregnancy is found possible quite.Should tell
that at insignificant omission of walls of a vagina the woman can not show any complaints, but with age omission can progress.
Thus, at omission and loss of genitals quality of life of the woman due to involvement of bodies of uric system, intestines, symptoms for the worse changes from genitals. Except change of quality of life, also the probability of development of complications is unpleasant.
of the Reason of omission of genitals
Functional insolvency of the copular device of internal genitals and a pelvic bottom (a muscular framework) comes under the influence of one or several factors:
- of Post-traumatic damage of a pelvic bottom (the most often arising in the course of childbirth). Omission of a vagina will be promoted by heavy ruptures of a crotch, and also incorrectly taken in ruptures or infection even of correctly taken in gap in the postnatal period. Small ruptures of a crotch, and also an epiziotomiya do not result in insolvency of muscles of a pelvic bottom as at the same time there is no damage actually muscles. Omission of walls of pelvic bodies after normal childbirth is explained by a muscle strain or damage of tissues of crotch and still more is a consequence of violation of nervous regulation of muscles - sphincters - circular muscles which “lock“ an urethra and an anus, interfering with an exit of urine and a calla respectively. The risk of omissions increases at an operational rodorazresheniye (imposing of nippers) and at repeated childbirth as with age insolvency of the copular device is aggravated. Besides, at repeated childbirth fruit weight, as a rule, happens more. Especially accurately it is visible at the women who gave birth to large children and also at polycarpous pregnancy. At difficulty of passing of a head through a vulvarny ring, inefficiency of attempts the doctor makes the decision on carrying out an epiziotomiya - a crotch section as at an excessive muscle strain of a crotch the fruit head just and forms weakness of muscles of a pelvic bottom.
- the Insolvency of soyedinitelnotkanny structures which is shown omission of other internals.
- Violation of synthesis of steroid, including sex hormones.
- the Chronic diseases which are followed by violation of exchange processes, microcirculation. For example, carry diabetes, a metabolic syndrome (the state which is characterized by obesity, increase of arterial pressure, violation of perception insulin fabrics), hereditary diseases of a metabolism to such diseases and other.
- Hard physical work.
Types of shift of genitals
we Will give classification of shift of a vagina and uterus on severity from top to bottom.
- vagina Shift from top to bottom:
- omission of one of walls of a vagina or both; but walls do not go beyond an entrance to a vagina;
- of a wall of a vagina knaruzh from a vaginal entrance leave. Close anatomic ties between a bladder and a wall of a vagina promote that against pathological changes of muscles of a pelvic bottom there is an omission (as if sagging in a vagina gleam) a forward wall of a vagina which involves also a bladder wall, forming the tsistotsel (a bladder vybukhaniye in a vagina gleam). Tsistotsele increases also under the influence of own pressure in a bladder therefore the vicious circle is formed. It is similarly formed also to a rektotsela (a rectum vybukhaniye in a vagina gleam);
- the full loss of a vagina which is followed often by loss of a uterus.
- to the level of an entrance to a vagina; the last at a natuzhivaniye supports as
- at the partial (beginning) loss of a uterus or its neck limits of a sexual crack, and the similar beginning loss of a uterus most often is shown at a physical tension and increase of intra belly pressure (a potuzhivaniye, cough, sneezing, a raising of weights, etc.) ;
- incomplete loss of a uterus: out of a sexual crack not only the neck, but also part of a body of a uterus is defined; the body completely is defined by
- at full loss of a uterus out of a sexual crack.
If defects of basic structures are insignificant
and internal genitals at a natuzhivaniye do not fall below the plane of an entrance to a vagina (complaints at the same time usually are absent), do not carry out treatment. The exception is made by patients with an urine incontience at a tension which plans surgical treatment. In other cases tactics of treatment of omission and loss of internal genitals is defined individually. It can be conservative (application of uterine rings from synthetic material) or surgical.Uterine rings are established by
in a vagina in case of existence of contraindications for surgical treatment (for example, the accompanying somatic pathology of various bodies and systems - hearts, lungs, kidneys, etc., advanced age of the patient). They can be silicone and remain in a vagina within several months. (Necrosis of fabrics as a result of the constant pressure of a ring upon vagina walls) patients have to delete other uterine rings which make of rubber more often for the prevention of decubitus for the night. After selection of a uterine ring the patient is trained independently to enter and delete it. Frequency of inspection of such patients is defined individually, usually the first inspection is performed in a week, and then in the absence of complaints, by each 4 - 6 months.If defects of basic structures are insignificant
the Cardinal solution of the problem of loss of genitals is a surgical treatment. The operation purpose - for a long time to eliminate all defects of basic structures. The set of the operations pursuing this aim is developed. Usually these operations are carried out through a vagina.by
of Gisteropeksiya (fixing of a uterus to something) it is carried out to the women planning to have further children at inefficiency of conservative treatment. The best results of treatment are yielded by a method of fixing of a uterus to a forward longitudinal linking of a sacrum, and kresttsovo - uterine sheaves are hemmed to a sacrum not directly, and by means of a synthetic grid or a site of a fastion.
At loss of walls of a vagina carry out a kolporafiya and a perineoplastika - operation which consists in excision of “excess fabrics“, strengthening of muscles of a crotch due to sewing together of their legs. To the women who transferred a kolporafiya in case of the subsequent pregnancy perform operation of Cesarean section.
If at the woman the urine incontience, without loss of genitals takes place, then such method as plasticity operation by a free synthetic loop - TVT/TVT - O can be used. Intervention allows to eliminate an unpleasant symptom (an urine incontience), but at the same time omission of walls of a vagina is not liquidated. Operation continues 20 - 30 minutes under local anesthesia. In the course of this operation the doctor through three small sections in nadlobkovy area carries out a special tape from synthetic material of polypropylene under an urethra. The tape supports an urethra and interferes with an involuntary urination at increase of intra belly pressure. The surgeon checks efficiency of intervention directly on operation time. The patient is offered to execute several kashlevy movements and if dribble of urine does not happen, then operation is complete. If necessary the doctor changes loop tension force.
At full loss of a uterus at advanced age carry out a vaginal extirpation of a uterus (i.e. full removal of a uterus through a vagina). During this operation at the same time it is possible to execute forward or back plasticity of a vagina, correction of hernia of a gut etc. from the same access
Prevention of omission of genitals
at the end of 1940 - x years the gynecologist Arnold Kegel developed the basic program of exercises for development of muscles of a crotch intended for treatment of women for an urine incontience. Training of muscles of a pelvic bottom helps at many malfunction of urinogenital bodies not only at women, but also at men (an urine incontience, prostatitis, etc.) promotes regulation of sexual functions (an erection, an ejaculation and an orgasm) and treatment of diseases of a rectum (hemorrhoids, an incontience a calla, etc.) . Exercises represent isometric (reduction of a muscle without change of its length) reductions cross - the striped muscle fibers which are a part of a pelvic bottom.Even if you have
no signs of weakness of muscles of a pelvic bottom, their additional development improves blood supply of bodies of a small pelvis, restores their anatomy. Development of this group of muscles is prevention and treatment of stagnation of a blue blood, chronic inflammatory processes and omissions of walls of a vagina, so, prevention and treatment of pelvic pain, a hypoplasia of genitals, insufficient sensitivity at sex life, problems with incubation, an urine incontience. Similar exercises are used for preparation for childbirth and strengthening of self-checking of an orgasm.
the Woman can identify crotch muscles as follows: sit down on a toilet bowl, move apart legs. Try to stop an urine stream, without moving legs. Muscles which you use for this purpose and are your promezhnostny muscles.
of Exercise of Kegel consist of three parts:
- of Slow compression. Strain muscles as you did it for an urination stop. Slowly count to three and relax.
- of Reduction. Strain and relax muscles as soon as possible,
- of Pushing out. Potuzhtes is moderate down, as at a chair or childbirth. This exercise causes tension of promezhnostny and some belly muscles. You also feel tension and relaxation of an anus. Begin trainings with 10 slow compression, 10 reductions and 10 vytalkivaniye on 5 times a day. In a week add 5 exercises to everyone, continuing to carry out their five once a day. Add 5 exercises to each exercise in a week until them becomes on 30. Then continue to do at least 5 sets of exercises a day for maintenance of a tone. You can carry out exercises practically anywhere: during walk, viewing of the TV, sitting at a table, lying in a bed.
at the beginning of occupations that your muscles do not want to remain in a tension during slow compression. Perhaps, you will not be able to carry out reductions quickly enough or rhythmically. It because muscles still weak. Control over muscles improves thanks to practice. If muscles were tired in the middle of exercise, take rest several seconds and continue. Carrying out exercises, do not forget to breathe naturally and exactly. Do from one to two hundred compression every day. Such physiotherapy exercises allow:to stimulate
- kompensatorno - adaptive reactions in the damaged fabrics of the switching device of a bladder and urethra for the purpose of normalization of its activity;
- to improve to a traffic (food) of bodies of a small pelvis, to eliminate uncontrollable reductions of a detruzor - the smooth muscles (which are not relating to crotch muscles), closing a bladder; to strengthen
- myshechno - the copular device of a pelvic bottom, a muscle of an urethra, a basin, a stomach and back;
- to promote recovery of the anatomist - topographical relationship of bodies of a small pelvis;
- to make the all-strengthening impact on an organism.