Prolapse
- Pelvic Prolapse
- Pelvic organ prolapse occurs when a pelvic organ-such as your bladder, uterus or rectum-drops (prolapses) from its normal place in your lower abdomen and pushes against the walls of your vagina. This can happen when the tissues that hold your pelvic organs in place get weak or stretched from childbirth or aging.
- Some of the things you might experience if you have prolapse are:
-
• Pressure from pelvic organs pressing against the vaginal wall
• Feeling fullness vaginally, like a tampon is out of place
• Feeling as if something is falling out of your vagina, or being able to feel a bulge just outside the vagina
• Pull or stretch in your groin area or pain in your lower back
• Releasing urine without meaning to (incontinence), or needing to urinate a lot
• Being unable to empty your bladder without leaning forward or rocking on the toilet
• Having problems with your bowels, such as constipation Diagnosing prolapse- Your doctor will ask you questions and do a physical exam that will include a pelvic examination. You might need to have an ultrasound of your pelvis, kidneys and bladder.
- Treatment
- This will depend on the organs that have prolapsed, your age, desire for more children and how bad your symptoms are.
- If your symptoms are mild, you may be able to do things at home to help yourself feel better. You can relieve many of your symptoms by adopting new, healthy habits. A physiotherapist specialized in pelvic floor disorders will recommend you special exercises that make your pelvic muscles stronger. Reach and stay at a healthy weight. Avoid lifting heavy things that put stress on your pelvic muscles. In women with bladder prolapse (cystocele) a series of treatments with Erbium-YAG laser (FOTONA), might help reduce the symptoms and restore the health of the tissues.
- If you still have symptoms, you might need to see a gynecologist to be fitted with a device called a pessary. It is a removable device that you put in your vagina and it helps hold the pelvic organs in place, just like a comfortable bra keeps your breasts supported.
- Surgery is another treatment option for serious symptoms of pelvic organ prolapse. You may want to delay having surgery if you plan to have children or if you need to lose a large amount of weight. The strain of childbirth and the pressure of the extra weight on your pelvic tissues could cause your prolapse to come back.
- You may want to consider surgery if:
- • You have tried a pessary and it’s not working well for you
• You have a lot of pain because of the prolapsed organ
• You have a large rectocele (prolapse of the large bowel into the vagina)
• The prolapse makes it hard for you to enjoy sex- Pelvic organ prolapse can come back after surgery. Pelvic floor physiotherapy and vaginal laser treatments make your pelvic tissues stronger and will help you recover faster from surgery. When performed together these treatments can help you more than surgery alone.
- Disclaimer: The cost of the pessary and the vaginal laser treatment are not covered by OHIP.
