uterine prolapse
Introduction
Introduction Uterine sag is also called uterine prolapse, the inner wall of the uterus can not be well contracted and restored, drooping into the vagina, and may extend to the outside. The general symptoms of uterine prolapse, at least there will be a feeling of falling (the feeling of falling out of the lower abdomen), usually back pain, severely drag the bladder and rectum, and there will be frequent urination, urinary discomfort or stool Not feeling good.
Cause
Cause
1. Damage caused by production (such as giant infants, dystocia, etc.)
2. The pressure in the abdominal cavity is too high (such as obesity, chronic cough, constipation, or tumor compression in the pelvis, which will increase the pressure in the abdominal cavity).
3. Age and organ aging plus the decrease of estrogen estrogen in females, the pelvic floor muscles (PFM) lose tension and the uterine ligaments gradually degenerate and shrink.
4. After various types of pelvic surgery, it may also cause sequelae of uterine prolapse.
5. Even if there is no above experience, but the congenital pelvic muscles weak relaxation can also cause uterine prolapse.
Examine
an examination
Related inspection
Vaginal palpation vaginal gynecological routine examination of postpartum pelvic floor muscle examination and evaluation
The symptoms caused by uterine prolapse are based on the fact that the uterus is a pocket-like tissue in which a woman nurtures a fetus during pregnancy, and is usually fixed in the pelvic cavity, but once it sag for various reasons, it causes various symptoms of discomfort. include:
1. The pelvic cavity has a feeling of pressure, and the lower abdomen has a heavy feeling.
2. Feel pain in the lower back.
3. I feel pain during intercourse.
4. There is a rectum in the anterior chamber of the uterus, so if it sag, dysuria or defecation may occur.
5. Severe patients will feel protrusions in the lower body.
6. Severe patients with uterine prolapse have difficulty walking.
Mainly based on signs. In addition, certain checks should be done. Hemorrhoid patients do not understand urine, take the bladder lithotomy position. First, let the patient cough or suffocate to increase abdominal pressure, observe whether there is urine overflow from the urethra to determine whether there is tension urinary incontinence, then empty the bladder for gynecological examination.
1. First of all, pay attention to the situation of vaginal wall prolapse and uterine prolapse in the absence of force. And pay attention to the vulva situation and the degree of perineal rupture.
2. Vaginal speculum to observe whether the vaginal wall and cervix are ulcerated, and whether there is uterine rectal fossa.
3. In the vaginal internal examination should pay attention to the levator ani muscles on both sides, determine the width of the levator ani muscle fissure, the position of the cervix, and then determine the size of the uterus, the location in the pelvic cavity and the attachment with or without inflammation or tumor.
4. Finally, the patient is given abdominal pressure, and if necessary, the sputum can be taken to make the uterus prolapse and then percussion to determine the degree of uterine prolapse.
Diagnosis
Differential diagnosis
First, submucosal fibroids: can not find the cervix on the prolapse, the vaginal wall does not come out before and after, the hand can be inserted into the vagina to touch the cervix.
Second, cervical elongation: mostly unmarried women. Before and after the vaginal wall does not come out, the anterior and posterior iliac crest is very high, the uterus is still inside the pelvic cavity, only the cervix is extremely prolonged as a column, protruding beyond the vaginal opening.
Third, chronic uterine inversion: the uterus can not be found on the mass, but can find the depression of the entrance to the fallopian tube on both sides, the surface is red mucous membrane, easy to bleed, triple vacancy in the sacral cavity, can not touch the uterus.
Fourth, vaginal wall cysts or fibroids: often misdiagnosed as bladder bulging or uterine prolapse, after examination of the uterus is still in the normal position or is squeezed upwards by the mass, and the tumor has nothing to do with the cervix.
The symptoms caused by uterine prolapse are based on the fact that the uterus is a pocket-like tissue in which a woman nurtures a fetus during pregnancy, and is usually fixed in the pelvic cavity, but once it sag for various reasons, it causes various symptoms of discomfort. include:
1. The pelvic cavity has a feeling of pressure, and the lower abdomen has a heavy feeling.
2. Feel pain in the lower back.
3. I feel pain during intercourse.
4. There is a rectum in the anterior chamber of the uterus, so if it sag, dysuria or defecation may occur.
5. Severe patients will feel protrusions in the lower body.
6. Severe patients with uterine prolapse have difficulty walking.
Mainly based on signs. In addition, certain checks should be done. Hemorrhoid patients do not understand urine, take the bladder lithotomy position. First, let the patient cough or suffocate to increase abdominal pressure, observe whether there is urine overflow from the urethra to determine whether there is tension urinary incontinence, then empty the bladder for gynecological examination.
1. First of all, pay attention to the situation of vaginal wall prolapse and uterine prolapse in the absence of force. And pay attention to the vulva situation and the degree of perineal rupture.
2. Vaginal speculum to observe whether the vaginal wall and cervix are ulcerated, and whether there is uterine rectal fossa.
3. In the vaginal internal examination should pay attention to the levator ani muscles on both sides, determine the width of the levator ani muscle fissure, the position of the cervix, and then determine the size of the uterus, the location in the pelvic cavity and the attachment with or without inflammation or tumor.
4. Finally, the patient is given abdominal pressure, and if necessary, the sputum can be taken to make the uterus prolapse and then percussion to determine the degree of uterine prolapse.
