Pelvic floor problems are often a taboo subject. Many women know little about them and talk little about them. On the other hand, we know from daily practice that women sometimes have a very good sense of their own bodies and problems.
With these informative blogs, we want to offer understandable and accessible information. Not to scare, but just to put women on the road to good care for themselves!
What is a prolapse?
With prolapse or prolapse of the pelvic organs, the supporting tissue that holds the bladder, the last part of the intestine or the uterus in place is weakened. This can cause a bulge of these organs.
Sagging is common in women.
The figures we find vary somewhat depending on the source of the study and the way in which the occurrence of prolapse was measured.
Nevertheless, we know with certainty that:
- half of all women who have ever given birth have some degree of prolapse.
- 30-50% of all women experience mild to severe symptoms of that prolapse.
- an increasing number of women are seeking help for this
- 10-20% of those seeking help will undergo surgical treatment.
There are different types of subsidence:
- Prolapse of the bladder (cystocoele): this manifests as a bulging of the front wall of the vagina
- Prolapse of the uterus (uterus prolapse/descensus uteri): this manifests itself as a lowering of the uterus towards the outlet of the vagina.
- Prolapse of the vaginal apex: this is a bulging of the vaginal dome, which may occur after removal of the uterus.
- Prolapse of the bowel (rectocoele): this manifests as a bulging of the rear wall of the vagina
- Other problems such as a prolapse of the small intestine, or telescoping of the intestine (intussusception).
How can you tell if you might have a prolapse? Or in other words:
What problems can this cause?
- Feeling of heaviness between the legs, which sometimes gets worse as the day progresses
- A bulge (or ball) that can be felt in the vagina
- Inability to hold back urine, wind and/or stool (incontinence)
- Constipation problems (constipation or difficulty in expelling stool) or difficulty in urinating
- An overactive or irritable bladder
- Inconvenience in making love
- Pain in the small pelvis
In short, these are all symptoms that are accompanied by unpleasant feelings: the symptoms can provoke fear and shame and are often accompanied by a reduced quality of life.
But please note that we should not "over-medicalise"either. All scientific international guidelines emphasise that prolapse only matters if the woman herself experiences discomfort as a result.
So it could well be that you are walking around with a little more prolapse or "mobility" in those organs, without noticing it or having any problems with it.
So don't be put off!
This information is mainly meant to help. Help to understand what may be happening in your body.
You should also know that prolapse is rarely, if ever, "dangerous". It will not endanger your life or health, but it can be very unpleasant for some women with increasing symptoms!
But there are solutions.
As always, everything starts with understanding your own body. In future blogs, we will share more information on the possible tests you can undergo to find out about this problem. We will also share more information on exercises, aids (pessaria) or surgery.
Don't wait, take care of yourself.
Wondering who to contact?
Take a look in our "Links", but also your trusted family doctor or gynaecologist will surely be able to put you on the right track!
Good luck!
Dr. Jorien Vercruyssen (MD), Gynaecologist, Gynaecology and Obstetrics UZA
Hedwig Neels (MPT, PhD), Physiotherapist Gynaecology and Obstetrics UZA and UAntwerpen
