Prolapse: what really does work?
The worst cases of prolapse can make women feel as if their insides are literally falling out. But some are too minor even to cause symptoms and are discov-ered during an examination for something else.
‘The ligaments and muscles that make up the pelvic floor start to stretch, and the organs in the abdomen slip down,’ says Dr Philip Owen, a consultant obstetrician and gynae-cologist at the Princess Royal Maternity hospital in Glasgow.
Stretching can occur during pregnancy and childbirth. Being over-weight and ageing are risk factors. According to the Royal College of Obstetricians and Gynaecologists, half of women over 50 will have some degree of prolapse.
‘Menopausal women are at risk as muscle tone deteriorates and oestrogen levels fall, which cause the wall of the vagina to become thin and less able to support itself,’ says Dr Owen.
TYPES OF PROLAPSE
UTERO-VAGINAL: The uterus pro-trudes into the vagina and in some cases slips out. Up to 30per cent of women who have had children develop a utero-vaginal prolapse later in life. They are common in postmenopausal and overweight women as the weight puts pressure on the abdomen.
BLADDER: The bladder pushes into the vagina and ‘this can cre-ate a “reservoir” of urine that can-not be emptied which can lead to irritation, spasms and inconti-nence,’ says Dr Owen. It can also result in leaking when a woman laughs or coughs.
RECTOCELE: This occurs when a loop of the bowel presses into the vagina, creating an S-bend where faeces can collect. ‘In some cases, women find it difficult to empty their bowels,’ explains Dr Owen.
Rectocele mostly occurs in women who have undergone a hysterectomy.
TREATMENTS
LOSInG weight can help to lessen the pressure on the abdominal area. Phys-iotherapy can reduce the symptoms of any pelvic organ prolapse. Your doctor can refer you.
Ring-shaped pessaries can add support within the vagina. They are worn all the time and need to be replaced every six months.
Surgery may be offered for severe uterine prolapse. One option is synthetic mesh to support the pel-vic floor, but this has been linked to long term side-effects. Other options include autologous slings, created from a woman’s tissue.
See your doctor if you have chronic constipation, as long term straining contributes to prolapse.