Female Pelvic Medicine and Reconstructive Surgery
Gregory J. Bailey MD, FACOG, FPMRS
6440 W Newberry Rd, Suite 409
Gainesville, FL 32605
(352) 333-6161

 

 


Because vaginal and uterine prolapse has several different causes, there is no single way to prevent these problems. Currently, a woman cannot change her genetic risk profile which influences the strength of her connective tissue. She can however make wise choices that influence those risks which are modifiable.

In general, avoiding increased pressure inside the abdomen and on the pelvic floor is wise. This can be done by:

  • Maintaining a normal weight or losing weight if overweight. Overweight women are at a significantly increased risk of developing prolapse.
  • Constipation and chronic straining during bowel movement increase a women’s chance of developing prolapse, especially a rectocele. A diet with plenty of fiber and fluids, as well as regular exercise is important for maintaining regular bowel function. If constipation persists despite these measures, further evaluation and treatment is recommended.
  • Seek medical attention to evaluate and treat a chronic cough which increases abdominal and pelvic pressure.
  • Avoid heavy lifting and learn how to lift safely by using leg and arm muscles as much as possible.
  • Don’t smoke or kick the habit!
  • Avoid repetitive strenuous activities.
  • Learn and perform pelvic floor muscle exercises (Kegel)regularly to improve the strength of the pelvic floor, and limit the likelihood of developing prolapse. Once prolapse has developed pelvic floor exercises will not correct the prolapse, but they may limit the development of worsening prolapse and may diminish some of the symptoms.

There has been considerable discussion about whether a cesarean delivery (C-sections) might reduce the chance of developing prolapse later in the life. While there are probably cases where this might be true, there are potential complications of cesarean deliveries, which increase with the number of cesareans a woman has over the course of her life. This is a very important and complicated question which should be addressed with a woman’s obstetrical caregiver. It is clear that being pregnant alone regardless of the type of delivery contributes to the development of pelvic floor disorders. However, it is important to remember that there are women who have never been pregnant who leak urine and stool or have prolapse - and women who have delivered many times who do not. There is no clear answer to this question at this time.

When considering your treatment options it is best to work with your urogynecologist to make a plan that works best for you. A lot depends on your individual problems, and more depends on your preferences. A woman should seek treatment whenever her symptoms have a negative impact on her life – you don’t have to wait until your symptoms are 'really bad'. Vaginal and uterine prolapse, while common, is not a normal result of childbirth and aging. You do not have to 'learn to live with it'. Be sure to have regular pelvic exams to check for early signs of prolapse. Ask your doctor if they are measuring your prolapse in a systematic way – this will enable them to notice subtle changes over time. The most commonly used system of measure for prolapse is called the “pelvic organ prolapse quantification” or POP-Q system.

Seeking medical help does not mean that you have to have surgery right away. Some women start with more conservative treatment like physical therapy, and go on to surgery only if their symptoms from prolapse are not under control.

Sources
American Urogynecologic Society
Original publication date: May, 2008

Women's Pelvic Health, 6440 W Newberry Rd, Suite 409, Gainesville FL, 32605 (352) 333-6161