Vaginal prolapse in one in four women
Incorrect lifting is one of the causes of a prolapse of the uterus or bladder. One in four women will experience this in her lifetime. 14 frequently asked questions about these so-called vaginal prolapses.
1. Where are the pelvic floor muscles?
The pelvis is a kind of funnel that is closed at the bottom by a supporting plate of muscles and supporting tissue. There are three openings in the middle: the vagina, the urethra and the anus.
2. What are those muscles good for?
They are normally a bit tense and thus ensure that the organs in the lower abdomen (the uterus, the intestines, the bladderurethra, urethra and vagina) remain in place and you do not inadvertently lose urine or stools.
3. What is a prolapse?
A prolapse occurs because the pelvic floor muscles stretch or get damaged. They are no longer able to do their job properly. The uterus, bladder and/or intestines then sink into the vagina and may even come out.
4. How can that arise?
Such a slackening or damage to the pelvic floor muscles can have various causes. The most important are pregnancy and (vaginal) delivery. Excessive strain due to standing or heavy work also plays a role, as does years of incorrect urination and defecation behavior (for example, due to constipation), a lot of coughing and severe obesity. In short: anything that puts excessive pressure on the pelvic floor.
Prolapse complaints often arise in transition. And if your mother has had a prolapse, you have an extra high chance of getting it too.
5. What do you notice about a prolapse?
First, women often feel or see a bulge in their vagina or between their legs. Other complaints are a nagging pain in the lower back and abdomen, and an uncomfortable feeling or pain when cycling or having sex. Sometimes there are also problems with holding urine, urinating or defecating (constipation). The symptoms worsen during the day. Lying down for a while often reduces the discomfort.
Incidentally, a prolapse does not always cause complaints. Most women who have given birth have some degree of prolapse without noticing it.
6. Can men get a prolapse too?
Yes, although that is much less common. In men, it is usually the bowel that prolapses and then ends up in the anus.
7. Is it dangerous?
A prolapse poses no health risk. In very rare cases, the tubes that carry urine from kidney bring to bladder, get pinched. The complaints can be very annoying, uncomfortable and painful.
8. Can you damage a prolapsed organ with sex?
New. But making out may feel uncomfortable or painful.
9. Can it hurt if you go through the problems for a long time?
Yes. Many women are ashamed of their complaints and do not go to the doctor about it. But the longer you wait, the harder it is usually to do anything about it.
10. When is it wise to sound the alarm?
As soon as you experience complaints. The doctor can treat some forms of incontinence with medication. In case of other complaints, he will usually refer you to a pelvic physiotherapist or a gynaecologist. By the way, you can also go directly to a pelvic physiotherapist to go; there is no need for a referral letter.
11. What does a pelvic physiotherapist do?
There you will learn to feel where your pelvic floor muscles are and to train them, so that you can tighten and relax them at the right time. On average, this involves six to nine sessions, spread over six months.
12. What if pelvic physiotherapy does not help?
There are then two options: a pessary or an operation. A pessary is a ring that is placed in the vagina and offers extra support there, so that the organs do not prolapse (further). This is not very invasive but should be changed two to four times a year.
Another possibility is an operation in which a gynecologist puts the prolapsed organs back into the right place via the vagina. This is done either by strengthening the walls of the vagina, or by repairing the ‘suspension system’ of a prolapsed vagina. Nowadays it is almost always possible to preserve the uterus, even if it has prolapsed.
13. What can you do yourself?
Most importantly, you learn to properly load your pelvic floor muscles. It often goes wrong without you being aware of it. Lifting a heavy box or stack of books, loosening a stuck lid, pressing at a difficult bowel movements: to gain strength, you naturally hold your breath. The pressure that this creates on the abdomen and pelvic floor stretches the ligaments and muscles further and further and pushes the organs downwards.
By properly absorbing that increased abdominal pressure, you can prevent many problems. You do this by tensing the pelvic floor and abdominal muscles during heavy exertion and at the same time breathing through. In this way, the pressure goes off the boiler, as it were.
14. Can you prevent a prolapse completely with this?
No, because stretched or damaged tissues and muscles cannot be repaired with exercise. But you can (considerably) slow down the process of sagging and prolapse. That is why it is useful to do the exercises if you have no complaints yet. Pelvic floor physiotherapy may also prevent the complaints from returning after treatment.
In this video, urogynecologist Manon Kerkhof answers all your questions about prolapses, incontinence and other pelvic floor related problems and discusses possible solutions.
Sources):
- Plus Magazine
