Uterine Disorder: Causes, Symptoms, Test and Treatment

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Diseases affecting the uterus or any other part of your reproductive system are referred to as uterine disorders. Some common uterine problems include uterine fibroids, endometriosis, uterine prolapse, and uterine tuberculosis.

There are four uterine disorder 

  1. Cystocele and Urethrocele
  2. Rectocele
  3. Uterine prolapse

I had earlier shared What is Uterine Abnormalities?: Symptoms, Causes, Treatment. I hope you read the post.

uterine disorders
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Cystocele and urethrocele

Cystocele: 

  • It is a downward displacement of the bladder into the vagina.

Urethrocele:

  •  It is a downward displacement of the urethra into the vagina.

Causes:

  • Associated with obstetric trauma to fascia, muscle, and ligaments during childbirth.
  • genital atrophy with age
  • Congenital disability 
  • After hysterectomy

Signs and symptoms:

  • May be asymptomatic in early stages 
  • Pelvic pressure or heaviness, backache, nervousness
  • Urinary symptoms: urgency, frequency, incontinence, incomplete emptying
  • Aggravated by coughing, sneezing, standing for an extended period
  • Obesity; which increase intra-abdominal pressure

Diagnostic evaluation: 

  • History collection
  • Physical examination
  • Pelvic examination
  • Lab investigations
  • Urine analysis
  • Cultures analysis

Management: 

  • Vaginal pessary
  • Estrogen therapy
  • Pelvic floor muscle exercises
  • Surgery ( if cystocele is large and interfere with bladder functioning)
  • May do anterior vaginal colporrhaphy ( repair of the anterior vaginal wall)
  • Complications of surgery include urinary retention, bleeding (requires vaginal packing)

Complications:

  • Urinary incontinence
  • Infection

Rectocele

It is displacement (protrusion) of the rectum into the vagina.

Causes 

  • Obstetrical trauma.
  • During childbirth.
  • Pelvic surgery.
  • Age.

Signs and symptoms

  • Pelvic pressure or heaviness, backache, perineal burning.
  • Constipation (may have difficulty in a fecal evacuation; the patient may use fingers in the vagina to push feces up so defecation may occur).
  • Incontinence of feces and flatus.
  • Visible protrusion into the vagina .

 Diagnostic evaluation

  • History collection.
  • Physical examination and vaginal examination.
  • Use sims speculum to the uplift cervix and fully evaluate condition.

Management

  • Pessary.
  • Estrogen replacement
  • Pelvic floor muscle exercise.
  • Surgery (posterior colpoplasty; repair of the rear vaginal wall).

Complication

  • Total fecal incontinence.

Uterine Prolapse

It is an abnormal position of the uterus in which the uterus protruded outward. Uterus herniates through the pelvic floor and protrudes into the vagina and possibly beyond the introitus.

Causes

  • Obstetrical trauma.
  • Overstretching of musculofascial supports. 

Degrees

First degree

Condition of the cervix: Cervix prolapse into the vaginal canal

Second degree 

Condition of the cervix: Cervix is at the introitus

Third-degree

Condition of the cervix: The cervix extends over the perineum

Marked Procidentia

Condition of the cervix: The entire uterus protrudes outside the vaginal cavity.

Signs and symptoms 

  • Low backache or dyspareunia.
  • Pressure and heaviness in the pelvic region.
  • Bloody discharge because of cervix rubbing against clothing or inner thighs.
  • Urinary frequency, urgency, or repeated bladder infections.
  • Symptoms are aggravated by obesity, standing, straining, coughing, or lifting a heavy object because of increased intra-abdominal pressure.

Diagnostic evaluations 

  • History collection.
  • Physical examination.
  • Pelvic examination.

Complications 

  • Necrosis of cervix and uterus.
  • Infection.

Management 

  • Hysterectomy or surgical correction
  • Vaginal pessary
  • Pelvic floor muscle exercises
  • Estrogen cream

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