Prolapse of pelvic organs
Prolapse of pelvic organs is caused by a weakening of the pelvic floor.
The muscles of the pelvic floor are made of the same kind of tissue as
the muscles in your arms or legs. So they need exercise to keep up their
strength. Prolapse can mean that for instance the bladder drops through
the front wall of the vagina, or the rectum drops through the back wall
of the vagina. Or it can the uterus or cervix that drop through the ”top”
of the vagina. Which organ is involved depends on the location of the weakening
of the pelvic floor.
Prolapse of the uterus can cause a lot of problems for a woman and seriously
affect her quality of life. It’s often older women who’re affected, because
the production of female sex hormone, oestrogen, stops after menopause.
And this weakens the muscles of the pelvic floor.
Reasons for prolapse
Prolapse can be caused by a number of factors; the most common are:
-
Child birth: during a vaginal birth the pelvic floor muscles need to expand
a lot. This can damage the muscles and weaken the pelvic floor. So
many births, giving birth to large children and other factors related to
vaginal birth can further weaken the pelvic floor. That’s why it’s so important
to do pelvic floor exercises after giving birth.
-
Obesity: obesity can weaken the pelvic floor muscles due to the extra
strain on the pelvic floor.
-
Chronic bronchitis: if you have frequent, severe coughing fits over a
long period of time due to e.g. chronic bronchitis, it may cause prolapse.
-
Genetic disposition: the elasticity/strength of the pelvic floor may be
genetically determined.
Symptoms
The symptoms depend on how badly damaged the pelvic floor muscles are.
The most common symptoms are:
- a bearing-down sensation
- a sense of fullness
- visible signs, bits falling out
- frequent urination
- trouble emptying the bladder
- bowel movement problems
- stress incontinence: wetting yourself when coughing, laughing, lifting, jumping, or running
- changes to the sex life due to changed anatomy
- noises from the vagina due to changed anatomy.
Treatment
There’re a number of treatments we can offer you for prolapses. If your
symptoms are mild, your condition can be improved through exercises that
strengthen the muscles of your pelvic floor. In some cases hormone treatment
can help. If you’re overweight, losing weight may help.
If these treatments fail or can’t be used, an operation may be necessary.
Below you can read more about what happens during the operation.
Before the operation
Some prolapse operations can be performed as out-patient procedures; some
require that you stay at our clinic for a day or two. It all depends on
the type of prolapse you have. But you must have somebody to come and pick
you up at the clinic and stay with you for the next 24 hours. And it’s
important that you tell the specialist before the procedure about any drugs
or medicine you take, because some of them are dangerous in combination
with the anaesthesia. It’s also very important that you do pelvic
floor exercises both before and after the operation. That’s why we teach
you some exercises to strengthen your pelvic muscles. But the ideal solution
is that you book an appointment with a physiotherapist to help you with
the exercises. It’s also a good idea to stop smoking when the decision
to operate has been made because smoking slows down the healing of wounds,
and that goes for the period after the operation as well.
Fasting:
-
You are
not
allowed to eat anything 6 hours before your operation.
- You are allowed to drink water and juice until 2 hours before your operation.
The operation
You’ll have either local anaesthesia, spinal/epidural anaesthesia, or in rare cases general anaesthesia for the operation. We perform the operation via the vagina, and it takes between ½ and 1½ hours, depending on the type of operation. The prolapsed vaginal wall will be stitched up by opening the lining of the vagina and strengthening the vaginal wall to keep the bladder and rectum in place. In case of a prolapsed uterus, the uterus is stitched up and the ligaments supporting it are shortened. Before the operation you’ll have a catheter put into your bladder. We use soluble thread, which means that there’re no threads to be removed after the operation.After the operation
After the operation you should take it easy for a couple of days. If you’re an in-patient, we’ll help you get out of bed as soon as possible, to reduce the risk of blood clots.
Bleeding
You can experience a bit of bleeding or brownish vaginal discharge for
up to 4 weeks after the operation.
Fever
You may run a slight fever, but that’s nothing to worry about.
Hygiene
To avoid infection, you should
not
use tampons. Take showers only, and don’t go swimming for at least 4 weeks
after the operation.
Activity
How long sick leave you’ll need depends on the type of operation. So that’s something you’ll discuss with the specialist before you go home. For the first week after the operation you’ll need help for most daily tasks.
You can have sex again after 3-6 weeks, depending on the kind of operation you’ve had.
Keeping up your pelvic floor exercises is vital for the lasting effect of the operation.
How long sick leave you’ll need depends on the type of operation. So that’s something you’ll discuss with the specialist before you go home. For the first week after the operation you’ll need help for most daily tasks.
You can have sex again after 3-6 weeks, depending on the kind of operation you’ve had.
Keeping up your pelvic floor exercises is vital for the lasting effect of the operation.
Diet
It’s important to stay regular by eating foods with lots of fibres and
taking walks. You should drink about 1½ litres of fluid every day.
Check-up
You come in for a check-up 4 weeks after the operation.