At Home with Chris Jessen 2018 - 192

PROMOTION
drops down to the oppening; this
occurs in 10% of women who have
had a hysterectomy.
The type and severity of a prolapse
will determine the symptoms. These can
include any of the following:
SENSATION - The feeling of a lump or
a bulge 'coming down'.
BLADDER - Frequent urination,
incomplete emptying, urinary leakage
on coughing, sneezing or laughing, and
frequent cystitis.
BOWEL - Incomplete bowel emptying,
constipation or needing to push back
the prolapse to allow stools to pass.
SEX - Uncomfortable or a lack of
sensation during intercourse.

Is surgery avoidable?

Could it be
a prolapse?
If you're suffering from this distressing and embarrassing
condition, the good news is that it can be treated

T

he organs within a woman's
pelvis - the uterus, bladder
and bowel - are normally
held in place by ligaments
and muscles that form a hammock,
known as 'the pelvic floor'. If these
support structures are weakened by
overstretching, the pelvic organs can
bulge from their natural position into
the vagina. This is known as Pelvic
Organ Prolapse (POP).
'I can feel a lump down below and
there is a dragging sensation, Doctor'
is not an uncommon complaint heard in
a urogynaecology clinic. This is a classic
sign of a pelvic organ prolapse.
Any event or factor that increases
pressure within the abdomen can lead
to POP, including:
Pregnancy and childbirth
Ageing, especially after the menopause
Being overweight
Constipation, persistent coughing
and heavy lifting
Hysterectomy. The top of the vagina
(vault) can prolapse after this surgery
Genetics factors.
There are different types of pelvic
prolapse, depending on which organ is

bulging into the vagina. They are are:
CYSTOCELE - the bladder bulges into
the front wall of the vagina.
RECTOCELE - the rectum bulges into
the back wall of the vagina.
UTERINE PROLAPSE - the uterus
hangs down into the vagina.
VAULT PROLAPSE - where the vagina

MEET THE EXPERT
Miss Avanti Patil,
MBBS, DFFP,
FRCOG, is a
consultant
gynaecologist
and obstetrician at
Buckinghamshire
Healthcare
NHS Trust.
Miss Patil has broad expertise in
general gynaecology and special
interests in Urogynaecology (urinary
incontinence, urodynamics and pelvic
organ prolapse, vaginal reconstructive
surgery) and Post-partum perineal
problems. She is also a lead consultant
for women with spinal injuries.

People with a mild prolapse, or no
symptoms, may choose to take a 'wait
and see' approach. The following might
help to ease the symptoms:
Lifestyle changes - losing weight,
managing chronic cough, stopping
smoking and avoiding constipation,
heavy lifting and high-impact exercise.
Pelvic floor exercises to strengthen
the pelvic muscles.
If, however, the prolapse is more
severe and the symptoms are affecting
daily life, it may be time to consider
treatment options, including pessaries,
physiotherapy and surgery.
Pessaries are plastic or silicone
devices that fit inside the vagina and
help to support the pelvic organs. They
come in various shapes and sizes, but
the most common type is a ring pessary.
Sometimes surgery is the best option
to relieve symptoms, ensuring the
bladder and bowel function normally
after the operation. Every effort is made
to ensure sex is comfortable, too.
The decision to have surgery will
depend on the severity of the symptoms
and the impact they have, while the type
of surgery will depend on the type of
prolapse, the age and general health
of the patient, and whether or not they
plan to have children in the future. Some
women may choose to delay having
surgery until their family is complete.
The key points to remember when
dealing with a prolapse is that it is
not life-threatening and that not
everyone with prolapse needs surgery.

FOR MORE INFORMATION
Private practices at BMI Chiltern
Hospital, Great Missenden, Bucks
and BMI Shelburne Hospital, High
Wycombe, Bucks
Call 07702 499 1890/1296 337988
Email lgcprivatepractice@
gmail.com
Table of Contents for the Digital Edition of At Home with Chris Jessen 2018
