Prolapse of pelvic organs

Prolapse of pelvic organs is caused by a weakening of the pelvic floor. The muscles of the pelvic floor are made of the same kind of tissue as the muscles in your arms or legs. So they need exercise to keep up their strength. Prolapse can mean that for instance the bladder drops through the front wall of the vagina, or the rectum drops through the back wall of the vagina. Or that the uterus or cervix drop through the ”top” of the vagina. Which organ is involved depends on the location of the weakening of the pelvic floor. 

Prolapse of the uterus can cause a lot of problems for a woman and seriously affect her quality of life. It’s often older women who’re affected, because the production of female sex hormone, oestrogen, stops after menopause. And this weakens the muscles of the pelvic floor.

Reasons for prolapse

Prolapse can be caused by a number of factors. The most common are:  

  • Child birth: During a vaginal birth, the pelvic floor muscles need to expand a lot. This can damage the muscles and weaken the pelvic floor. Multiple births or giving birth to large children can further weaken the pelvic floor. That’s why it’s so important to do pelvic floor exercises after giving birth.       
  • Obesity: Obesity can weaken the pelvic floor muscles due to the extra strain on the pelvic floor.
  • Chronic bronchitis: If you have frequent, severe coughing fits over a long period of time due to for example chronic bronchitis, it may cause prolapse. 
  • Genetic disposition: The elasticity/strength of the pelvic floor may be genetically determined. 
Symptoms

The symptoms depend on how badly damaged the pelvic floor muscles are.

The most common symptoms are: 

  • A bearing-down sensation
  • A sense of fullness
  • Visible signs, bits falling out
  • Frequent urination
  • Trouble emptying the bladder
  • Bowel movement problems
  • Stress incontinence: wetting yourself when coughing, laughing, lifting, jumping or running
  • Changes to the sex life due to changed anatomy
  • Noises from the vagina due to changed anatomy
Treatment

There’re a number of treatments we can offer you for prolapses. If your symptoms are mild, your condition can be improved through exercises that strengthen the muscles of your pelvic floor. In some cases hormone treatment can help. If you’re overweight, losing weight may help.   

If these treatments fail or can’t be used, an operation may be necessary. 

Below you can read more about what happens during the operation. 

Before the operation

Some prolapse operations can be performed as outpatient procedures; some require that you stay at our clinic for a day or two. It all depends on the type of prolapse you have.

It’s important that you have somebody to come and pick you up at the clinic and stay with you for the next 24 hours.

Likewise, it is important that you tell the specialist about any drugs or medicine you take before the procedure, because some of them may be dangerous in combination with the anaesthetic.

We strongly recommend that you do pelvic floor exercises both before and after the operation. We’ll teach you some exercises that can strengthen your pelvic muscles. But the ideal solution is that you book an appointment with a physiotherapist to help you with the exercises.

It’s also a good idea to stop smoking when the decision to operate has been made because smoking slows down the healing process. That goes for the period after the operation as well. 

Fasting:

  • You are not allowed to eat anything during the last 6 hours before your operation
  • You are allowed to drink water and juice until 2 hours before your operation
The operation

You’ll have either a local anaesthetic, spinal/epidural anaesthetic, or in rare cases general anaesthetic for the operation. We perform the operation via the vagina, and it takes between ½ and 1½ hours, depending on the type of operation. The prolapsed vaginal wall will be stitched up by opening the lining of the vagina and strengthening the vaginal wall to keep the bladder and rectum in place. In case of a prolapsed uterus, the uterus is stitched up, and the ligaments supporting it are shortened.  Before the operation you’ll have a catheter put into your bladder. We use soluble thread, which means that there’re no threads to be removed after the operation.

After the operation

After the operation, you should take it easy for a couple of days. If you’re an in-patient, we’ll help you get out of bed as soon as possible, to reduce the risk of blood clots.

Post-operative checkup

You’ll come in for a checkup 4 weeks after the operation.

Good to know

Fever: You may run a slight fever, but that’s nothing to worry about.

Bleeding: You can experience a bit of bleeding or brownish vaginal discharge for up to 4 weeks after the operation.

Hygiene: To avoid infection, you shouldn’t use tampons until the bleeding has stopped. Take showers only, and don’t go swimming for 4 weeks after the operation.

Activity and sex: How long sick leave you’ll need depends on the type of operation. That’s something you’ll discuss with the specialist before you go home. During the first week after the operation, you’ll need help with most daily tasks. You can have sex again after 3-6 weeks, depending on the kind of operation you’ve had. Keeping up your pelvic floor exercises is vital for the lasting effect of the operation.

Diet: It’s important to avoid constipation and maintain regular bowel movements, so eat foods with lots of fibres and go for a walk. You should drink about 1½ litres of fluid every day.

Side-effect and complications

If you have severe pain, high fever or any heavier bleeding than an ordinary period, you must contact the clinic at +45 8612 6121 or +45 2320 4221.