Pelvic organ prolapse occurs when an organ, such as the uterus, descends and is displaced from its natural location. The term is used to refer to organs that protrude from the vagina or rectum.
This type of pathology is secondary to the weakening of the supporting muscles of the pelvic floor. The risk of developing it increases with age.
According to the characteristics of the prolapse and the structures that it affects, this can be differentiated into:
- Previous: when what descends is the urethra, bladder, or both. May also be called: cystocele and/or urethrocele.
- Medium: descent of the uterus or vaginal vault: uterine prolapse and/or enterocele.
- Later: prolapse of the rectum called rectocele.
In our Gynecology consultations we offer you the appropriate solutions if you have a genital prolapse.
On Institute of Gynecology of Barcelona Dra. Gómez Roig We are specialists in these types of medical services.
What is genital or pelvic organ prolapse?
Genital prolapse is an affectation that only affects women. This pathology is more frequent when the tissues that support the organs in the lower abdomen relax. Menopause can favor this situation.
The tissues, or rather the pelvic floor muscles are responsible for correctly holding the uterus, bladder and rectum.
When the pelvic floor muscles relax too much, the organs move downward, pressing against or protruding from the vagina.
If the bladder protrudes through the vulvar space, medical specialists refer to the problem as cystocele
If, on the contrary, it is the rectum that appears through the wall of the vagina, it is called rectocele.
Instead, a uterine prolapse occurs when it is the uterus that descends through the vaginal wall and emerges through the vulva.
There are several factors that are associated with a higher risk of a woman having a genital prolapse, such as pregnancy, the number of vaginal deliveries, obesity and advanced age, among others.
How can I know if I have a prolapse?
On many occasions there are several women who with this problem do not present any symptoms. This depends in part on the degree of involvement.
Women who do have a clinic may present the following symptoms:
- Sensation of weight or pressure in the pelvis or vagina.
- Abdominal or pelvic pain.
- Visualization of a lump coming out of the vagina and vulva.
- Loss of urine when laughing, coughing or sneezing.
- Pollakiuria: Need to urinate suddenly and without being able to wait.
In cases of pelvic organ prolapse it can happen that, when a woman goes to the bathroom, she has the need to press the lump that comes out of the vagina with her finger. This need arises from the inability to urinate if this practice is not performed.
Is there any test to detect a genital prolapse?
The test that detects genital prolapse is the physical exploration performed by the specialist physician. In a gynecological position, it can be seen if the woman suffers from this pathology.
Sometimes, the doctor may request that the woman perform exercises of valsalva, or abdominal pressure, to accentuate the prolapse.
Normally, during the exploration of a prolapse, it is also checked whether or not urinary incontinence coexists.
Is there anything I can do to improve the clinic?
To improve the symptoms of this pathology, it is recommended to practice the exercises of the pelvic floor. These exercises strengthen the muscles of the lower part of the pelvis. This muscle is what controls the flow of urine and bowel movements.
Exercises of this type are also known as Kegel exercises.
Your doctor or midwife can teach you how to do them. There are also gyms specialized in the rehabilitation of the pelvic floor.
What treatment should I carry out if I am diagnosed with a prolapse?
If diagnosed, you should undergo treatment if the pelvic organ prolapse is accompanied by clinic.
Women who do not have symptoms or do not feel discomfort do not need treatment.
In cases where women do notice it, or it is in an advanced degree, doctors suggest different treatments:
- Pelvic floor exercises, also called Kegel exercises.
- Using a vaginal pessary: This device is placed inside the vagina to support the prolapse and move the involved organ to its original place. Pessaries come in different shapes and sizes. They can be adapted according to each particular case.
- Surgery: A surgeon can return sagging organs to their original location, as well as strengthen the tissues that hold them in place.
How can I prevent it?
A woman can prevent the displacement of the organs of the lower abdomen taking into account the following considerations:
- It is recommended to lose weight, if you are overweight.
- You should be treated for constipation, if you have it.
- Avoid lifting heavy objects.
Prevention is the basis of current medicine and the one that shows the best results.
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How are pelvic floor exercises performed?
To perform the exercises, the first thing to know is the anatomy and which are the muscles that must be contracted and relaxed. Sometimes it is not easy to make this differentiation.
One possible way to learn is by:
- The placement of a finger inside the vagina. Subsequently, the muscles that surround the finger must be contracted, and learn to be aware of the exercise performed.
- Pretending that the woman is sitting on a small-sized ball or marble, and that she has to lift it with her vagina when she decides to get up.
Another way to learn to do the exercises is to try to stop the flow of urine during urination.
During the performance of the activity, the correct muscles must be distinguished.
Once you know which muscles to contract, you can do the exercises in any position, sitting in a chair or lying down.
How often should I do them?
The exercises should be done three times a day, and three or four days a week.
In each activity, the muscles must be contracted between 8 and 12 times each time, and these must be kept contracted for about 6 to 8 seconds. Follow this routine for at least 3 to 4 months.
The results of strengthening the muscles are noticeable after 2 or 3 months. It is a somewhat slow procedure, but effective.
How do Kegel exercises help?
Kegel exercises have been shown to be useful and effective in preventing pelvic organ prolapse.
This type of activity is capable of:
- Reduce urine leakage in people with urinary incontinence, which means they leak urine when they cough, laugh, sneeze, or exert themselves.
- Control the urgent need to urinate in people with incontinence.
- Control the release of gases or involuntary bowel movements.
- Reduce pressure in the vagina caused by prolapse of the bladder, uterus, or rectum.
If you notice something strange in your vagina, or a lumpy sensation, don't panic. Go to Institute of Gynecology of Barcelona Dra. Gómez Roig. Our professionals will give you the best solution.
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Head of the Obstetrics and Gynecology Service at the Sant Joan de Déu Hospital in Barcelona. Associate Professor of Obstetrics and Gynecology and Coordinator of the Sixth Course of Medicine at the University of Barcelona, UB. Director of the Dra. Gómez Roig Institute and Coordinator of Obstetric and Gynecological Processes at the Corachan Clinic in Barcelona.