Cystocele, Urethrozelen, Enteroceles And Rectocele

These diseases represent reductions of an organ in the vaginal canal: cystocele (bladder), Urethrozelen (urethra), enterocele (intestinal and peritoneal) and rectocele (rectum). The main symptom is a fullness or pressure in the pelvis or vagina. The diagnosis is made clinically. Treatment options include pessaries, exercises to strengthen the pelvic floor muscles and surgical measures.

Cystocele, Urethrocele, enterocele and rectocele occur particularly often together. A Urethrocele always occurs practically together with a cystocele (cystourethrocele). Cystocele and cystourethrocele usually develop urogenital at weakening the diaphragm. An enterocele usually occurs after a hysterectomy. By weakening the fascia and fascia pubocervicalis rectovaginalis the apical part of the vagina, including the peritoneum and the small intestine deszendiert. A rectocele is brought about by an interruption of the bilateral levator ani muscle.

These diseases represent reductions of an organ in the vaginal canal: cystocele (bladder), Urethrozelen (urethra), enterocele (intestinal and peritoneal) and rectocele (rectum). The main symptom is a fullness or pressure in the pelvis or vagina. The diagnosis is made clinically. Treatment options include pessaries, exercises to strengthen the pelvic floor muscles and surgical measures. Cystocele, Urethrocele, enterocele and rectocele occur particularly often together. A Urethrocele always occurs practically together with a cystocele (cystourethrocele). Cystocele and cystourethrocele usually develop urogenital at weakening the diaphragm. An enterocele usually occurs after a hysterectomy. By weakening the fascia and fascia pubocervicalis rectovaginalis the apical part of the vagina, including the peritoneum and the small intestine deszendiert. A rectocele is brought about by an interruption of the bilateral levator ani muscle. The severity of these disorders is defined by the extent of protrusion: Grad 1: up to the upper vagina Grade 2: to the introitus Grade 3: outside the introitus symptoms and complaints A fullness or pressure in the lower abdomen or in the vagina and feeling, as whether members wanted to drop out, are common specifications. The institutions can produce bulge into the vaginal canal or through the vaginal opening (introitus), v. a. during abdominal pressure or when coughing. Dyspareunia may occur. Often a cystocele or cystourethrocele is accompanied by stress incontinence. Overflow incontinence, or particularly for damage to sacral nerve, urge incontinence may also develop. Enteroceles can cause pain in the lower back. Rectocele can cause constipation and incomplete defecation; some patients have to push in the rear wall of the vagina manually to empty the chair. Diagnostic examination of the anterior or posterior vaginal wall during the patient presses the diagnosis is confirmed by the study. When lying in lithotomy position patient to recognize a cystocele or cystourethrocele by relegates the posterior vaginal wall with a single-blade speculum. When the patients are asked to press a cystocele or cystourethrocele phenomenon occurs in visible or palpable as soft, reponible protrusion of the front vaginal wall. Of these, an inflamed Skene’s gland (Skene’s glands) distinguished by their location on the front and sides of the urethra, through tenderness and sometimes by a secretion of pus during palpation. An enlarged Bartholin’s gland can be differentiated by their position on the inside of the labia majora; in the presence of inflammation may be pressure sensitive. Enterocele and rectocele are identified by pushing back the front vaginal wall in lying in lithotomy position patients. When prompted to press enteroceles and rectocele could become more palpable visible and rectovaginal examination. The patients are also tested in a standing position with the knee tightened (for example with one foot on a chair.) And pressing; Some cuts are occasionally recognized only by a rectovaginal examination during this maneuver. A possible urinary incontinence is also being investigated. Pessary treatment and pelvic floor exercises (z. B. Kegel exercises) If necessary, surgical correction of the attachment apparatus, the therapy can be initiated with a pessary and Kegel exercises. A pessary is a prosthesis that is inserted into the vagina to hold the prolapsed structures after reduction in the correct position. Pessaries are available in various shapes and sizes, and some are inflatable. Pessaries can cause Vaginalulzera, if they are not properly adjusted in size and not cleaned routinely (at least once a month, possibly more often). Pelvic floor exercises (including Kegel exercises) can be recommended. The Kegel exercises are based on the isometric contraction of the pubococcygeus. By introducing vaginal cones with graduated weights that make it easier for the patient to focus on the contraction of the correct muscle, as well as by biofeedback devices or by electrical stimulation, which causes the muscle to contract, the exercises can be supported. Pelvic floor exercises can reduce bothersome symptoms of prolapse and stress incontinence, but are not shown to reduce the severity of the prolapse. Surgical correction of the attachment apparatus (front and rear colporrhaphy) may be helpful in severe discomfort or failure of conservative measures. The Perineorrhaphie (operational shortening and gathering of the dam) may also be required. If possible, a colporrhaphy (surgical correction of the vagina) is usually delayed until the family planning is complete, because a subsequent vaginal birth could make the operation result to nothing. Colporrhaphy and Perineorrhaphie be carried out usually with a vaginal approach. Surgery to correct urinary incontinence can be done in a meeting with the colporrhaphy. After surgery, the patient should not lift heavy for 3 months. After surgical correction of a cystocele or cystourethrocele a urethral catheter is left for <24 hours. Key points A Urethrocele is almost always in conjunction with a cystocele before and cystocele, Urethrocele, enterocele and Rectozele are likely to occur together. To help identify a cystocele or cystourethrocele, just press the back wall of the vagina from a single-blade speculum while the Pstientein is in lithotomy position and ask you to burden them. To recognize enteroceles and rectocele, the front wall of the vagina is pushed back when lying in lithotomy patients. Recommend pessaries and / or pelvic floor exercises, but if these are ineffective, surgical correction should be considered.

Health Life Media Team

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