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What causes uterine prolapse? The 6 major symptoms of uterine prolapse. The main cause of uterine prolapse is damage to the birth cervix, the main cervical ligament and the uterosacral ligament, and the failure of the supporting tissue to return to normal after delivery. The occurrence of uterine prolapse is caused by the poor development of the genital supporting tissue. One is birth injury.
This is the main cause of uterine prolapse. The pelvic floor is mainly composed of the pelvis, pelvic fascia, levator ani muscles and perineal muscles. No matter how much abdominal pressure is generated by coughing, holding your breath, or standing, under normal circumstances, the above structures or tissues can support and fix the organs in the pelvis to keep them in a normal position. Especially difficult labor. Delayed labor. Vaginal surgery or prolonged second stage of labor, perineal laceration or stretching, leading to tearing of the pelvic fascia and levator ani muscles, weak and defective pelvic floor tissue, widening and opening of the urogenital hiatus, and excessive abdominal pressure can cause the unrecovered large uterus to prolapse into the vagina. Especially poor food intake during the puerperium; or premature labor, especially physical labor, if the pelvic fascia and levator ani muscles are not well recovered; or improper tear repair, including episiotomy, weakens the normal function of the pelvic floor, leading to uterine or vaginal prolapse. Multiple births affect the recovery of supporting tissues and are also a factor in prolapse.
The second is ovarian dysfunction.
Female reproductive tract prolapse can be seen clinically after the desperate period.
The third is congenital factors.
Congenital developmental abnormalities result in a weak uterine support structure and lack of tension.
The fourth is nutritional factors.
Genital prolapse is related to nutritional deficiencies. Due to nutritional deficiencies, physical weakness, muscle relaxation, and atrophy of the pelvic fascia.
5. Increased abdominal pressure.
High abdominal pressure is an important factor causing or aggravating genital tract prolapse.
Symptoms of uterine prolapse.
Uterine prolapse refers to a reproductive syndrome in which the tissue supporting the uterus is damaged or weak, causing the uterus to drop from its normal position along the vagina, below the level of the ischial spine of the external cervical opening, or even completely out of the vagina. Its main symptoms are back pain, and in severe cases, it can affect the bladder and rectum, leading to frequent urination, incomplete urination, or difficult defecation.
1. Lumbar pain.
Especially in the sacrum, it is more obvious after labor and can be relieved after bed rest. In addition, the patient feels sagging in the lower abdomen, vagina, and perineum, which is aggravated after fatigue.
2. Vaginal swelling.
The patient reported that a ball-shaped object came out of the vagina, which was more obvious when walking or doing physical labor, and returned to the original position by itself after bed rest. In severe prolapse, the object fell out all day and could not return to the original position by itself. The patient felt discomfort due to friction with clothes during walking and activities, and ulcers, infections, increased secretions, and even bleeding occurred after long-term friction. Local tissues became thicker and keratinized over time.
3. Urinary tract symptoms.
Most patients with uterine prolapse experience a sudden increase in abdominal pressure when they laugh, cough violently, or exert physical strength, leading to urinary incontinence and urine overflow. Uterine prolapse is often accompanied by varying degrees of bladder herniation, but whether there is stress urinary incontinence depends on whether the anatomical relationship between the bladder and the urethra has changed. A small number of patients with uterine prolapse have difficulty urinating, leading to urinary retention. Urinating is only possible by pushing the inflated bladder forward with the fingers. The reason is that the bladder herniation is severe and the inflated bladder is lower than the urethra.
4. Menstrual changes, excessive vaginal discharge.
Pelvic organ prolapse causes blood circulation disorders, local congestion, affects normal menstruation, and can cause menorrhagia. In addition, due to blood circulation disorders, ulcers and infections of the organs, leucorrhea increases, accompanied by bloody secretions.
5. Generally does not affect conception, pregnancy, and delivery.
Although it does not affect conception, pregnancy and delivery, those with unrecoverable uterine prolapse may experience cervical edema and difficulty in cervical dilation after delivery, leading to dystocia.
6. Physical signs.
The cervix is located in the vagina, <14 cm from the hymen, until the uterine body is completely separated from the vaginal opening. Unable to compensate for uterine prolapse is usually accompanied by rectal bladder expansion, thickening and keratinization of the vaginal mucosa, hypertrophy and elongation of the cervix, and the bladder uterine fossa is >2 cm away from the anterior vaginal fornix, which can be as long as 4-5 cm. In severe uterine prolapse with bladder prolapse, the folds of the vaginal bladder transverse groove disappear, the lower limit of the bladder can be longer than the external cervical opening, and severe uterine prolapse with bladder opening forms a positive triangle with the urethral opening.
According to the opinions of the two disease research cooperation groups of some provinces, cities and autonomous regions in Qingdao in 1981,
During the examination, when the patient lies flat and pushes down the uterus, the degree of uterine descent is divided into three degrees:
Grade I: The cervix prolapses to less than 4 cm from the hymen but does not separate from the vaginal opening.
Mild: The external cervical os is less than 4 cm away from the edge of the hymen and does not reach the edge of the hymen.
Severe: The cervix has reached the edge of the hymen and is visible at the vaginal opening.
Grade II: The cervix and part of the uterus are separated from the vaginal opening.
Mild: The cervix protrudes out of the vaginal opening, but the uterus remains in the vagina.
Severe: Part of the uterus protrudes from the vaginal opening.
Third degree: The cervix and uterine body are completely separated from the vaginal opening. |
