Uterine Prolapse
The uterus lies in the pelvic cavity supporeted by connective tissue and pubococcygeus muscle. Uterine Prolapse is a condition where the uterus slides from its normal position into the vaginal cavity. This can be attributed to loss of muscle tone or weakening of the muscles holding the uterus against the pelvic wall. Uterine prolapse can occur due to ageing or childbirth trauma on account of large babies or difficult labor. Other causes for uterine prolapse include pelvic tumor, obesity and chronic constipation. Lack of exercise and tight corsets can lead to uterine prolapse. Lack of adequate rest in the post pregnancy stage or heavy manual work can lead to uterine prolapse.
A woman suffering from uterine prolapse suffers lower back pain. There is a feeling of bearing down or heaviness in the pelvis. There may be increased frequency in urination and pain during sexual intercourse. A woman might suffer discomfort in the lower abdomen and heavy menstrual periods. Difficulty in passing stools, hemorrhoids and urinary tract infection might be noticed due to complications owing to uterine prolapse. A pelvic examination reveals any uterine prolopse or protusion of the cervix ino the lower part of the vagina.
Treatment for uterine prolapse depends on the degree of prolapse and the woman's age and general health condition. Vaginal pessaries may be able to hold the uterus in place for mild uterine prolapse. But there may be side-effects such as irritating and foul smelling discharge and ulcerations. Kegels exercises can go a long way in strengthening the pelvic floor muscles. Hormone therapy such as estrogen replacement can prevent further weakening of the pelvic muscles. Hysterectomy is the surgical option to treat uterine prolapse. Uterine prolapse can be prevented with good antenatal care and proper rest and folowing correct lifting techniques.
Read up additional information on Kegels exercise
Cystoscopy
Cystoscopy (cystouresthroscopy) is a diagnostic procedure of viewing a person's urinary passage and the urinary bladder, collecting urine samples and examining the prostrate gland through an instrument. The cystoscope is as thin as a pencil and has a light at the tip. Many cystoscopes have extra tubes to guide other instruments for procedures to treat urinary problems. Through a cystoscope, the urologist can focus on the inner surfaces of the urinary tract. Some cystoscopes use optical fibers that carry an image from the tip of the instrument to a viewing piece at the other end.
Ridid cystoscope: This is a solid straight telescope that is used along with a high intensity light source and a separate channel to allow other instruments to be attached.
Flexible cystoscope: This is used particularly for diagnosis and follow-up of most bladder tumors. It is a fibre optic instrument that can bend easily and has manoeuvarable tip that makes it easy to pass along the curves of the urethra.
Cystoscopy is also done to evaluate problems that cannot be seen on x ray. Cystoscopy is used to further investigate the problems detected by ultrasound or intravenous pyelography. In women, cystoscopy helps to reveal uterine prolapse. A common and temporary side effect of this test is swelling in the urethra. A urinary catheter may be left in the patient's bladder to help drain the urine until the swelling in the urethra subsides.
Hysterectomy
Hysterectomy is the surgical removal of the uterus that can sometimes save the life of a woman. Hysterectomies are usually performed abdominally or vaginally. Laparoscopic hysterectomy is also performed in some cases.
Reasons for hysterectomy
Gynecological cancer: Cancer of the uterus or cervix usually necessitates removal of the uterus and cervix. Endometrial cancer, cancer of the uterus or cervix or fallopian tubes usually requires hysterectomy surgery.
Endometriosis: In some cases of severe bleeding following endometriosis, a hysterectomy surgery is advised. This is the second leading reason for hysterectomies.
Fibroids: While most fibroid tumors can be treated by non-surgical methods, hysterectomy surgery may be the only permanent solution.
Uterine prolapse: When the uterus moves from its usual place down into the vagina, it can affect other organs such as the bladder. This can happen due to childbirth, obesity, loss of estrogen after menopause and weak pelvic ligaments and tissues.
Other reasons for going for a hysterectomy surgery range from heavy or irregular menstrual periods to dysmenorrhea. Severe pelvic inflammatory disease can sometimes necessitate a hysterectomy.
Types of hysterectomy surgery
Total hysterectomy involves removal of the cervix and uterus. It is known as Oopherectomy. Partial hysterectomy is a surgical procedure to remove only the upper part of the uterus, leaving the cervix in place. This type of hysterectomy is referred to as supra cervical hysterectomy or subtotal hysterectomy. Radical hysterectomy involves removal of the uterus, cervix, upper part of the vagina and the supporting tissues.
Hysterectomy surgery performed prior to menopause can bring about severe and prolonged symptoms as compared to natural menopause. A woman can experience bone loss, loss of libido, depression and anxiety. Many women may need hormone replacement therapy (HRT) following total hysterectomy where the ovaries are removed before menopause.
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