What women need to know about pelvic organ prolapse condition
Genital prolapse is a distressing condition and a large percentage of women develop some form of vaginal prolapse during their lifetime, most commonly following menopause, childbirth or a hysterectomy. Most women who develop this condition are older than 40 years of age.
Pelvic organ prolapse is descent of the pelvic organs (urinary bladder, uterus (womb) and rectum) into the vagina often accompanied by urinary, bowel, sexual, or local pelvic symptoms. It has been estimated that a half of women lose pelvic floor support, resulting in some degree of prolapse, and that of these women 10-20 per cent seek medical care.
Prolapse tends to run in families. It is more likely after menopause. After menopause, the estrogen level declines; and the support structures may weaken leading to prolapse.
Childbirth is another main cause of prolapse. The more vaginal births you have, the more likely you are to have a prolapse. Other reasons are: > Prolapse can also happen in women who haven’t had a baby, mainly if they cough, strain on the toilet, or lift heavy loads. > Prolapse can also happen in women who have had their womb removed (that is, had a hysterectomy). In a case like this, the top of the vagina (the vault) can prolapse.
Many women who have pelvic organ prolapse don’t have symptoms. When women do experience symptoms, they can range from relatively minor to debilitating. When a prolapse is further down, you may notice things such as: > Something ‘coming down’ or a lump in the vagina > Sexual problems of pain or less sensation > Urinary tract infections might be reoccurring, or > It might be hard for you to empty your bowel.
How to deal with it
Prolapse can be dealt in many ways depending on the symptoms and the severity. Prolapse can often be treated without surgery, chiefly in the early stages, when patient does not have much symptoms. The simple approach can mean: > Pelvic floor muscle training, where a programme of treatment is planned to suit your individual needs, with the advice of a pelvic floor physiotherapist. > Being aware of good bowel and bladder habits to avoid straining on the toilet.
Treatments, like lifestyle changes and physical therapy, are considered more conservative in approach and so are generally tried first. Pessaries, a device inserted into the vagina to provide support to the pelvic floor, offer a temporary solution to pregnant women or to women who are not medically fit for surgery.
Laser treatment is ideal for those women who have vaginal relaxation causing symptoms but not to the extent that they want to submit to a surgical intervention. Laser treatment is recommended in patients having milder form of vaginal prolapse and mild stress urinary incontinence.
Surgery can be done to repair torn or stretched support tissues and ligaments. The surgery makes the vaginal wall stronger and helps the tissues support the pelvic organs. There different surgical options and choosing one depends upon which organ(s) have descended, a woman’s age, history of previous pelvic surgery, and whether she wishes to retain her uterus.
Various minimally invasive surgical approaches are available now in young patients who wish to retain uterus and want to have pregnancies in future.
As prolapse is due to weak pelvic tissues and pelvic floor muscles, all women should keep their pelvic floor muscles strong — no matter what their age. It is important to strengthen the pelvic floor muscles after vaginal delivery by regularly performing Kegel’s exercises. Women at risk for vaginal prolapse (including those who have had corrective surgery) should, if possible, avoid heavy lifting or any activity that increases pressure within the abdominal cavity.
Any woman who experiences symptoms that may indicate a vaginal prolapse should contact her doctor. A vaginal prolapse is rarely a life-threatening condition. Timely medical care is recommended to evaluate for and to prevent problematic symptoms and complications caused by weakening tissue and muscles surrounding the vagina. Dr Alphy Puthiyidom, specialist
obstetrics & gynecology, International Modern Hospital (This article has been sponsored by the advertiser)