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Pelvic Prolapse
Working hard to stop the sag.
People
go through a gamut of occurrences in the daily course of living and these
life events can be profound enough to affect us both emotionally as well as
physically. Pregnancy, childbirth and being overweight are life events that can
affect our pelvic muscles. These muscles are directly responsible for keeping
pelvic organs like the urethra, vagina and rectum, in their correct places. As
these muscles weaken, they become unable to hold the pelvic organs in position,
and that’s when the sag sets in.
What
is a prolapse?
A
pelvic prolapse is a common condition, particularly affecting older women.
Prolapse literally means “to fall” and it occurs when the structures designed
to keep organs in place weaken or stretch too much. The most common types of
pelvic prolapses are rectal (rectum), bladder, vaginal or uterine (womb)
prolapse. In some cases, all of these can occur at the same time.
Pelvic
floor muscles may become weakened by any of the following events:
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Pregnancy and childbirth
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Menopause and ageing
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Heavy lifting
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Obesity
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Chronic straining or coughing
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Surgery, especially pelvic surgery
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Constipation
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Physically stressful activities/exercises
Some
women experience few symptoms while others can find it debilitating. The most
common symptoms are:
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A dragging sensation or feeling of something falling out
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Stress incontinence (small amounts of urine are passed while sneezing, coughing
or exercising)
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Constipation
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Difficult or painful sex
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Recurrent bladder infections
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Unusual or excessive discharge from the vagina
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Lower back pain
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Urinary complications
Treatment
Surgical
and non-surgical options are available and will depend on the severity of the
condition, the patient’s general health, age and desire to have children.
Non-surgical
options include:
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Kegel exercise
Pelvic floor strengthening exercises are usually recommended in mild cases of
uterine prolapse. They require the tightening of pelvic muscles for a few
seconds, as if trying to hold back urine, then release them.
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Pelvic muscle trainer
These are good for women who cannot do the Kegel exercises correctly. This
device can guide women to correctly and effectively exercise pelvic floor
muscles, using a biofeedback device.
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Vaginal pessary
A rubber or plastic, doughnut-shaped device that helps to prop up and hold the
uterus (cervix) in place. A doctor has to fit and insert the pessary, which
must then be cleaned frequently and removed before sex.
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Hormone replacement therapy (HRT)
This may help. However, there are some drawbacks to taking oestrogen, such as
an increased risk of blood clots, gallbladder disease and breast cancer. The
decision to use HRT must be made with your doctor after carefully weighing all
of the risks and benefits.
The
surgical option involves placing the uterus back into its normal position by
reattaching the pelvic ligaments to the lower part of the uterus to hold it in
place. Another technique uses a special material that acts like a sling to
support the uterus in its proper position.
Prolapse
is generally a non-threatening problem but it is important to address it right
away because if left untreated, it can interfere with bowel, bladder and sexual
functions. The sooner it is treated, the sooner your life can get back to
normal
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