The pelvis, or female pelvic cavity, contains three organs: the bladder in front, the uterus and vagina in the middle, and the rectum at the back.
What are the causes of organ descent (prolapse)?
A genital prolapse (or descent of organs) is an abnormal displacement of one or more pelvic organs downward, possibly resulting in the protrusion of this organ through the vulvar opening, deforming the vaginal wall. There are several types of organ descent depending on the affected organ(s).
- Urethrocele for the urethra
- Cystocele for the bladder
- Uterine prolapse for the uterus
- Cervical prolapse for the cervix
It is favored by natural childbirth and certain personal predispositions (tissues that hold less well). But also anything that leads to a significant increase in pressure in the abdomen (and tends to push the organs outside the abdomen): jobs that involve heavy lifting often, chronic smoking, or asthma due to coughing, constipation...
Genital-urinary prolapses: what are the symptoms?
- Discomfort in the lower abdomen
- A feeling of vaginal heaviness
- A sensation of the presence of a "bulge"
- or intra-vaginal (in the vagina)
- either outside the vulva, present during abdominal straining.
This "bulge" is more easily noticeable when standing, during exertion, or squatting, requiring manual reintegration before sitting down. It causes pain that increases when standing.
- Urinary disorders due to compression of the urethra (difficulty urinating, urinary leaks, stress incontinence)
- Sexual disorders (discomfort or bleeding during sexual intercourse)
Is it always necessary to have surgery for a prolapse?
No, definitely not! It all depends on the quality of life of the patient as it is a functional intervention. It is neither a life-saving nor an aesthetic intervention. The pelvis primarily has the mission of being functional: to provide sexual comfort during sexual activity, to allow for the evacuation of urine and feces when desired, and to be comfortable and not painful at all times. It is possible to have a significant prolapse and be minimally bothered.
Before proposing surgical treatment, in some cases rehabilitation through physiotherapy and/or the use of pessaries may be suggested: these are small devices in the shape of cubes or rings that, when inserted into the vagina, help to keep the organs in place.
Surgical treatment is a curative treatment, not a preventive one: surgery should be performed when the prolapse is bothersome, not out of fear that it will worsen.
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