The womb (uterus) is an unpaired hollow body of smooth muscle, in which the process of embryo development and gestation. Located
the uterus in the pelvic cavity, mezoperitonealno, behind the bladder, in front of the rectum. In women of reproductive age length of the uterus is about 7-8 cm, width - 4 cm. In nulliparous women uterine weight is 40-50 g, parous - 80 (associated with hypertrophy of the muscle membrane). Uterus - rather slider, and depending on the location of adjacent organs, it may take a different position. Normally, the uterus is in a position antefleksio (longitudinal axis is oriented along the axis of the pelvis), anteverzio (filled bladder and rectum is slightly tilted forward uterus). Most of the surface of the body except the vaginal part of the cervix is covered by peritoneum.
The uterus is composed of three parts:
- fundus - stands above the confluence of several of the fallopian tubes, is the convex upper part;
- the body of the uterus - the average of the cone-shaped;
- cervix - the lower rounded portion narrowed.
The lower part of the cervix protrudes into the vagina is called the vaginal portion, the upper section, which lies above the vagina - supravaginal part. On vaginal part of an opening of the cervix, in nulliparous women having a rounded shape, while giving birth - slit-like.
The layers of the uterine wall
The wall of the uterus has three layers:
- perimetrium (serous layer) - in most surface of the front, the rear wall of the uterus and tightly adherent to the myometrium, in the Isthmus of loosely attached;
- myometrium (muscular layer) - consists of three layers of smooth muscles (outer longitudinal, middle circular, inner longitudinal) doped with elastic fibers and fibrous connective tissue;
- the endometrium (the mucosa) - formed by columnar epithelium, having a surface (functional) and deep (basal) layer.
The uterus during pregnancy
The uterus during pregnancy is undergoing substantial changes
. Actively increases muscle layer
. Muscle fiber increasing in length and become more voluminous
. Furthermore, they increase the protein content - actomyosin, which is responsible for muscle contraction
. To prevent premature contraction of muscles of the uterus, there hormone progesterone
. With the lack of his generation emerge reducing the muscle layer of the uterus
. In this case, we are talking about increased tone of the uterus
. Periodically there is an increase in the tone of the uterus are normal, but significant permanent increase in the tone of the uterus may affect the development of the fetus, since the reduction of the muscular layer of blood vessels are compressed, resulting in impaired fetal nutrition
. The main danger is the lack of blood supply to the brain of the fetus
. The uterus during pregnancy increases from the first week, reaching a maximum size to date of birth
Uterine muscles are always in good shape, not only during pregnancy. They keep it relaxed, then reduced. Raising the tone of the uterus occurs during sexual intercourse and during menstruation, in the first case promotes sperm, in the second - the rejection of the functional layer of the endometrium.
Cervical erosion treatment
One of the common diseases of the female reproductive system is the erosion of the cervix. Treatment of this disease is highly effective, but must be carried out on time. By the term "cervical erosion" refers to lesion of the mucous membrane of the cervix. Treatment erosion includes the following methods:
- laser photocoagulation;
- chemical coagulation;
- radiosurgical method.
Uterine fibroids, treatment
Another common pathology is uterine fibroids. This benign tumor that occurs in the myometrium. Fibroids is a chaotic interlacing smooth muscle fibers. Units fibroids reach a fairly large size, can weigh several kilograms. The symptoms of this disease are menorrhagia, pain and a feeling of pressure in the abdomen. Also, there may be signs of disturbances in the functioning of the neighboring organs: colon, bladder, arising from the large amounts of uterine fibroids. Treatment of the disease can carry expectant character (this is justified for slow-uterine). In addition to drug therapy for the treatment of uterine used methods such as removal of the uterus, uterine artery embolization, FUS ablation of fibroids.
Removal of the uterus or hysterectomy - one of the most common surgeries in gynecology. Hysterectomy is used for those diseases where the use of alternative treatments is impossible. The indications for this surgery are, in addition to uterine fibroids are endometriosis, uterine prolapse, abnormal uterine bleeding, uterine cancer, cancer of the cervix, ovaries, fallopian tubes.
Depending on the amount of tissue removed distinguish these types of hysterectomy:
- subtotal hysterectomy (amputation of uterus) - carried out with preservation of the cervix;
- total hysterectomy (hysterectomy) - the uterus is removed from the cervix;
- gisterosalpingoovariektomiya - the uterus is removed with appendages;
- Radical hysterectomy - the uterus is removed with appendages, neck, upper part of the vagina, as well as the surrounding fiber lymph nodes.