Gynecology

Understanding Prolapse

Whether  you have heard of it or not, pelvic organ prolapse is a condition which affects as many as half of all women who have given birth. Prolapse happens when tissues that support the organs in the pelvis become relaxed and weak, which commonly occurs following childbirth.  As a result, the organs drop down and can press against or bulge into the vagina. You can envision the vagina as a tube with the front wall supporting the bladder, the back wall supporting the rectum and the top supporting the uterus; when any of these walls come crumbling down, the bladder, rectum or uterus can drop into that tube. Most women with prolapse, however, don’t have any symptoms. When symptoms appear, they can include: a bulge in the vagina or coming out of the vagina; fullness or pressure in the pelvis or vagina; leaking urine when laughing, coughing or sneezing; urgency to urinate; mild to severe difficulty with vaginal sex, based on severity and type of prolapse; the need to press on the bulge in the vagina to complete urination or a bowel movement (known as digital splinting). Your doctor or nurse can determine if you have a prolapse simply by doing a pelvic exam. Women who have no symptoms or who are not bothered by their symptoms do not need treatment.

If your prolapse symptoms are uncomfortable, you can take control of your health and comfort. Some women feel better when they do pelvic muscle exercises or Kegels to strengthen the muscles that control the flow of urine and bowel movements. Your nurse or doctor can teach you how to do these if you’re not already familiar with Kegels. In addition, a vaginal pessary, a device that fits inside the vagina to support the bladder, rectum or uterus and push it back into places, can also help women with prolapses. Finally, a surgeon can move dropped organs back into place and strengthen the tissues that keep them in place. This surgery is only recommended for women who have completed their families and don’t expect another pregnancy. To reduce your chances of pelvic organ prolapse, doctors recommend losing weight if needed; enjoy a fiber rich diet and with plenty of fluids to prevent constipation; getting treatment for any chronic coughs, which can exacerbate prolapse symptoms; if you are a smoker, it is important to quit smoking; avoiding activities that require you to lift heavy objects.  You can also talk to your Clinic Sofia doctor about any questions you may have about prolapse.

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