The pelvic organs, that is, the bladder, uterus, vagina, urethra, and rectum, are held in place by force applied by the muscles of the penis. pelvic floor. It acts like a kind of mesh, a hammock, that supports and holds all these abdominal and pelvic organs and prevents them from coming out.
When they stop working properly due to becoming weak, deformed, or loose, these organs lose their support and may fall out. That’s when we talk about prolapse of the pelvic organs (POP), that is, the prolapse of one or more of these organs from their normal anatomical position, a problem that is usually perceived as a lump in the vagina.
Although it is difficult to talk about the actual prevalence of this problem, it is estimated that it affects more than 50% of women who have had vaginal delivery, with a higher incidence in women aged 60 to 69 years.
Why does the pelvic floor appear?
Throughout our lives, the supporting structure of the pelvic organs can weaken for various reasons. Except age – as we have seen, the likelihood of prolapse increases with age – other factors play a role.
Among the most common are the presence multiple pregnancy – loosen the pelvic floor – obesityimplementation of some physical labor that require heavy lifting (tension can weaken the pelvic muscles) or having acquired genetic diseases.
Sometimes certain operations in the lower abdomen or perineum can also affect the appearance of these prolapses.
Not all pelvic prolapses are the same
In many cases, it is possible that the woman does not feel any symptoms as the descent is minimal or stopped halfway. You don’t notice or feel anything, and this condition is often discovered during a pelvic exam for a different reason.
But it also happens that the prolapse is intense, which means that the organs are completely outside the abdominal cavity. In this case, a woman can feel and palpate the prolapse, she feels it as an “external thickening,” says Dr. Raquel González López from the Department of Functional Urology of Female Urodynamics at the Fundación Jiménez Díaz University Hospital and co-author of the study. Ni Goth’s blog.
In this case, the most common symptoms are usually feeling of heaviness or pain in the pelvic areawhich may worsen during the day and when standing up or coughing; urinary incontinence; bladder infections; difficulty with defecation; or problems with sexual intercourse when the vagina is occupied. These symptoms directly affect the quality of life.
Interdisciplinary treatment, the key to recovery
Prolapse treatment depends on gravity symptoms. An assessment of the severity and what treatment is best to carry out is carried out multidisciplinary teamconsisting of urologists, gynecologists, general and digestive surgeons, rehabilitators, physiotherapists and, in some cases, psychiatrists.
This shared vision allows us to evaluate all aspects and “offer the best outcomes to improve quality of life and address problems or changes in functioning,” says Dr. Gonzalez.
Specialized units such as the Fundación Jiménez Díaz University Hospital. They have the ability to treat pelvic organ prolapse on a global scale, not only correcting the bulges, but also addressing the problems that have arisen, which, as we have already mentioned, usually greatly affect the quality of life.
The first step in all this collaborative work is to prepare a complete medical history to find out what family history is associated with prolapse, and also to establish the extent to which this problem affects daily life.
Physical examination allows not only to visualize and palpate the affected organs – it happens that only one organ is affected or, conversely, several, but also to know the state of the pelvic floor muscles.
With all this information, specialists evaluate whether it is convenient to follow one or another treatment, and if so, which one is best for each particular case. It must be taken into account that many of the prolapses, if left untreated and left over time, can cause problems in the future.
After diagnosis, the first step is to conservative treatment which resolves by eliminating risk factors (tobacco, weight loss, not carrying heavy weights, etc.); and pelvic floor exercises, which, while not changing the degree of prolapse, help strengthen the vaginal support system.
In other cases, intervention is needed to reduce or introduce prolapse and normalize activities such as urination or defecation. Surgery is the main method of repairing stretched vaginal walls and putting them back in place. Almost 12% of women undergo surgery for genital prolapse throughout their lives.
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