What studies do you need to undergo for the diagnosis of prolapse?
The Doctor evaluates the type and stage of omission during a gynecological visit, conducting an examination in a gynecological chair, as well as taking into account your complaints, which are sometimes enough to plan Treatment.
During the study, the doctor may ask you to strain your stomach and cough in order to assess the volume of omission and evaluate which treatment method you will offer. Depending on the age and complaints, the patient can be carried out:
Oncocytological examination, ultrasonography, aspiration biopsy of the uterine cavity. If complaints are related to impaired bowel movements, then perhaps the doctor will prescribe defecography to assess the condition of the intestine and exclude a possible proctologic disease.
How to treat pelvic prolapse?
In the treatment of prolapse, both non-surgical and surgical methods can be used. The main goal of any treatment method is to reduce your complaints and improve the quality of life, while maintaining the normal function of the surrounding organs. If you are sexually active, it is important to restore or maintain your sexual function without worsening it.
Depending on your complaints and the prolapse stage, the doctor will evaluate and offer the most suitable treatment. It is important to remember that no treatment method guarantees 100% positive results, and repeated prolapse is possible. However, there are methods that have proven themselves better than others.
Non-surgical methods of inurgery are offered to patients as the first choice. With omissions of an easier stage, Kegel exercises can be performed, but it should be understood that this process requires a lot of time, and you can achieve the desired result with it no earlier than after a couple of months.
As the next step, the doctor may offer to place a pessary in the vagina - a round silicone device. Depending on the complaints, a pessary of the right size and shape is selected, it is placed in a compressed form in the vagina, where it occupies the desired position and holds the organ (uterus or bladder) in the right place.
The pessary helps best with the omitting of the anterior wall and uterus, worse - with rectocele. It is important to regularly care for the pessary and wash it, and it is also necessary to re-visit the doctor so that he can evaluate the integrity of the vaginal wall and check if bedsores have formed.
Surgical treatment of dependence on the type of prolapse, your age and wishes can be used by various operating approaches.
This method is widely used throughout Europe and the United States. Dr. Juris Vītols has been using it for more than 15 years. Over time, laparoscopic correction of prolapse improved, and now JV Klīnika doctors perform it according to the model of French colleagues, which, in comparison with other methods, provides better treatment results.
Four small incisions are enough to perform laparoscopic correction. An assistant in achieving good results is a specially selected mesh, which has the thinnest structure and is provided specifically for the treatment of prolapse of the pelvic organs. However, the main condition for achieving a good result is the experience of an operating gynecologist, his knowledge of anatomy, as well as laparoscopic suturing skills.
The main advantages of laparoscopy are improved visualization of anatomical structures, a decrease in postoperative pain, a faster recovery after surgery and a lower risk of complications.
During this operation, a mesh is fixed to the front and / or posterior wall of the vagina, the second end of which is fixed so as to ensure the correct and natural direction of vaginal tension. Thus, the mesh forms a new durable layer that strengthens the walls of the vagina and organs, holding them in the correct position.
Often during such an operation, it is advisable to additionally remove the uterus, which significantly improves the results of treatment. If the patient plans a pregnancy in the future, then the uterus can be preserved. In this case, delivery should be carried out using a planned cesarean section. Laparoscopic sacocolpopexy is strongly recommended for young, Sexually Active Women, but age is by no means an obstacle.
In a study conducted in England, the oldest woman who underwent this operation was 97 years old. The main advantage of this method, in comparison with other operations with the use of a mesh, is that in one approach you can adjust all weaknesses by covering the front and back wall of the vagina without opening the vagina. There are similar operations during which the mesh is attached only to the cervix or to the dome of the vagina.
In such cases, if the patient is diagnosed with cystocele or rectocele, it is additionally necessary to carry out vaginal correction of the anterior or posterior wall of the vagina, which is not recommended for sexually active women. The effectiveness of laparoscopic sacocolpopexy is observed in more than 90% of cases, and it is important that this effect, in comparison with other methods, is the most persistent.
