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You hear very little about it and yet … A third of women (50% over 50) will be affected by prolapse – or organ descent – during their lifetime!
What are the causes of prolapse?
As the name suggests, it is a fall of one or more organs (vagina, bladder, uterus, rectum, intestine) out of the small pelvis. Most often, the muscles and ligaments of the perineum relax after trauma: childbirth too fast,use of forceps, passage of a big baby…
Magali, 40, says: “ The day after my son was born, when I got up, I was scared of my life. Something was coming out of me! A doctor came to explain to me that I was suffering from quite a severe prolapse. According to him, my perineum lacked tone, since I had spent a good part of my pregnancy lying down. »
If the prolapse mainly concerns women who have given birth, it is not necessarily linked to the birth of her children. It can happen years later, often around menopause. At this age, the tissues lose their elasticity, the organs suffer from less effective support.
The lifestyle also favors the occurrence of prolapse. The practice of certain sports (running, tennis …), a chronic cough, or constipation increase the risks because they cause repeated contractions of the pelvic floor (all the organs of the small pelvis). The most common prolapse is called cystocele (more than 50% of cases). It’s about a fall of the anterior vaginal wall and bladder.
Organ descent: what are the symptoms?
Women with prolapse talk about feeling of “gravity” at the bottom of the belly. The descent of organs does not go unnoticed. Not only do you feel it physically, but you can also… “see” it!
Nefeli, 29, recalls: “ I had a shock while looking with my mirror: a kind of “ball” came out of my vagina. I later found out that it was my uterus and bladder. »On a daily basis, prolapse constitutes a real embarrassment. It is difficult to stand for a long time, walk for a few hours or even carry your child without feeling your organs “fall”. This unpleasant sensation disappears by lying down for a few moments.
Prolapse: associated disorders
As if that weren’t enough, prolapse is sometimes accompanied by urinary or anal incontinence. Conversely, some women may have difficulty urinating or passing stool.
Organ loss: a still taboo problem
« I am 31 years old and feel like I have an old problem! My prolapse changed my intimate life. It makes me uncomfortable … Fortunately, my husband is less embarrassed than me », Says Elise. A feeling of shame and fear, shared by many women… So much so that some still hesitate before going to their gynecologist to discuss this ” small ” problem. Know, however, that medicine can now help you regain a normal life!
However, the taboo surrounding organ descent has faded over the generations. The proof: in ten years, the number of consultations has increased by 45%!
Treatment of prolapse: perineal rehabilitation
To treat moderate prolapse, a few physiotherapy sessions and you’re done! Perineal rehabilitation does not put the organs back in place, but restores tone to the muscles of the small pelvis. Enough to erase this unpleasant feeling of ” gravity In the lower abdomen. When the organs come out of the vagina, surgery is (almost) a must.
Descent of organs: surgery
Par laparoscopy (small holes in the abdomen and at the level of the navel) or vaginal route, the intervention consists of fix strips between the different organs to hold them. Sometimes the surgeon has to perform a hysterectomy (removal of the uterus). This is why some women wait several years before spending time on the operating table, the time to have as many babies as they want …
In still other cases, a prosthesis is placed during vaginal surgery. This decreases the risk of recurrence, but increases the risk of infection, fibrosis, pain during intercourse, etc.
Prolapse: placing a pessary
The pessary comes in the form of a inflated cube or a ring. It is inserted into the vagina, to support the falling organs. This technique is little used by French doctors. Above all, it remains a good indication for improving the quality of life of the patient while awaiting surgery.