Treatment of prolapse of the pelvic organs in a modern gynecological clinic in Moscow at low prices!

Risk factors for prolapse and prolapse of the pelvic organs in women are:

• Pregnancy and childbirth through the natural birth canal, including those complicated by obstetric perineal trauma
• Features of the constitution of a woman and insufficiency of parametric fiber
• Chronic increase in intra-abdominal pressure
• Systemic connective tissue dysplasia (hernias of other localization, varicose veins, joint hypermobility, high degree of myopia, etc.)
• Violation of the synthesis of steroid hormones (estrogen deficiency)
• Violation of the blood supply and innervation of the pelvic floor
• Genetic conditioning

Symptoms of prolapse of the pelvic organs in women

• In the first place is the formation detected by the patient herself, protruding from the genital gap (a symptom of the prolapse of the walls of the vagina and uterus)
• Gaping of the genital slit at rest and / or tension
• Recurrent and difficult to treat inflammatory diseases of the vaginal mucosa
• Sensation of a foreign body, discomfort in the perineum when walking, trying to sit down
• Urinary incontinence - stress incontinence, difficulty, slow or rapid, intermittent, incomplete urination, or inability to empty the bladder without repositioning the pelvic floor hernia
• Chronic constipation, difficulty in defecation, gas incontinence, in severe cases - feces
• Pulling pain in the lower abdomen, lower back, sacrum, aggravated by a long vertical position of the body, by the end of the day, after lifting weights
• Discomfort during intercourse
• Progression of varicose veins after childbirth

Often, women do not initially turn to a gynecologist, but to a related specialist: a urologist or a proctologist.

With complete prolapse, a woman can independently visualize the uterus in the form of a formation protruding from the genital slit. On examination, the prolapsed uterus looks like this:

• shiny or matte surface;
• ulcerative lesions as a result of constant friction of the uterus;
• bleeding;

Diagnostics

Diagnosis of prolapse of the pelvic organs in women is based on a combination of data:

• Patient complaints.
• Anamnesis of life and disease.
• General inspection.
• Gynecological examination.
• Instrumental methods of examination.
• Examinations with related specialists according to indications.

Gynecological examination

During a gynecological examination, the doctor reveals the prolapse of the pelvic organs. To determine the degree of pathology, a woman is invited to strain or cough.

Instrumental examination methods

Instrumental examination methods include:

• colposcopy;
• Ultrasound of the pelvic organs;
• smears for flora and oncocytology.

In the presence of a cystocele (omission of the anterior wall of the vagina), it is mandatory to consult a urologist with additional examination methods:

• general urine analysis;
• urine culture;
• Ultrasound of the kidneys;

In the presence of a rectocele, a consultation with a proctologist is required with an assessment of:

• severity of rectocele;
• sphincter insufficiency;
• the presence of hemorrhoids.

Surgery

Surgical treatment is classified as follows:

• own tissues
• With the use of synthetic implants

It is preferable to use combined surgical treatment with uterine fixation, vaginal plastic surgery and strengthening of the pelvic floor muscles.

Surgical access can be:

• Vaginal
• laparoscopic

Don't delay your visit to the doctor

If you contact the specialists of our center soon, you will be able to avoid surgical intervention and get by with conservative methods of treatment! The best doctors of the "Center for Gynecology, Reproductive and Aesthetic Medicine" will develop for you! They will prescribe individual treatment depending on the characteristics of your body, the mode of work and rest, nutrition, etc.

Forecast

With timely therapy, the prognosis is favorable. Most of the women who underwent surgical correction of the pathology fully return to social and sexual activity.

In the case of an organ-preserving operation in women of reproductive age, pregnancy is possible. The risks of managing pregnant women after surgery for prolapse of the pelvic organs are increased, but the course of pregnancy is possible without complications under the supervision of an obstetrician-gynecologist.

If treatment has not been carried out, the condition may worsen up to the complete prolapse of the uterus.

Prevention

Prevention of prolapse of the pelvic organs is a set of measures aimed at improving elasticity and maintaining the necessary tone of the pelvic floor muscles.

Preventive measures include:

• provision of adequate support during childbirth;
• suturing ruptures of the perineum and birth canal;
• careful imposition of a vacuum extractor and obstetric forceps strictly according to indications;
• timely diagnosis and treatment of prolapse of the pelvic organs in the initial stages;
• elimination of the cause of constipation and flatulence;
• treatment of chronic cough together with related specialists;
• adequate physical activity;
• body weight control;
• balanced and rational nutrition;
• timely treatment of concomitant gynecological diseases;
• therapeutic exercises in the postpartum period;
• laser therapy;
• electrical stimulation of the pelvic muscles.

In order to avoid problems with uterine prolapse in adulthood, prevention must begin in childhood. To do this, it is enough to maintain normal abdominal pressure and treat concomitant pathology, which can lead to an increase in intra-abdominal pressure.

Women are prohibited from performing work related to lifting and carrying weights of more than 10 kg, which is prescribed in legislative acts.

In the menopausal period, prevention comes down to regular visits to the obstetrician-gynecologist.

Other related articles

If the prolapse of the internal female organs is not detected in time and the appropriate methods of correction are not carried out, then this pathology can develop into a more serious illness - uterine prolapse....

Genital prolapse is a slowly developing pathology, the initial stage of which is the displacement of the cervical part of the uterus to the exit from the vaginal cavity due to the weakening of the muscles of the perineum....

The degree of displacement of the uterine cavity is determined by the doctor during a gynecological examination by determining the level of the location of the organ relative to the walls of the vagina.

Colpopexy, as a method of surgical therapy for prolapsed vaginal walls, is rarely used in modern gynecology without the use of synthetic materials.

With the weakening of the muscular frame of the perineum, the pelvic organs may begin to prolapse, that is, to sag. With a belated diagnosis, this can lead to their complete loss ....

Prolapse of the uterus is characterized by the movement of the organs of the female reproductive system towards the exit from the vagina. There are 4 stages of development of this pathology, which can contribute to the prolapse of the organ....

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Zhumanova Ekaterina Nikolaevna

Head of the Center for Gynecology, Reproductive and Aesthetic Medicine, Candidate of Medical Sciences, Doctor of the Highest Category, Associate Professor of the Department of Restorative Medicine and Biomedical Technologies, A.I. Evdokimova, Member of the Board of the ASEG Association of Specialists in Aesthetic Gynecology.

• Graduated from the Moscow Medical Academy named after I.M. Sechenov, has a diploma with honors, passed clinical residency at the Clinic of Obstetrics and Gynecology named after. V.F. Snegirev MMA them. THEM. Sechenov.
• Until 2009, she worked at the Clinic of Obstetrics and Gynecology as an assistant at the Department of Obstetrics and Gynecology No. 1 of the Moscow Medical Academy. THEM. Sechenov.
• From 2009 to 2017 she worked at the Medical and Rehabilitation Center of the Ministry of Health of the Russian Federation
• Since 2017, she has been working at the Center for Gynecology, Reproductive and Aesthetic Medicine, JSC Medsi Group of Companies
• She defended her dissertation for the degree of candidate of medical sciences on the topic: "Opportunistic bacterial infections and pregnancy"

Myshenkova Svetlana Alexandrovna

Obstetrician-gynecologist, candidate of medical sciences, doctor of the highest category

• In 2001 she graduated from the Moscow State University of Medicine and Dentistry (MGMSU)
• In 2003 she completed a course in obstetrics and gynecology at the Scientific Center for Obstetrics, Gynecology and Perinatology of the Russian Academy of Medical Sciences
• He has a certificate in endoscopic surgery, a certificate in ultrasound diagnostics of pathology of pregnancy, fetus, newborn, in ultrasound diagnostics in gynecology, a certificate in laser medicine. He successfully applies all the knowledge gained during theoretical classes in his daily practice.
• She has published more than 40 works on the treatment of uterine fibroids, including in the journals Medical Bulletin, Problems of Reproduction. He is a co-author of guidelines for students and doctors.

Kolgaeva Dagmara Isaevna

Head of Pelvic Floor Surgery. Member of the Scientific Committee of the Association for Aesthetic Gynecology.

• Graduated from the First Moscow State Medical University. THEM. Sechenov, has a diploma with honors
• Passed clinical residency in the specialty "obstetrics and gynecology" on the basis of the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov
• She has certificates: an obstetrician-gynecologist, a specialist in laser medicine, a specialist in intimate contouring
• The dissertation work is devoted to the surgical treatment of genital prolapse complicated by enterocele.
• The sphere of practical interests of Kolgaeva Dagmara Isaevna includes:
  conservative and surgical methods for the treatment of prolapse of the walls of the vagina, uterus, urinary incontinence, including the use of high-tech modern laser equipment

Maksimov Artem Igorevich

Obstetrician-gynecologist of the highest category

• Graduated from the Ryazan State Medical University named after Academician I.P. Pavlova with a degree in General Medicine
• Passed clinical residency in the specialty "obstetrics and gynecology" at the Department of Clinic of Obstetrics and Gynecology. V.F. Snegirev MMA them. THEM. Sechenov
• He owns a full range of surgical interventions for gynecological diseases, including laparoscopic, open and vaginal access
• The sphere of practical interests includes: laparoscopic minimally invasive surgical interventions, including single-puncture access; laparoscopic surgery for uterine myoma (myomectomy, hysterectomy), adenomyosis, widespread infiltrative endometriosis

Pritula Irina Alexandrovna

Obstetrician-gynecologist

• Graduated from the First Moscow State Medical University. THEM. Sechenov.
• Passed clinical residency in the specialty "obstetrics and gynecology" on the basis of the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov.
• She is a certified obstetrician-gynecologist.
• Possesses the skills of surgical treatment of gynecological diseases on an outpatient basis.
• He is a regular participant in scientific and practical conferences on obstetrics and gynecology.
• The scope of practical skills includes minimally invasive surgery (hysteroscopy, laser polypectomy, hysteroresectoscopy) - Diagnosis and treatment of intrauterine pathology, pathology of the cervix

Muravlev Alexey Ivanovich

Obstetrician-gynecologist, oncogynecologist

• In 2013 he graduated from the First Moscow State Medical University. THEM. Sechenov.
• From 2013 to 2015, he underwent clinical residency in the specialty "Obstetrics and Gynecology" on the basis of the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov.
• In 2016, he underwent professional retraining on the basis of GBUZ MO MONIKI them. M.F. Vladimirsky, majoring in Oncology.
• From 2015 to 2017, he worked at the Medical and Rehabilitation Center of the Ministry of Health of the Russian Federation.
• Since 2017, she has been working at the Center for Gynecology, Reproductive and Aesthetic Medicine, JSC Medsi Group of Companies

Mishukova Elena Igorevna

Obstetrician-gynecologist

• Dr. Mishukova Elena Igorevna graduated with honors from the Chita State Medical Academy with a degree in general medicine. Passed clinical internship and residency in obstetrics and gynecology at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov.
• Mishukova Elena Igorevna owns a full range of surgical interventions for gynecological diseases, including laparoscopic, open and vaginal access. He is a specialist in providing emergency gynecological care for diseases such as ectopic pregnancy, ovarian apoplexy, necrosis of myomatous nodes, acute salpingo-oophoritis, etc.
• Mishukova Elena Igorevna is an annual participant of Russian and international congresses and scientific and practical conferences on obstetrics and gynecology.

Rumyantseva Yana Sergeevna

Obstetrician-gynecologist of the first qualification category.

• Graduated from the Moscow Medical Academy. THEM. Sechenov with a degree in General Medicine. Passed clinical residency in the specialty "obstetrics and gynecology" on the basis of the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov.
• The dissertation work is devoted to the topic of organ-preserving treatment of adenomyosis by FUS-ablation. He has a certificate of an obstetrician-gynecologist, a certificate in ultrasound diagnostics. He owns a full range of surgical interventions in gynecology: laparoscopic, open and vaginal approaches. He is a specialist in providing emergency gynecological care for diseases such as ectopic pregnancy, ovarian apoplexy, necrosis of myomatous nodes, acute salpingo-oophoritis, etc.
• Author of a number of publications, co-author of a methodological guide for physicians on organ-preserving treatment of adenomyosis by FUS-ablation. Participant of scientific and practical conferences on obstetrics and gynecology.

Gushchina Marina Yurievna

Gynecologist-endocrinologist, head of outpatient care. Obstetrician-gynecologist, reproductive specialist. Ultrasound doctor.

• Gushchina Marina Yuryevna graduated from the Saratov State Medical University. V. I. Razumovsky, has a diploma with honors. She was awarded a diploma from the Saratov Regional Duma for excellent academic and scientific achievements, and was recognized as the best graduate of the SSMU. V. I. Razumovsky.
• She completed a clinical internship in the specialty "obstetrics and gynecology" at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov.
• He has a certificate of an obstetrician-gynecologist; doctor of ultrasound diagnostics, specialist in the field of laser medicine, colposcopy, endocrinological gynecology. She repeatedly took advanced training courses in "Reproductive Medicine and Surgery", "Ultrasound Diagnostics in Obstetrics and Gynecology".
• The dissertation work is devoted to new approaches to differential diagnosis and tactics of managing patients with chronic cervicitis and early stages of HPV-associated diseases.
• He owns a full range of minor surgical interventions in gynecology, performed both on an outpatient basis (radiocoagulation and laser coagulation of erosions, hysterosalpingography), and in a hospital setting (hysteroscopy, cervical biopsy, conization of the cervix, etc.)
• Gushchina Marina Yurievna has more than 20 scientific publications, is a regular participant in scientific and practical conferences, congresses and congresses on obstetrics and gynecology.

Malysheva Yana Romanovna

Obstetrician-gynecologist, pediatric and adolescent gynecologist

• Graduated from the Russian National Research Medical University. N.I. Pirogov, has a diploma with honors. Passed clinical residency in the specialty "obstetrics and gynecology" on the basis of the Department of Obstetrics and Gynecology No. 1 of the Medical Faculty of the First Moscow State Medical University. THEM. Sechenov.
• He has a certificate of an obstetrician-gynecologist, an ultrasound diagnostician, a specialist in laser medicine, pediatric and adolescent gynecology.
• He owns a full range of minor surgical interventions in gynecology, performed both on an outpatient basis (radiocoagulation and laser coagulation of erosions, cervical biopsy), and in a hospital setting (hysteroscopy, cervical biopsy, conization of the cervix, etc.)
Abdominal organs
• Passed clinical residency in the specialty "Obstetrics and Gynecology" on the basis of the Department of the Federal State Budgetary Educational Institution of Additional Professional Education "Institute for Advanced Studies of the Federal Medical and Biological Agency".
• He has certificates: an obstetrician-gynecologist, a specialist in the field of colposcopy, non-operative and operative gynecology of children and adolescents.

Baranovskaya Yulia Petrovna

Doctor of ultrasound diagnostics, obstetrician-gynecologist, candidate of medical sciences

• Graduated from the Ivanovo State Medical Academy with a degree in general medicine.
• She completed an internship at the Tambov Regional Clinical Hospital with a degree in obstetrics and gynecology
• He has a certificate of an obstetrician-gynecologist; doctor of ultrasound diagnostics; a specialist in the field of colposcopy and treatment of cervical pathology, endocrinological gynecology.
• Repeatedly took advanced training courses in the specialty "Obstetrics and Gynecology", "Ultrasound Diagnostics in Obstetrics and Gynecology", "Fundamentals of Endoscopy in Gynecology"
• He owns the full range of surgical interventions on the pelvic organs, performed by laparotomy, laparoscopic and vaginal accesses.

Pelvic organ prolapse in women

Pelvic organ prolapse is a common occurrence in women who have given birth after 45-50 years. Less often, but even at a younger age, nulliparous girls are diagnosed with partial (complete) uterine prolapse due to a hereditary (genetic) factor.

What is pelvic organ prolapse?

Pelvic organ prolapse is a prolapse of the pelvic organs, i.e. displacement of the cervix (uterine fundus) into the lower part of the vagina due to weakening of the abdominal muscles.

According to the anatomy of the female body, the ligaments and fascia of the small pelvis are designed to hold the uterus in a normal position. But influenced by a number of factors they begin to weaken, and the uterus - to go down, until it completely falls out.

When the vaginal walls are lowered, the anatomical location of the pelvic organs is subject to abnormal modification. The ligaments designed to hold the uterus become less elastic and can no longer support the most important female organ in a normal physiological position. In particular, nearby organs (bladder, rectum) become involved in the pathology. The tissues of the vagina gradually begin to fall down.

Causes of pelvic organ prolapse

The primary cause of uterine prolapse is pregnancy. Numerous factors associated with pregnancy, such as trauma or complications during childbirth, maternal malnutrition, or fetal weight, can lead to excessive stress and damage to the muscles and ligaments that support the uterus. Some of the damaged muscles and ligaments will never fully regain their strength and elasticity.

Prolapse of the pelvic organs in women occurs due to:

• congenital anomalies in the development of connective uterine tissue;
• chronic constipation;
• colds, accompanied by a strong (frequent) cough, provoking an increase in intra-abdominal pressure;
• obesity;
• childbirth more than 3 times in a row;
• lifting weights, heavy physical work;
• age-related changes with a decrease in tissue elasticity in women after 50 years;
• oncology with localization of the tumor in the genitals, beginning to compress the uterine cavity;
• birth trauma of the perineum;
• the birth of a large fetus .;

Pelvic organ prolapse in women usually provokes 2 or more factors at once: displacement (omission) of the rectum And Bladder additionally. In nulliparous women with an abnormal structure of internal organs, a congenital defect plays the main role.

Provoking factors

Pelvic organ prolapse is not a disease. This is a pathological condition caused by provoking factors in the course of life in adult women, unless, of course, we are talking about birth defects. The uterus descends, shifts and no longer presents normally as a result of:

• relaxation of muscles, ligaments of the diaphragm of the pelvic floor;
• mechanical damage to the perineum, for example, due to abortion (surgical intervention) on the genitals;
• multiple pregnancy;
• broncho-pulmonary diseases with chronic paroxysmal cough, constant stay of the muscles of the diaphragm in strong tension
• oncology, tumors in the abdominal cavity;
• birth trauma in case of inept use by doctors of obstetric forceps, vacuum extractor;
• frequent constipation, attempts when going to the toilet.

Symptoms of pelvic organ prolapse

At the initial stage, the prolapse of the uterus practically does not declare itself. Only with age, under the influence of provoking factors, do patients begin to show signs of abnormal development of connective tissue or weakening of muscle fibers:

• , the flow of longer painful periods;
• the presence of a foreign body in the vagina (crotches);
• dull, with a return to the lower back, not amenable to analgesics;
• , acute urinary retention
• passing urine in small portions;
• chronic constipation;
• stool incontinence in severe pathology.

Gradually, the signs become more noticeable, lead to a deterioration in the quality of life of women, a negative impact on the psyche and intimate sphere, and the formation of pelvic dysynergy syndrome.

Clinical manifestations of uterine prolapse are usually easy to diagnose without examination by a gynecologist. More often and for no reason, the lower abdomen begins to hurt, the menstrual cycle changes with the passage of painful periods.

Women begin to experience discomfort and pain during moments of intimacy. If at an early stage, with a displacement of the uterus, the symptoms are hardly noticeable, then at 3-4 stages begin to manifest themselves with renewed vigor against the background of eversion or subsidence of the walls of the vagina down.

If the pathology begins to progress, then can be seen visually protrusion of part of the uterus in the form of a surface peeking out of the genital slit. Possibly education. bedsores against the background of trauma when walking women or a constantly protruding neoplasm outward.

In advanced cases the genitals outside begin to bleed, which can lead to infection, congestion in the pelvis. Signs that should not be ignored:

• swelling of the tissues of the uterine mucosa;
• bleeding in violation of blood circulation in the pelvis;
• soreness of the labia on palpation in case of a strong displacement of the uterine cavity;
• with blood;
• pain in the vagina, lack of sensation along the girth of the male genital organ during intimacy.

Types and stages

Normally, when the cervix with the vagina is slightly tilted back, and the uterus itself is tilted forward and is well held in the small pelvis due to the muscles and ligamentous apparatus (forming the perineum). Depending on the degree of prolapse of the uterus, 4 stages of pathology are classified:

1. 1 stage- lowering of the uterine os to the middle of the vagina with more than 1 cm of its drop-down zone above the hymen;
2. 2 stage with a displacement of the cervix and the organ itself to the exit into the vagina, with the location of the drop-down point a little more than 1 cm from the hymen. At the same time, the protrusion from the genital gap is not yet observed;
3. 3 stage when the external pharynx of the cervix is ​​displaced beyond the vagina, the area below the hymen is prolapsed by more than 1 cm;
4. 4 stage with complete prolapse of the uterus in the perineum, a reduction in the length of the vagina by 2-3 cm.

What examinations need to be done?

Examination for genital prolapse begins in the gynecologist's office with history taking, visual examination of the labia. Often, doctors determine the cause of prolapse already at the initial examination.

If you are concerned about constipation, then the main method of examination:

• colposcopy to assess changes, abnormal location of the small pelvis;
• urodynamic study with;
• cystoscopy with examination of the bladder;
• sigmoidoscopy with the study of the cavity from the inside of the rectum in case of suspected endometrial hyperplasia , polyposis , , ;
• rectovaginal examination in the gynecologist's office using mirrors;
• cytology with taking a smear from the cervical cavity;
• ultrasound, sonography of the pelvic organs to determine the degree of displacement of the bladder.

Additionally, women are referred to a urologist for examination of the urinary system.

Treatment of pelvic organ prolapse in women

Treatment depends entirely on the stage of uterine prolapse: conservative or operational. The prolapse of the vaginal and uterine fornix is ​​an inevitably progressive pathology and it is unlikely that the course can be stopped with the help of medications.

In most cases, the pathology becomes protracted nature, When can't do without surgery. Of course, when developing treatment, the doctor takes into account the age of the woman, the desire to give birth in the future. If genital prolapse is minor or surgery for a number of reasons contraindicated, then it is possible to carry out more gentle methods in order to preserve the main organ of childbearing - the uterus:

• plastic surgery of the vagina in the absence of atrophic modifications in the genitals;
• suture of ligaments to fix the uterus.

An effective minimally invasive technique for suturing the vagina, however, is prescribed to women who do not plan to have a sexual life, as a rule, in old age.

Damage to neighboring organs(bladder, intestines) correction of presentation or laparoscopy is indicated in case of cervical stump prolapse.

Effective Procedures:

• physiotherapy;
• gymnastics according to Yunusov, Kegel to strengthen the abdominal muscles and pelvic abdomen;
• oriental dances to strengthen the muscles of the buttocks;
• gynecological massage.

With excessive prolapse of the vaginal walls, surgery becomes the only treatment option.

Medications

Medicines as a strengthening therapy are prescribed exclusively at an early stage with a slight displacement of the body of the uterus beyond the anatomical boundaries. The basis of therapy:

• ointments, creams with estrogens (the main sex hormones of women), for example: "Eplir", "Gynocomfort" and "Epigen Intim";
• suppositories for intravaginal administration in order to normalize metabolism, blood microcirculation;
• vaginal tampons;
• pessaries in the form of rubber rings, different in diameter, inserted into the vagina to fix the cervix into a special hole;
• antiseptics as a prophylaxis for douching, washing the vagina in order to avoid the development of swelling of the mucous membrane, the introduction of infection.

Women during menopause hormone replacement therapy indicated in order to strengthen muscles (ligaments, pelvic organs), normalize blood circulation.

Surgical intervention

Uterine prolapse is most often corrected surgically. Main method- laparoscopy if women want to preserve childbearing functions. Other types of operations:

• anterior colporrhaphy to remove the anterior wall of the vagina, dissect the subcutaneous tissue to access the connected fascia, suture the protruding uterus together with the bladder for proper presentation;
• posterior colporrhaphy with the capture of the posterior wall of the vagina, the imposition of 3 clamps on the arch to determine the normal shape in the future and the formation of a diamond-shaped flap, cutting off the excess mucosa with tension, stitching the wound, followed by drying the vagina, rubbing with an alcohol disinfectant composition;
• uterine fixation to strengthen lowered organs with abdominal or transvaginal access to strengthen the sacrum and abdominal wall;
• colporrhaphy median with pulling the cervix closer to the perineum, separating the mucosal flap, pressing the exposed surfaces against each other and suturing;
• hysterectomy- the best option for correction in case of severe pelvic organ prolapse.

Often carried out Elkin method for partial removal of organs, followed by fixation of the stump, installation of a prosthesis. This method allows you to maintain a normal sexual life in women in the future.

The operation is a rough version of the impact on the female genital organs and often leads to serious injuries, severe pain in the postoperative period. Often women additionally prescribed analgesics (suppositories) containing estrogen, anti-inflammatory drugs.

After the operation, it is important to stay still 2-3 weeks under medical supervision, since bleeding, blood loss are possible.

Laparoscopy- the most gentle and safe method that does not leave scars, adhesions and scars, does not negatively affect the condition of the vagina. Moreover, it allows women to lead a normal sexual life. The method consists in creating a support for the uterus in the form of a mesh with the possibility of leaving it inside the body.

When performing vaginal surgery, women should not ignore the following doctor's recommendations during the recovery period:

• do not sit for 3-4 weeks;
• do not strain when defecation;
• avoid constipation;
• do not lift weights;
• refuse to visit the pool, sauna and baths for up to 2 months, until the body is fully restored;
• stop sexual activity for 2 months.

Alternative home treatments

According to gynecologists, prolapse of the pelvic organs is not a terrible diagnosis, however, with a slight degree of uterine prolapse. It is quite possible to recover at home, although of course with the permission of the attending physician and after passing a complete medical examination.

To help:

• Kegel exercises with no contraindications. The constant providence of these exercises will help the uterus return to its normal position, increase the tone of the muscles of the pelvic organs. You can spend it in a comfortable home environment and even on a walk, in transport;
• massage, regular sessions for 2-3 months on a gynecological chair to return the organ to its normal anatomical position;
• , with the addition of potassium permanganate;
• Yunusov gymnastics involving urination. It consists in tension of the muscles of the perineum, imitation of urinary retention;
• bandage, constant wearing will restore the pelvic organs, maintain the uterus at a normal level. It is necessary to wear until the muscles acquire normal tone, but not more than 12 hours in order to avoid putting excessive stress on the pelvic organs.

Exercises

Today, the most effective system, Kegel, exercises to compress the sphincter, pull up the lower abdomen by tightening the muscles located at the bottom of the pelvis. You need to carry out the exercises without haste, repeating each several times and gradually increasing the load on the muscles.

It is desirable to perform in a standing position, you need to use a rubber ball, holding it between your knees, so passing in a circle for 2-3 three minutes.

As a preventive measure for uterine prolapse, classical yoga has proven to be effective. Regular practice leads to positive results within 2-3 months. Yoga strengthens the abdominal muscles.

If you combine gymnastics with folk methods, then the results will be quite noticeable at the initial stage of the prolapse of the pelvic organs.

Forecast for life

Traditionally, it was assumed that, if left untreated, uterine prolapse would gradually worsen. However, there is some research that this is not the case and that spontaneous remission can occur.

During treatment the prognosis is good, but since the defect is mainly due to physiological weakening of the muscles and ligaments, relapse may occur. However, with adequate treatment, fertility can be preserved in younger patients.

Complications and consequences

Complications of uterine prolapse: friction of the vaginal epithelial lining leading to vaginal sores and ulceration.

Uterine prolapse and its accompanying symptoms: urinary incontinence, can lead to urinary tract infections.

There is also bleeding in some cases. Uterine prolapse due to weakened muscles can be complicated by accompanying prolapse of other organs pelvis, bladder (cystocele), or rectum (rectocele).

Interesting

Vaginal prolapse, or prolapse of the pelvic organs in women, is a diagnosis that is most often made in women after childbirth and during menopause. Much less often, women before and after 30, as well as those who have not given birth, treat this anomaly of the female reproductive system.

What is pelvic organ prolapse?

Prolapse of the pelvic organs is their physiological violation of the location. The descent and prolapse of the walls of the vagina (uterus) occurs when there is a weakening of the muscles of the pelvic floor. This pathology of the organs also manifests itself in the form of a displacement of the rectum and bladder.

What threatens the prolapse of the uterus and vagina?

Since the early stages proceed almost imperceptibly, many women do not even suspect the presence of pathology. But the presence of pathology and the lack of its treatment affects the quality of sexual life (and both partners). Also, women may "leak" when using tampons and the appearance of serious and dangerous problems with urination and defecation.

Left untreated, prolapse of the uterus or vaginal walls can lead to:

• the development of infections, and subsequently to pyelonephritis and cystitis;
• possible circulatory disorders in the pelvic organs and, as a result, to edema and even death of organs;
• partial and complete prolapse can lead to injury to the uterus or vagina, infection and ulcers;
• spontaneous abortions and problems with conception, as well as lengthening the postpartum period.

You can prevent any consequences by timely contacting a doctor, as well as regular preventive examinations.

Omission and prolapse of the vagina: symptoms and varieties

As mentioned above, in the initial stages, the pathology does not manifest itself in any way and may not bother the woman at all, but later omission can be manifested by the following symptoms:

• pulling pains (lower abdomen, lower back and sacrum);
• sensation of a foreign body, heaviness and pressure in the vagina;
• pain during intercourse;
• inflammatory processes in the vagina;
• sometimes incontinence or, conversely, urinary retention;
• difficulty and discomfort when walking;
• dryness and burning in the vaginal area;
• possible excessive spotting, etc.

The prolapse of the anterior and posterior walls of the vagina or cervix, as a rule, proceeds slowly (without symptoms and signs) at the initial stage, but when it begins to progress, it happens quite quickly. It can also be accompanied by infection and inflammatory processes, which complicates the treatment.

Varieties of prolapse and prolapse of the uterus and vaginal walls and their symptoms

Several stages of this disease are determined, each of which has its own characteristics and signs, as well as methods and treatment regimens. Only an experienced doctor can determine the stage of the disease and prescribe treatment, so it is advisable to undergo preventive examinations by a specialist in a timely manner.

What are the types and stages of omission?

• The prolapse of the walls of the vagina (posterior, anterior or both) may be accompanied by prolapse of the bladder and weakening of the muscular wall and septum of the vagina (without the organ going beyond the entrance and without going beyond the prescribed anatomical limits of the bladder).
• Cervical prolapse (prolapse): total or partial prolapse and prolapse with total or partial vaginal prolapse.
• Complete or partial omission and prolapse of the walls with part of the bladder or part of the rectum.

Omission and prolapse of the vagina: causes

The main cause of this disease is the weakening of muscle tone and the structure of the pelvic organs, which causes a violation of the normal arrangement of the internal organs of the genitourinary system and its normal functioning.

Also, the causes of prolapse and prolapse of the uterus and vagina in women are:

• frequent pregnancies and childbirth;
• the birth of a large fetus;
• difficult childbirth (complicated and prolonged, as well as birth trauma and perineal ruptures);
• heavy physical activity (sports, weight lifting, etc.);
• age-related changes (after 40 years, during menopause);
• weakening of the abdominal muscles and elasticity of the ligaments;
• congenital anomalies;
• chronic constipation and chronic cough, which leads to increased intra-abdominal pressure;
• overweight, obesity or sudden weight loss;
• the presence of tumors and neoplasms;
• unscrupulous surgery (removal of the uterus without fixing the vaginal dome);
• smoking;
• disruption of the liver and accumulation of fluid in the abdominal cavity;
• enlargement of the spleen;
• hormonal disorders, etc.

It is very important to timely establish the causes of uterine prolapse in a woman: whether it is the prolapse of the walls of the vagina or uterus after childbirth or changes as a result of a violation of hormone production during menopause. An accurately diagnosed disease and an identified cause can achieve good results in treatment. The main thing here is not to self-medicate and consult a doctor.

The first thing to do when you feel any of the above symptoms is to make an appointment and consult a doctor. If you do not regularly visit the gynecologist's office, then it is advisable to check the general condition of the body.

Omission of the vagina and uterus: treatment, initial appointment

At the initial appointment, the doctor examines the vagina and collects information about the patient's condition. Already during the examination, the doctor will be able to assess the degree of development of the disease and give directions for treatment or additional diagnostics.

In varying degrees, upon examination, you can determine:

• location of prolapse of the uterus or vagina;
• the condition of the muscles and ligaments of the pelvic floor;
• the stage and nature of violations;
• physiological causes of prolapse or prolapse, etc.

The doctor will also ask questions about your state of health and the possible causes that led to this disease.

Diagnosis of the disease

For each specific clinical case, the doctor prescribes tests and gives directions for diagnosis, which may include:

• (two sensors - transabdominally and transvaginally) of the pelvic organs (uterus,);
• hormonal tests;
• urine tests for infections;
• other tests and examinations.

Treatment plan for uterine (vaginal) prolapse or prolapse

There are several ways to deal with this problem. The doctor can apply one of them already at the initial examination, if the stage of the disease and the patient's condition allow it. We are talking about wearing a special uterine ring (pessary), which supports the uterus and does not allow it to fall below a certain level.

It should be noted that the pessary is not intended to treat uterine prolapse like other methods, but it can eliminate a number of symptoms and significantly improve the patient's quality of life. In some cases, a pessary is prescribed to prevent drooping during physical exertion or before long walks, for example.

Methods for the treatment of prolapse of the uterus (walls, cervix):

• Physical therapy (one of the ways is Kegel exercises) is prescribed when the patient has minor symptoms of prolapse and when there are no individual contraindications. This form of treatment is able to completely cure the patient and normalize the quality of life. A massage may also be prescribed.
• Surgical treatment (vaginoplasty) is prescribed when it is impossible to hold the pelvic organs with the help of physical exercises or when using medications (this is possible when the uterus prolapsed after childbirth).
• Hormone replacement therapy is most often prescribed for a lack of estrogen (with menopause). It can be both vaginal creams and suppositories.

If other diseases, such as infections, were also detected during the diagnosis, then additional medication is prescribed. Since the prolapse of the cervix can cause emotional discomfort, and not just physical, it is possible to appoint consultations with a psychotherapist or psychologist.

Re-admission

The doctor monitors the treatment of each individual patient, so after a period after the start of treatment, which is determined by the doctor, a second appointment is made to evaluate the course of treatment.

If, according to the results of the examination, it becomes clear that everything is fine, then the patient is allowed to go home with instructions for physiotherapy and recovery before the control appointment. If the examination does not show the necessary improvements, then it is possible to prescribe additional examinations and draw up new treatment regimens to determine why the previous course did not work, how to treat uterine prolapse and what to do next. An individual schedule of subsequent visits is also drawn up.

Control reception

A follow-up appointment is scheduled after the end of treatment to make sure that the treatment has a long-term effect. The patient is invited to an appointment in 21-30 days or several months, depending on how complicated the disease was.

Treatment result

Omission (prolapse) of the pelvic organs is completely cured or (in especially difficult cases) a significant improvement in the condition is achieved. The terms of treatment and full recovery are strictly individual. If sexually transmitted infections were detected during the diagnosis, then treatment (for infections) is also prescribed to the partner.

Prevention

To avoid this pathology, it is necessary to adhere to simple and affordable rules:

• compliance with the diet (correct and rational selection of products);
• weight control;
• physical activity (moderate, or only physiotherapy exercises);
• do not lift weights (more than 5 kg).

And do not forget to make it a habit to regularly come for an examination to: this helps prevent the appearance and development of various diseases and pathologies of the genitourinary system.

One of the main misconceptions that concerns women's health and this particular pathology is that many, having discovered that they have a prolapse or prolapse of the genital organs, are in no hurry to go to the doctor, because it does not bother them much. But, like any other disease, prolapse of the genitourinary system can gradually worsen, leading to more complex and costly treatment. Therefore, it is necessary to go to the doctor.

You can get more useful information for your case only by consulting with a specialist. We invite you to make an appointment with any of the doctors of our center by calling the number listed on this page or through the online registration form.

Many women, especially those who have had a natural childbirth, face the problem of pelvic floor prolapse at a certain age. This condition concerns not only women's health, but also negatively affects a woman's lifestyle in general - it creates obstacles to a full-fledged sexual life, sports and recreation.

"Letidor" asked the experts what are the causes of the pathology and what to do.

What is uterine prolapse

Galina Stepanovna Lazarenko, obstetrician-gynecologist, PhD, doctor of ultrasound diagnostics

Omission (prolapse) of the uterus is a pathology in which the pelvic organs are displaced below the anatomical boundary, which in the most severe cases leads to prolapse of the uterus. The omission of the pelvic floor muscles is accompanied by discomfort, pulling pains in the lower abdomen, colitis, constipation, and later the presence of dysuric disorders (difficult and frequent urination, urinary incontinence).

Causes of omission

Alana Azrailovna Morgoeva, obstetrician-gynecologist of the Nova Clinic Network of Reproduction and Genetics Centers

Pelvic organ prolapse is a problem affecting a woman's social health. According to statistics, such a pathology is detected in almost every second Russian woman over 50 years old, significantly reducing the quality of life.

The cause of the development of prolapse may be a genetic and racial predisposition ( more common in Asian women - approx. ed.). In addition to this, there are factors that increase the risk of developing pathology:

• heavy physical activity;
• smoking;
• chronic lung diseases;
• obesity;
• age (decrease in the amount of sex hormones);
• connective tissue pathology, which can occur, for example, with varicose veins.

provoke prolapse uterus can:

• surgery on the pelvic organs (extirpation of the uterus or supravaginal amputation);
• pelvic floor muscle injuries due to difficult childbirth;
• childbirth (it is believed that any pregnancy that lasts more than 20 weeks can cause prolapse).

Galina Stepanovna Lazarenko

Causes of occurrence include malformations of the pelvic organs, genetic predisposition, trauma during childbirth, heavy lifting weighing more than 10 kg, as well as the presence of benign formations in the pelvis and high intra-abdominal pressure against the background of obesity and constipation.

How is pelvic organ prolapse treated?

Galina Stepanovna Lazarenko

Treatment depends on the severity and clinical manifestations. At 1-2 degrees, conservative treatment is prescribed: gymnastics, gynecological massage, female sex hormones - estrogens - in the form of suppositories, ointments, vaginal tablets to improve microcirculation and metabolism.

Patients with 3-4 degrees of severity are subject to surgical intervention.

Alana Azrailovna Morgoeva

To avoid prolapse of the uterus, a woman must carefully listen to her body. At the slightest deviation from the norm, you should immediately seek the advice of a specialist. This is all the more important for the reason that in the early stages of the disease, a positive effect can be achieved through conservative treatment. As the pathology progresses, surgery becomes the only method for correcting pelvic organ prolapse. Many operations have been developed to correct the prolapse of the pelvic organs. In each case, the doctor conducts a thorough examination, applies the necessary diagnostic methods of examination, after which an effective treatment regimen is developed individually for each patient.

About the prevention of uterine prolapse

Galina Stepanovna Lazarenko

Preventive measures include: the release of women from hard physical work, heavy lifting, as well as physical education and special physical exercises aimed at strengthening the abdominal muscles and pelvic floor muscles.

An important role is played by the rational management of pregnancy, childbirth and the postpartum period.

Alana Azrailovna Morgoeva

An important task is the prevention of uterine prolapse. The following measures can prevent the development of pathology:

• accurate management of childbirth and timely correction of gaps;
• treatment of chronic diseases that are accompanied by an increase in intra-abdominal pressure (constipation, tumors of the abdominal cavity);
• weight loss, diet therapy;
• hormone replacement therapy for hypoestrogenic conditions;
• performing a special set of exercises;
• physiotherapy treatment;
• wearing a vaginal pessary.

Prolapse of the pelvic organs: personal experience

That summer, when I first realized that something was wrong with me, I turned 45 years old. I lived in a country house with a three-year-old daughter, my husband came to visit us for the weekend, and everything was fine until I felt that something was preventing me from walking and that something was in my shorts. First shock, then an attempt to touch this something. A small soft bag, like a tumor, was literally at the exit from the vagina.

To be honest, my first thought was cancer.

Then I calmed down a little, talked with my mother and sister, and at the women's council they decided that it looked like a prolapse of the uterus.

From that day on, the problems began. At first it was uncomfortable for me to walk, then this part began to fall out so much that from time to time I had to literally fill it back with my hands. I was terribly worried, only I was in no hurry to see a doctor, it was a pity that the weather was good, I decided to wait until autumn - to send the child to the garden and then take care of myself.

She told her husband. He seemed to react normally, with understanding. But problems began in my sexual life - firstly, I was ashamed that everything was wrong there, and secondly, every time the sexual intercourse became more and more painful.

Autumn has come. I went to an appointment with a gynecologist, she confirmed the alleged diagnosis - pelvic organ prolapse, something like this sounded.

She suggested surgery and gave me a few days to think.

I thought 4 months - until life became so uncomfortable and bad that even cry. But I couldn’t cry, laugh, cough, go to the toilet - everything immediately fell right into my shorts.

Already in the winter, I again came to the reception, and only then did I finally decide to have the operation. It took a couple of weeks to collect the necessary tests and undergo important examinations.

The operation lasted 4 hours. They warned in advance that it was not a fact that the uterus would be left.

Pelvic organ prolapse can occur in the anterior (34%) (Fig. 1), middle (14%) (Fig. 2), posterior (19%) (Fig. 3). sections of the pelvic floor.

Anterior prolapse includes:

• Urethrocele (prolapse of the urethra and the anterior wall of the vagina)
• Cystocele (prolapse of the bladder and anterior wall of the vagina)
• Cysto-urethrocele (prolapse of the urethra, bladder, and anterior vaginal wall)

Figure 1. Anatomy of the female pelvic organs with prolapse of the anterior vaginal wall (cystocele).

Prolapse of the middle section includes:

• Descent of the uterus (apical prolapse)
• Vaginal dome prolapse (complete prolapse of the vagina, develops after removal of the uterus and cervix)
• Enterocele (protrusion through the pouch of Douglas loops of intestine or mesentery)

Figure 2. Anatomy of the female pelvic organs with combined prolapse of the walls of the vagina and uterus (apical prolapse).

Posterior prolapse includes:

• Rectocele

Figure 3. Anatomy of the female pelvis when the posterior wall of the vagina is prolapsed (Rectocele)

It should be noted that isolated prolapse in one section is quite rare, it is often accompanied by the prolapse of the vaginal walls in neighboring sections.

There are 2 most common and generally accepted classifications:

The first Baden-Walker. According to this classification, there are four stages of pelvic prolapse:

• 1 stage. The most prolapsing area of ​​the vagina is located just above the hymenal ring;
• 2 stage. The maximum prolapsing area is located at the level of the hymenal ring;
• 3 stage. The maximally prolapsing area extends below the hymenal ring;
• 4 stage. Complete prolapse of the vagina;

The second is the ICS-1996 classification, POP-Q, in which 4 stages are also distinguished. At the 1st stage, the most prolapsing point of the vagina is 1 cm above the hymenal ring. At the 2nd stage, the most prolapsing point is located below the ring, but not less than 1 cm. The 3rd stage occurs when the vagina falls out, but not completely, while at least 2 centimeters of it should remain inside. Stage 4 - complete prolapse of the vagina.

Figure 4. Baden-Walker classification

Symptoms of prolapse of the pelvic organs

Unfortunately, pelvic organ prolapse is not only an anatomical problem. Complaints are almost never limited to "feeling of a foreign body protruding from the vagina." The abnormal position of the pelvic organs leads to pronounced (frequent urge, chronic urinary retention,), rectum (constipation, difficulty in defecation, gas and stool incontinence), creates difficulties in sexual life up to the complete rejection of the latter, is the cause of chronic pain syndrome.

Fortunately, today most of the problems outlined above are curable with surgery. will be described below.

Causes of prolapse of the pelvic organs

• prolonged traumatic childbirth,
• systemic connective tissue dysplasia,
• local estrogen deficiency,
• diseases constantly accompanied by an increase in intra-abdominal pressure (bronchitis, asthma, constipation, etc.),
• overweight,
• a sedentary lifestyle can also be a factor in the development of uterine prolapse, rectocele or cystocele.

The prolapse of the pelvic organs occurs due to damage or weakening of the supporting fascio-ligamentous apparatus, for a number of the above reasons. The cervix is ​​the apex of the pelvic floor and when it is lowered, a traction displacement of the anterior and posterior walls of the vagina occurs, followed by its complete eversion outward. The anterior and posterior walls of the vagina are separated from the bladder and rectum only by sheets of intrapelvic fascia. With its defects, the bladder and / or rectum begin to descend into the lumen of the vagina - forming a prolapse and prolapse of the walls of the vagina.

The prevalence of pelvic organ prolapse in Russia

The frequency of certain types of prolapse of the pelvic organs in women under the age of fifty in our country varies and ranges from 15 to 30 percent. And by the age of fifty, this figure increases to 40 percent. Among older women, pelvic prolapse and prolapse are even more common. Their frequency reaches an impressive 50 - 60 percent.

Recent studies show a very depressing picture.

By the age of fifty, virtually every tenth woman needs surgical treatment of pelvic organ prolapse, and by the age of eighty, this figure doubles.

Diagnosis of prolapse of the pelvic organs

It is not enough to make a diagnosis, collect complaints and anamnesis of the disease. Conducting a vaginal examination is a mandatory diagnostic item and is carried out primarily to identify the type of prolapse of the walls of the vagina, because the visual picture with cystocele, rectocele and uterine prolapse (uterocele) may be similar.

• Ultrasound of the bladder with the determination of residual urine.
• Ultrasound of the pelvic organs.
• Uroflowmetry.
• Urine culture for flora and sensitivity to antibiotics.

Conservative treatment

Conservative treatment is widely popular due to its simplicity and long history. It is with this method that most patients begin their treatment. There are 4 main non-surgical treatment options, which are:

• Lifestyle changes and the fight against excess weight, reducing the severity of physical activity, preventing constipation and respiratory diseases.
• Pelvic floor muscle training.
• Wearing special bandages and pessaries. (Figure 5)
• The use of laser technology.

Unfortunately, the window of therapeutic possibilities of most conservative methods (i.e., the period when the treatment brings the greatest effect) is quite narrow and mainly concerns the prevention or treatment of the initial forms of prolapse.

Operations

To date, surgery is the only method that provides long-term effectiveness of treatment.

At present, traditional surgical interventions for PROGRESSIVE forms of cystocele or uterine prolapse cannot be considered the optimal choice, involving plastic surgery with own tissues without the use of implants - “mesh” (Anterior colporrhaphy, perineolevathoroplasty, sacrospinous fixation, ventrofixation, etc.)

The reason is the extremely high risk of recurrence (up to 50-70%) with a sufficiently large number of complications (sexual dysfunction, pain syndrome, etc.). In Russia and the CIS countries, traditional techniques are still the main operations performed for pelvic organ prolapse. And hysterectomy (removal of the uterus) is often used to “treat” pelvic organ prolapse, which in most cases is completely unjustified and even harmful. The conventional wisdom that if you remove the uterus, then "there will be nothing to fall out" is a delusion.

The uterus itself has no effect on prolapse, being the same hostage to the situation (defect of the ligaments of the pelvic floor), as well as other organs of the small pelvis (bladder, rectum, loops of the small intestine). The last one does not offer to delete. Hysterectomy (removal of the uterus) using modern technologies is completely optional and has no (including oncological) grounds (if the uterus is healthy). At the same time, it must be understood that the removal of this organ can lead to damage to the nervous structures that regulate urination, disrupt the blood supply to the pelvic organs, and, finally, lead to prolapse of the vaginal dome (when the uterus has already been removed) in every fifth to seventh woman.

In most cases, the indication for surgical treatment with the use of synthetic mesh prostheses is the prolapse of the pelvic organs of stage III-IV.

Today, pelvic floor reconstruction technologies have a "patient-centric" nature, when, in fact, there is no standard technique, implant or technology. There is an internationally recognized approach, which consists in combining techniques to achieve the best result for each patient individually. So, one of the most progressive methods is when combined modified techniques for restoring the pelvic floor with one's own tissues with selective endoprosthesis replacement of individual ligaments and the use of mesh implants (Fig. 6).

Figure 6. "Hybrid" reconstruction of the pelvic floor with the use of mesh implants in the prolapse of the pelvic organs of the 3rd stage.

With a hybrid approach, the summation of the pluses and the leveling of the minuses of both methods takes place. Our Center is one of the pioneers in this direction. In our practice, we most often use materials produced by a domestic enterprise (St. Petersburg), as we have already convinced ourselves of the high quality of these implants and have the opportunity to directly influence the improvement of all elements of these products thanks to long-term scientific and technical cooperation.

Pelvic floor reconstructive surgery is a very specific field that requires a deep understanding of the anatomy and function of the pelvic organs, as well as a strong command of both “mesh” and “traditional” operations. Knowledge makes the doctor free to choose the method of treatment, and the patient - satisfied with the results.

Every year more than 900 operations are performed in our Center for prolapse (omission) of the pelvic organs (also in combination with urinary incontinence).

We consider the monitoring of long-term results of treatment to be the most important element of our work. More than 80% of our patients are regularly examined by specialists of the Center in the late postoperative period. This allows you to see a real picture of the effectiveness and safety of the treatment.

The cost of treatment of prolapse and prolapse of the pelvic organs:

Most of the patients receive assistance free of charge within the framework of compulsory health insurance (under the CHI policy).

It is possible and treatment for cash. The price depends on the volume and complexity of the operation. On average: from 50,000 to 80,000 rubles. (The price includes: surgery, anesthesia, hospital stay, mesh implant and other expenses).