Pelvic Prolapse and Reconstruction

 

Pelvic prolapse is a condition that can affect many female patients, with roughly one in every three women suffering from prolapse or related disorders during their lifetime. It refers to the sagging of any of the pelvic floor organs, which include the bladder, uterus, vagina, small bowel and the rectum, descending into or externally from the vaginal canal or anus.

Causes of Pelvic Prolapse

The most common causes of pelvic prolapse are pregnancy, labour and childbirth. Other factors which cause abdominal pressure such as obesity, constipation, cancer of the surrounding organs and hysterectomy (surgical removal of the uterus) can also cause pelvic prolapse.

Common Types of Pelvic Prolapse

Common types of pelvic prolapse include:

  • Cystocele: prolapse of the bladder into the vagina
  • Uterine prolapse: prolapse of the uterus
  • Urethrocele: prolapse of the urethra
  • Enterocele: prolapse of the small bowel
  • Vaginal vault prolapse: prolapse of the vagina
  • Rectocele: prolapse of the rectum

Symptoms of Pelvic Prolapse

Although some patients do not notice pelvic prolapse, symptoms which can indicate pelvic prolapse include:

  • A full, bloated feeling of pressure in the pelvic region
  • Backache in the lower back
  • Leaking of urine or a constant feeling of needing to urinate
  • A feeling that something is falling out of the vagina
  • Pain during intercourse
  • Bleeding from the vagina
  • Constipation

Pelvic Reconstruction Surgery and Other Treatment

Various treatments for pelvic prolapse are recommended depending on a patient’s symptoms.

A common procedure is pelvic reconstruction surgery, which aims to restore the normal anatomy of the pelvic region by repairing the affected organ. Surgery is typically minimally invasive, with small incisions being made to the abdomen in order to perform the reconstruction. Alternatively, the affected organ may be removed entirely.

Non-­surgical options can also help to relieve symptoms of pelvic prolapse. A small removable mechanism known as a pessary can be inserted into the vagina to provide structural support to the organ in question. This procedure is most commonly used on less severe cases of pelvic prolapse, and holds the organ in position without causing discomfort.

Exercises to strengthen the pelvic floor muscles can be performed to relive symptoms of pelvic prolapse. These are called Kegel exercises, and practising them can help to give better support to the organs in the pelvic region. The exercises can be integrated easily into your daily routine, and may lessen the likelihood of pelvic reconstruction surgery being necessary.

 

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