Prolapse is a common problem for females of all ages, worldwide. Yet prolapse is one of those conditions that many women are way too embarrassed to talk about, even with their closest friends.
Some can’t even discuss prolapse with their doctor, choosing instead to put up with light bladder leakage, discomfort, a poor sex life and low self esteem rather than get help, advice and treatment.
Prolapse surgery is one of several treatment options
If you think you have a prolapse, or believe you’re going to have one in future because of your age or childbearing history, you may think the only option is prolapse surgery. Your doctor could even suggest it, especially as prolapse surgery is not a major procedure and it’s very successful in 80 and 90% of cases.
The good news is that prolapse surgery is usually the last resort. There are other treatment options especially if your prolapse is mild or moderate. But as with any health condition, prevention is better than cure. And there are a number of simple things you can do to prevent prolapse happening in the first place.
Prolapse is not an inevitable part of childbirth or aging. Nor should you have to live with it if you do get one! For many women, a prolapse is but a temporary condition resulting from one of several causes including:
- A long and intense labour. Prolapse might happen after the birth or years later
- Falling oestrogen levels during or after menopause. This hormone helps your pelvic floor muscles stay strong and flexible. So its loss could weaken the muscles holding your organs in their correct position
- Straining to lift heavy objects or go to the toilet
- A condition such as obesity or a chronic cough
In days gone by, prolapse surgery sometimes included hysterectomy, but now many doctors avoid this as it’s proven to be unnecessary. If you have been told prolapse surgery is the best option for you, then read on to find out what this simple surgery entails.
What happens during prolapse surgery?
Serious cases of prolapse often require surgery to reposition the organs that have snuck out of place and to restore the support structure. The surgery is performed under either a spinal anaesthetic (you’re awake in the top half of your body) or a general anaesthetic. The surgery itself is usually quite straightforward: the surgeon makes an incision in your vagina then places stitches in the tissue supporting the vagina. These stitches may be at the front or the back walls of the vagina or both, depending on the type of prolapse you have.
An additional stitch may be made at the top of the vagina or into the cervix to support the vagina. This stitch may cause temporary discomfort in your buttock.
The surgeon may use mesh reinforcement to strengthen the repair and reduce the risk of your prolapse recurring. This mesh provides a longer lasting repair and is successful in 80% of people. It’s a flexible, lightweight synthetic material used extensively in surgery, especially in hernia repairs. It has many holes to allow your own tissues to grow into it. It provides a framework for support of the organ or organs that have prolapsed. You won’t feel it once it’s in place!
After prolapse surgery
At the end of the operation a catheter is inserted into your bladder to drain urine. A material pack is placed in the vagina to prevent bleeding and will stay in there for one to two days. Antibiotics will most likely be given to you during the surgery, and you’ll also take antibiotics after the surgery to prevent infection.
You’ll be allowed to go home once you are feeling well and you’re able to pass urine with no problem – usually within a few days of the operation.
There can be complications and some discomfort after prolapse surgery. Your doctor or specialist will explain what these are. However, in most cases, the surgery achieves great results and you’ll be just as active as before, or even more so than you were pre-surgery.
Other types of prolapse surgery
There is also a sling surgical procedure to correct severe cases on prolapse, such as where there are several organs heading south. This surgery is more complicated but it has a very high success rate.
Another, recently developed surgery for prolapse involves repairs to the pelvic floor muscle itself, as sometimes during childbirth the pelvic floor becomes detached at the edges of the bony pelvis. This cannot be easily repaired through the vagina. Instead the muscle is reattached via laparoscopic surgery.
Ask your doctor or surgeon to explain these procedures in detail, if one of these operations is recommended for you.
How to reduce the risk of prolapse
Keeping your pelvic floor muscles strong and healthy is the main thing you can do to prevent prolapse or to recover from a mild or moderate prolapse. Every woman should do pelvic floor exercises (often referred to as Kegel exercises after the doctor who invented them) regardless of age or risk of prolapse. These very effective exercises are easy to do and can do wonders for the health of your pelvic region:
- Help keep your organs in their rightful place
- Help you push out the baby during the final stage of delivery
- Help prevent bladder leakage
- Enhance your sexual response
- Increase your ability to grip with your vaginal muscles – a useful function for holding in tampons and to heighten sexual feeling for you and your partner
To boost your general health and help prevent prolapse, experts also recommend:
20 to 30 minutes of aerobic exercise three to five times a week. Exercise helps your muscles, tendons and ligaments to stay strong and will also help you stick to the correct weight for your height and age.
Eating the right food to literally lighten the load on your internal support structures. Too much weight can put pressure on your pelvic floor muscles, tendons and ligaments. While a high-fibre diet with lots of fruit and vegetables will ensure that your bowel movements are regular and soft. If you aren’t straining to go, the pressure is decreased.
Stop smoking as it can contribute to the prolapse because smokers are much more likely to develop a cough. Coughing is risk factor for damaging muscles and ligaments in your pelvis. If you don’t smoke, you’re less likely to cough and therefore less likely to suffer a prolapse.
Lift heavy objects correctly. Keep your back straight and bend only at the knees and hips. Support your spine by tightening your stomach muscles. Lift the weight using your strong leg muscles rather than your more vulnerable abdominals. Ask a friend to help you lift heavy items, rather than risk straining yourself.
Oestrogen replacement therapy during menopause can help prevent prolapse, as it’s the reduction of estrogen that causes muscles to weaken. Hormone replacement therapy will help prevent degradation of your muscles and so reduce the risk of prolapse.
What to do if prolapse causes you to spring a leak when you laugh
If you’ve a prolapse, you’re probably experiencing some light bladder leakage or stress incontinence. Poise has wonderfully discreet products for managing light bladder leakage. Only you will know you’re using them, as they’re thin and discreet like regular panty liners but more absorbent giving you the protection you need.