Pelvic Floor Prolapse

pelvic8Help with a Pelvic Floor Prolapse

If your Pelvic Floor Prolapse is mild, there are some steps which may help you improve the condition of the prolapse or reduce the risk of the prolapse getting worse.

This may include:

  • doing regular pelvic floor exercises (see below)
  • losing weight if you are overweight and maintaining a healthy weight for your build – you can check your body mass index (BMI) using the healthy weight calculator

Other Factors Around Pelvic Floor Problems

If you smoke, you should give up because the persistent cough most smokers have can make a prolapse worse. See stopping smoking for more information and advice.

Pelvic floor exercises help weak or damaged pelvic floor muscles which cause urinary incontinence, so exercising these muscles is often one of the first treatments recommended.

Stress urinary incontinence is caused by loss of support of the urethra which is usually because of damage to the strength of the pelvic floor muscles, generally as a result of vaginal childbirth.

Pelvic organ prolapse happens when an organ in your tummy drops from its normal place and pushes against the walls of your vagina. This can happen when muscles get weak or stretched from childbirth or surgery.

Having weak or damaged pelvic floor muscles can make a prolapse more likely.

Pelvic organ prolapse can be uncomfortable or painful, but it isn’t usually a serious health problem, and for some women it can get better over time.

Organs involved can be bladder, urethra (the tube that takes urine from the bladder to outside the body), uterus, vagina, small bowel or rectum. More than one pelvic organ can prolapse at the same time.

Causes
Strain during childbirth to muscles and tissues in your lower belly are the most common cause. These muscles normally keep your pelvic organs in place and if they don’t recover after childbirth, they can’t support your pelvic organs.

 

Removing the uterus (hysterectomy) can also leave other organs in the pelvis with less support.

 

Other causes can be prolonged coughing fits, (from bronchitis, asthma or smoking), and pressure on your pelvic organs from obesity, chronic constipation or pelvic organ tumours. There can also be a genetic link.

 

Older women are more likely to have pelvic organ prolapse – a reduction in your oestrogen level resulting in weaker muscles.

 

These causes together or individually lead to a weakened pelvic floor, which can, in turn, lead to leakage of urine when you laugh, cough or sneeze. The more the pelvic floor is weakened, the less it supports the uterus. When the uterus hangs low enough it’s called a prolapsed womb. Problems with a low-slung or weakened pelvic floor can also lead to bowel leakage, kidney infections and more.

Symptoms of pelvic organ prolapse
The most common symptom of pelvic organ prolapse is the sensations of pressure from pelvic organs pressing against the vaginal wall, which can also be a feeling of fullness in your lower tummy. You might also feel as if something is falling out of your vagina, pulling or stretching in your groin or lower back pain.

 

Other symptoms are incontinence or a frequent need to urinate, pain in your vagina during sex, and bowel problems such as constipation.

Diagnosis of pelvic organ prolapse
At Somerset Urology Associates, we will ask about your symptoms and medical history, including pregnancies, and examine your pelvis.

Treatment of pelvic organ prolapse
Depending on which organ is involved and how uncomfortable your symptoms are we may advise lifestyle changes, including what and how much you drink [see incontinence], avoiding heavy lifting and standing up for long periods of time.

 

Special exercises can also make your pelvic muscles stronger [Read more at pelvic floor]. Pelvic floor exercises are also used to treat urinary incontinence so may be useful if this is one of your symptoms.

 

Stronger symptoms and greater discomfort may warrant a removable device called a vaginal pessary that is placed in your vagina to help hold the pelvic organs in place. Pessaries come in a variety of sizes and can be made of rubber, plastic, or silicone-based material, and your pessary needs to be fitted initially by a specialist so it holds the pelvic organs in position without causing discomfort. The pessary may need to be removed and replaced every few months.

 

If you have a severe prolapse, you may have trouble keeping a pessary in place, so surgery is a treatment option for serious symptoms of pelvic organ prolapse.
You may want to consider surgery if you have a lot of pain, if the pelvic organ prolapse seriously affects your bladder and bowels or makes it difficult for you to have sex.

 

Types of surgery for pelvic organ prolapse include:

  • repair of the tissue that supports a prolapsed organ
  • repair the tissue around the vagina
  • closing the opening of your vagina
  • removal of the uterus (hysterectomy): this may form part of your treatment, but does not directly treat a prolapse

The front walls of your vagina will be rebuilt and the internal organs such as your bladder, uterus and bowel, put back into their correct position. Sometimes a type of mesh can be used to strengthen your vaginal wall or add extra support to your rectum or small bowel.

 

Less invasive surgery in the form of keyhole surgery (Laparoscopy) is used and many prolapse operations are done as day surgeries with no overnight stay. General anaesthetic is not required and recovery tends to be quicker with fewer complications.

 

NB: surgery may not be appropriate if you plan to have children. Straining in childbirth could cause your prolapse to reoccur.

 

For most patient, surgery is successful, with improvement to bowel and bladder function and a result of having your pelvic floor tightened up can be more enjoyable sex.

 

Hormone Replacement Therapy (HRT)
This can help relieve some of the symptoms associated with prolapse, such as dryness of the vagina or discomfort during sex, and is widely used for women who have symptoms of a prolapse after menopause.

Read More About Female Urology problems

Leave a Reply