Prolapse and Urinary Incontinence

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Pelvic Organ Prolapse

The pelvic floor consists of the muscles, ligaments, connective tissue and nerves that support the pelvic organs-namely the uterus, vagina, rectum and bladder. When the pelvic floor is damaged or becomes weak e.g. with menopause or menopause, it may become unable to support the pelvic organs. As a result, one or more of the organs may drop (prolapse) below their normal positions, causing symptoms such as discomfort due to a protruding lump at the vagina, and urinary incontinence.

Treatment options

  • Non surgical treatmentA ring pessary may be fitted during a gynaecological consultation; the pessary has to be changed every few months.
  • Pelvic floor reconstructive surgeryThis consists of several procedures to restore the normal structure and function of the female pelvic organs.

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Urinary Incontinence

Urinary incontinence (UI) refers to involuntary leakage of urine. It is a distressing problem which occurs if your bladder muscles suddenly contract or the sphincter muscles are not strong enough to hold back urine.

There are different types of incontinence and treatment may be medical or surgical depending on the type and cause of the problem. If coughing, laughing and sneezing cause you to leak urine you may have stress incontinence. Physical changes resulting from pregnancy, childbirth, and menopause often cause stress incontinence.

Treatment for stress urinary incontinence

This depends on the severity of the condition. Options include:

  • Non surgical treatmentPelvic floor exercises also called Kegel's exercises can be helpful.
  • SurgeryThis involves the use of synthetic tapes which are placed midway along the urethra e.g. transvaginal tapes (TVT), and transobturator slings (TOT). The tape is inserted during a day surgery procedure and adjusted to provide the right amount of support to the urethra.

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