Causes and treatment of uterine prolapse

  Uterine prolapse is a condition in which the uterus drops from its normal position along the vagina and even prolapses outside the vaginal opening. It is more common in the postpartum period, and it is important to learn to prevent this uterine disease and reduce its incidence.  Causes of uterine prolapse 1, childbirth injury is the main reason for the onset of uterine prolapse. The pelvic floor is mainly composed of the pelvis, pelvic fascia, anal raphe and perineal muscles. Regardless of how much pressure is generated in the abdominal cavity during coughing, breath-holding and standing weight-bearing, under normal circumstances, the above structures or tissues can support and fix the pelvic organs so that they are in a normal position. In case of childbirth, especially in obstructed labor, stalled labor, assisted vaginal surgery or prolonged second stage of labor, perineal laceration or stretching occurs, resulting in tearing of the pelvic fascia and anal levator muscle, weak and defective pelvic floor tissues, widening and opening of the urogenital fissure, and pushing the large non-replaced uterus into the vagina under excessive abdominal pressure and uterine prolapse occurs. Especially in the puerperium, poor feeding or premature labor before the pelvic fascia and levator muscle recover well, and heavy labor, or improper repair of tears including perineal incision, all weaken the normal function of the pelvic floor and cause uterine or vaginal prolapse. The recovery of supporting tissues is also a factor of prolapse.  2.Ovarian hypoplasia is seen clinically in women with post-mortem prolapse of the reproductive tract.  3.Congenital factors Weakness of uterine support structures and lack of tension due to congenital developmental abnormalities are seen in uncommitted women.  4, nutritional factors Reproductive tract prolapse is related to nutritional deficiency. Because of nutritional deficiency, physical weakness, muscle relaxation and atrophy of the fascia in the pelvis.  Increased intra-abdominal pressure high abdominal pressure is an important factor contributing to or aggravating the prolapse of the genital tract.  The treatment of uterine prolapse should be based on the principle of strengthening or restoring the supporting role of the pelvic floor tissues and the ligaments around the uterus.  1, general therapy General therapy to improve physical fitness, strengthen nutrition, pay attention to proper rest, keep the bowels unobstructed, avoid increasing abdominal pressure and heavy physical labor, treat chronic diseases such as chronic cough, diarrhea. Chinese herbal medicine tonic Chinese and Yiqi soup as an auxiliary treatment.  2.Non-surgical treatment Non-surgical treatment method is applicable to the first degree of heavy and second degree of light uterine prolapse, frail or due to other diseases can not tolerate surgery, the use of uterine support and with general support therapy, with good results.  Chinese herbal medicine treatment is also available, including oral, intramuscular injection and local fumigation. In addition, physical therapy and sports therapy can also be tried.  3.Surgical treatment indications For those who are ineffective in conservative treatment or Ⅱ degree heavy or Ⅲ degree uterine prolapse, appropriate surgical methods should be selected according to the patient’s age, fertility requirements and general health condition.  (1) Anterior and posterior vaginal wall repair with shortening of the main ligament and partial hysterectomy of the cervix, which is the so-called Mann’s operation, is suitable for those who are younger, have a longer cervix and wish to preserve their reproductive function.  (2) Total vaginal hysterectomy and anterior and posterior vaginal wall repair, which is suitable for those who have a grade II or III uterine prolapse with a bulging vaginal wall and who are older and do not need to have any more children.  (3) Anterior and posterior vaginal wall repair is suitable for degree I uterine prolapse with obvious anterior and posterior vaginal wall bulge without cervical lengthening, etc.  (4) Longitudinal vaginal septoplasty, which partially closes the vagina and causes loss of sexual intercourse after surgery, is only suitable for those who are old and frail or cannot tolerate complicated surgery due to other diseases, and there is no suspicion of malignant lesions in the uterus.