Pelvic organ prolapse and stress urinary incontinence are often situations where patients silently live with daily discomfort, trying to “endure” the condition. In such cases, you should not be embarrassed but promptly turn to specialists for help. Pelvic organ prolapse, otherwise known as prolapse or pelvic floor dysfunction, is a situation in which the bladder, rectum, or uterus “bulges” outward through the vagina due to reduced support for the muscles, fascia, and ligaments of the pelvic floor.
Before moving on to physical therapy for pelvic pain, you need to determine the cause of the problem. There are many reasons for such violations, but the main one is increased intra-abdominal pressure. Such pressure can occur during childbirth if the patient is overweight, has a chronic cough (bronchial asthma, smoking), or is engaged in weightlifting.
In all these cases, it is necessary to additionally strain the muscles of the abdomen, which, in turn, puts pressure on all the organs of the small pelvis and stretches the muscles and ligaments that support these organs.
What are the symptoms?
The most common complaint during prolapse is the sensation of a foreign body in the vagina. It is often accompanied by pulling pains in the lower abdomen and the vaginal area, which can become more pronounced with prolonged walking. More specific symptoms are characteristic of the prolapse of particular organs. So, if the bladder wall descends, urinary incontinence is usual, or, conversely, the inability to urinate without additional action. Patients have a constant urge to the toilet, incontinence of gas and stool, and frequent constipation.
How do you diagnose a problem?
There are no problems with prolapse diagnosis—this is done during a gynecological examination. It is essential to determine the degree of omission according to a particular classification system so that you can individually approach the treatment of each patient:
- The first stage is a situation in which the lowest point of descent does not reach 1 cm from the vestibule of the vagina, and it can be noticeable only if the patient pushes.
- The second stage is when the omission is on the eve of the vagina or goes beyond it.
- The third stage occurs when the descent goes even lower. The fourth stage is diagnosed when there is a complete prolapse of the entire length of the vagina.
Suppose you have urinary incontinence before planning treatment. In that case, you should undergo a urodynamic examination—a urologist does this. By emptying the bladder, you can make a differential diagnosis between stress incontinence, neurological, and mixed, when the problem must be approached from different angles. Bladder ultrasonography and defecography are also done to assess the condition of the rectum and bladder.