When The Bottom Falls Out: Prolapse In The Pelvis
Symptoms tend to occur when women are upright, straining, or coughing and to disappear when they are lying down and relaxing. For some women, sexual intercourse is painful.
Mild cases may not cause symptoms until the woman becomes older.
Prolapse of the rectum , small intestine , bladder , and urethra are particularly likely to occur together. A urethrocele and cystocele almost always occur together.
) or problems completely emptying the bladder .
Can Uterine Prolapse Be Prevented
There is no certain way to prevent uterine prolapse. However, the following can help lower your risk:
Lose weight, if youre overweight
Follow a diet rich in fiber and fluids to prevent constipation and straining
Avoid heavy lifting
Quit smoking, if you smoke
Seek prompt treatment for a chronic cough, which can place extra pressure on your pelvic organs
Do Kegel exercises to strengthen your pelvic floor muscles
These actions may also help if you already have uterine prolapse.
See your healthcare provider when symptoms first start to bother you. Dont wait until your discomfort becomes severe. Regular pelvic exams can help detect uterine prolapse in its early stages.
Are Home Remedies Effective For A Bladder Infection
People have used cranberry products to prevent bladder infections. Cranberries contain a substance that can prevent bacteria from sticking on the walls of the bladder. A Cochrane Database systematic review of cranberries for preventing UTIs in 2012 concluded that the evidence for cranberry products, particularly cranberry juice, over the long term is small and that cranberry juice could not be recommended at that time for the prevention of UTIs. Further studies need to evaluate other cranberry preparations.
Probiotics are preparations that contain live bacteria, for example, lactobacillus, that can prevent other bacteria from growing and moving up from the bladder to the kidney. The probiotic decreases the ability of the infecting bacteria from sticking to the bladder and growing and may also affect the ability of the individuals own body to fight off bacteria. A Cochrane Database review in 2015 demonstrated no significant difference in the risks of recurrent UTIs for probiotics compared with placebo or antibiotic prophylaxis in either women or children, however, there were a limited number of good-quality studies.
Adhering to the prescribed antibiotic regimen and staying well hydrated are essential components of home remedies for bladder infection.
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Could My Vaginal Bleeding Mean Uterine Prolapse
Dr. Khashayar Shakiba at Womens Pelvic Surgery of North Jersey understands your confusion about why this is happening, your concern for your health, and your physical pain and discomfort, and he can bring you relief on all three counts. Here, he explains all you need to know about uterine prolapse, including your options for treatment.
When Is Surgery Needed For A Prolapsed Bladder
Severe prolapsed bladders that cannot be managed with a pessary and/or behavioral therapy usually require surgery to correct them. There are several different types of surgery depending on the severity of the prolapse and whether or not other organs are affected.
- The bladder is repaired with an incision in the vaginal wall.
- The prolapsed area is closed and the wall is strengthened. This may be done primarily using one’s own tissues or through the use of grafts, which may be biologic or synthetic .
- If one has stress urinary incontinence, this is also corrected.
- Depending on the procedure, surgery can be performed while the woman is under general, regional, or local anesthesia. Most women are discharged home on the same day of surgery.
- Various materials have been used to strengthen pelvic weakness associated with prolapsed bladder. A surgeon should explain in detail the risks, benefits, and potential complications of these materials, and he or she should explain the procedure itself before proceeding with the surgery. Complications related to surgery may include bleeding, infection, pain, urinary incontinence, recurrent prolapse, trouble urinating, and injury to the bladder.
- The cost of surgical treatment will vary with the procedure performed, the length of hospitalization, and the presence/absence of other medical conditions.
- After surgery, most women can expect to return to a normal level of activity after 6 weeks.
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When To See A Doctor About Bladder Prolapse
Painful or bleeding tissue protruding is one of the most obvious signs. However, women suffering from a very mild bladder prolapse or early-stage bladder prolapse may experience few, if any, symptoms.
If youre currently concerned you may be suffering from bladder prolapse or have experienced any combination of the symptoms above, see a doctor as soon as possible. If you believe this may be an emergency, dial 911 or visit an emergency care facility immediately.
How To Avoid Lower Back Pain
Back pain can occur because of a bad move, overloading, etc. It can be interesting to take a few minutes to analyze pain:
- Does it appear in the morning? During the night? In the evening, after a long workday?
- Is it caused by a particular move? A special posture?
- Is it improved by massage? Heat? Stretching?
These indications will help you identify what causes the pain and what relieves it.
In any case, the back likes and has to move! But be careful not to do painful movements, because the worst is not moving, being immobilized. Lets not forget that the word physiotherapist comes from the old Greek and means heal by movement.
Sports we recommend are soft sports like walking, swimming, gym, and you can try yoga or pilates as well.
What Are The Symptoms Of Prolapse
Physical symptoms include:
- A sense that something is falling out
- Pelvic pressure
- Urine leakage, frequency, chronic urinary tract infections, difficulty urinating
- Difficult bowel movements or trapping of stool
- Painful intercourse because of a bulge or protrusion
Women with pelvic organ prolapse can experience all, some or none of these symptoms.
Women with pelvic organ prolapse often feel alone, isolated and depressed. They may feel embarrassed by this condition and, because the condition is generally not discussed, do not seek treatment.
Deterrence And Patient Education
The Association of Pelvic Organ Prolapse Support provides up to date information regarding vaginal prolapses, including anterior vaginal wall prolapse, and the POP Risk Factor Questionnaire is also available on their website.
The International Urogynecological Association offers helpful informational leaflets for patients regarding cystocele and different management approaches in different languages. These leaflets should be given to women during urogynecological appointments for pelvic organ prolapse.
The American Urogynecologic Society offers an interactive POPQ tool designed to show different stages of vaginal wall prolapse. Its visual features could be incredibly beneficial during consultations with patients regarding pelvic organ prolapse expectations and management.
One study has shown that educational leaflets and a face-to-face conversation, when used together, provide a better understanding of the condition and improve women’s knowledge of the care offered, regardless of their education.
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What Is A Pessary
Many people with prolapse have bladder symptoms. Sometimes the dropped bladder actually causes a blockage and youre either unable to urinate all, or you have difficulty urinating. If you push or strain, that only makes the prolapse worse and it becomes even harder to void. In other people, the prolapse causes a discomfort, aching or a constant feeling that you have to urinate. In some people, the bladder becomes hypersensitive or overactive and you have to urinate very frequently. If you have any of these symptoms and you have a dropped bladder, uterus, or rectum, a pessary may relieve all of your symptoms.
How do I know if a pessary would be a good idea for me?
The only way to know if a pessary is for you is to try it. Try it. You might like itBut follow the instructions carefully.
How Do I Know If I Need Treatment
For the overwhelming majority of patients with prolapse treatment is completely elective. That means you decide if the symptoms are bad enough to warrant treatment. However, for some patients, treatment is medically necessary because your prolapse causes a blockage to the kidneys or such a severe blockage to the bladder that you are not able to urinate at all.
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When To Call A Professional
Prolapse of the pelvic organs is generally a nonthreatening problem. You should contact your physician for an evaluation if you are having bothersome symptoms, and you suspect you might have this problem. It is also important to report changes in urinary symptoms to your doctor, since urinary infections are a possible complication of prolapse.
When Should You Have Surgery For Prolapse
Consider surgery if the prolapse is causing pain, if you are having problems with your bladder and bowels, or if the prolapse is making it hard for you to do activities you enjoy. An organ can prolapse again after surgery. Surgery in one part of your pelvis can make a prolapse in another part worse.
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Tests For Bladder Prolapse
Tests that may be carried out to confirm or reject a diagnosis of bladder prolapse, depending on your symptoms, are:
- pelvic ultrasound to exclude any masses or cysts putting pressure on the bladder
- urodynamics a test of bladder function and to assess different types of incontinence
- a bladder scan to measure residual urine urine left in the bladder after emptying
- a midstream urine test to exclude urinary tract infection
- magnetic resonance imaging in some cases.
No Relief After Voiding The Bladder
When individuals feel no relief after voiding their bladder, it may indicate they have a prolapsed bladder. When the bladder prolapses, the malfunction causes part of the bladder to sag to an elevation underneath where the urethra meets the bladder. This bulge can be referred to as a cystocele. As a result of gravity and the impaired position of part of the bladder, patients cannot effectively fully empty their entire bladder. The reason is that urine accumulates in the cystocele, the region of the bladder that sags underneath the point where the urethra meets the bladder, and has no force to push it up to that opening.
The sensations a healthy individual experiences when the bladder contains a considerable amount of urine that needs to be voided are a result of the nerves in the bladder communicating with the brain. The brain then signals the sphincter to expel the urine, which effectively turns off the sensation individuals feel when they need to urinate. However, the brain will continue to send electrical signals to the nerves around the bladder that cause these sensations in prolapsed bladder patients because urine is still present.
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Can Anything Be Done To Prevent Prolapse
Although no one knows for sure, it makes sense that if you do regular strengthening exercises called Kegel exercises, the muscles will maintain their strength and prolapse will be prevented. Many doctors believe that undergoing a cesarean section instead of natural childbirth will reduce the likelihood of subsequent prolapse. Beware, though, a cesarean section has its own complications and it might not be the best solution for you. Elective cesarean section is a controversial subject, which you should discuss in detail with your doctor if you are considering it.
Prolapsed Bladder Care At Home
For mild-to-moderate cases of prolapsed bladder, the doctor may recommend activity modification such as avoiding heavy lifting or straining. The doctor may also recommend Kegel exercises. These are exercises used to tighten the muscles of the pelvic floor. Kegel exercises might be used to treat mild-to-moderate prolapses or to supplement other treatments for prolapses that are more serious.
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Treatment For Asymptomatic Bladder Prolapse
If you have no symptoms of bladder prolapse, you may not need treatment. This may be the case with stage 1 or stage 2 prolapse. In fact, you may not be aware of the bladder prolapse at all. It may be picked up by your GP during a routine examination, such as during a cervical screening test.
Lifestyle changes and physiotherapy are the key aspects of managing such cases. There are things you can do to help prevent the condition from getting worse, which may include:
- correction of position when sitting on the toilet
- avoiding heavy lifting
- pelvic floor exercises, which have been proven to reduce the symptoms of an early stage bladder prolapse and prevent any worsening
- seeking treatment and management for chronic cough and lung disease.
Seeing a pelvic floor physiotherapist is always recommended so that they can assess your pelvic floor function properly and show you the correct technique for doing pelvic floor exercises. The best published evidence supports supervised pelvic floor muscle exercises for the management of prolapse and urinary incontinence.
When Symptoms Become More Severe
If symptoms gradually worsen, this may be a sign of a kidney infection. Along with the traditional UTI symptoms of frequent and painful urination, these additional symptoms will occur.
- Fever and Chills
- Pain In the Lower Back
- You will experience mild to severe pain on one of both sides of the lower back depending on where the infection has spread.
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How Will I Be Evaluated
When you see your doctor, you will have a health history taken in order to get a thorough explanation of your symptoms. A pelvic exam is necessary to diagnose pelvic organ prolapse. If you do have prolapse, the urogynecologist will determine which organs are involved and how severe the prolapse is. Other tests might be ordered, based on your individual examination.
How Is The Cause Of Hematuria Diagnosed
If youre seeing your doctor for hematuria, theyll ask you about the amount of blood and when you see it during urination. Theyll want to know how often you urinate, any pain youre experiencing, if you see blood clots, and what medications youre taking.
Your doctor will then give you a physical examination and collect a sample of your urine for testing. The analysis of your urine can confirm the presence of blood and detect bacteria if an infection is the cause.
Your doctor may order imaging tests such as a CT scan, which uses radiation to create an image of your body.
Another possible test your doctor may want to do is a cystoscopy. This involves using a small tube to send a camera up your urethra and into your bladder. With the camera, your doctor can examine the interior of your bladder and urethra to determine the cause of your hematuria.
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When To See A Doctor
Get medical help as soon as you notice any UTI symptoms.
This is especially important if you have blood in your urine. Even if it only happened once or its a small amount, you should still visit a doctor.
When treated promptly, a UTI is easier to clear. Early treatment will help you avoid other complications.
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If The Pessary Is So Good Why Should I Consider Surgery
If the pessary works for you, there is no need to ever consider surgery. However, it does not work well for everyone. In some women the pessary works well with respect to holding their organs in place, but it unmasks incontinence. This means that when you use the pessary you start to leak urine. When that happens the choice is to not use the pessary, live with the prolapse and remain dry or have surgery.
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Get Medical Help If You
Have any bleeding during pregnancy. Although it is more common to have bleeding in early pregnancy, it is still important to seek the advice of a health care professional. Checkhere for more information.
- Feel any cramping or pain.
- Do not feel your baby moving or there is a change in the pattern of their movements.
- Have an elevated temperature. A normal temperature range is 36.1-37.3 degrees Celsius.
- Bleed heavily, pass blood clots or obvious pieces of tissue.
- Feel dizzy or faint.
Stages Of Bladder Prolapse
The severity of bladder prolapse can be measured in several ways. Terms such as mild, moderate and severe are not always completely accurate, as they depend on a persons opinion, but are often used in day-to-day conversations to help people understand the severity of the prolapse.A more commonly used grading is:
Many gynaecologists now use the Pelvic Organ Prolapse Quantification system, which measures in centimetres where the prolapse is in relation to the vaginal entrance to ascertain the stage of prolapse.
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What Investigations May Be Advised
The investigations you may need usually depend on many different factors, such as if you have other symptoms, if you have any other illnesses or conditions and your age.
It is likely that you will need to provide a sample of urine which will be sent to the local laboratory to be tested for infection. You may have blood tests and X-rays or scans.
A cystoscopy may be performed to assess your bladder. Having a cystoscopy entails a doctor or nurse looking into your bladder with a special thin telescope called a cystoscope. The cystoscope is passed into your bladder via your outlet for your urine . A cystoscopy which is done just to look into your bladder is usually carried out under local anaesthetic.
More details about the different tests can be found in the separate individual condition leaflets, mentioned above.