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TYPES OF PROLAPSE, GRADES AND TREATMENT

I have already told you about what a prolapse is and what are the  most frequent causes and symptoms . In this blog post I will do it about the types and degrees of prolapse that exist , as well as the different treatment options that can be carried out.

As always, both in this and in other issues that affect the health of the pelvic floor, my mission through En Soil Firm is to help you prevent future problems or improve them if you already suffer them. How? Sharing with you updated and quality information to fight the great ignorance that exists around this plot of women’s health.

In the case of the prolapse, such is the lack of information and the secrecy with which many women live it, that there has been talk of a  ” silent epidemic”  to refer to the spread of the prolapse worldwide. We have in our hands the option of trying to change it. We, from here, have already begun.

What types of prolapse exist?

Recall that the prolapse consists in the  descent of one or more organs of the pelvic cavity outwards . The organ that descends can be the bladder, the uterus, the vagina, the urethra or the rectum, although it may also be the case that two or more of them descend.

Some women only have one type of prolapse, while others suffer a combination of two or more types. This is because the pelvic organs and tissues are so intrinsically grouped and their functions so interrelated that if the prolapse of an organ is not treated, it can end up affecting the adjacent structures and develop another type of prolapse.

In general, the types of prolapse are called the organ that “falls” or goes outside, but it is important to note that the problem does not begin in the organ that descends, but in a weakening of the tissues that support these organs , such as We have said, of the muscles, ligaments and connective tissue that forms the pelvic floor.

Let’s see what each one consists of:

  • Cystocele: It is the most frequent of prolapses and occurs when the bladder falls into the vagina, forming a lump in the anterior wall of it. Frequently, both bladder and urethra (the tube that communicates the bladder with the outside) are prolapsed together. Symptoms of this type of prolapse include urinary urgency, loss of urine during sexual intercourse, and in more severe cases, difficulty urinating and risk of infection due to a bad emptying of the bladder.
  • Rectocele: the rectum (final section of the large intestine, before reaching the anus) falls on the posterior wall of the vagina. This modification of the position of the rectum affects bowel movement and constipation, hemorrhoids, incomplete emptying of stool, feeling of pressure and intestinal obstruction can occur.
  • Uterine prolapse: the uterus descends through the vagina, first showing the neck and then the uterine body. In the most severe cases, the uterus exits completely through the vaginal opening to the outside.
  • Vaginal dome prolapse: the vaginal dome, an area located in the highest part of the vagina, can descend causing the vagina, which is a blind sac, to turn around like a sock, leaving the inner part outside. It is common in women who have had a hysterectomy, that is, who have had their uterus removed.
  • Enterocele: the intestinal handles descend through the gap between the rectum and the back of the vagina. It can occur in isolation or be associated with rectocele or also with uterine prolapse.

Degrees of prolapse

Prolapse, according to its severity , can be classified into four grades for which there is a specific treatment.

  • Grade I or mild: slight decrease inside the vagina.
  • Grade II or moderate: the descent reaches the entrance of the vagina.
  • Grade III: the descended organ passes the vaginal opening outwards, the woman can notice the lump when walking and, above all, when making efforts.
  • Grade IV or total: the organ (bladder, uterus or rectum) goes out completely, both in effort and in rest.

How is prolapse treated?

As for the treatment, the first two grades , if they cause discomfort, should be treated by pelvic floor physiotherapy, in addition to carrying out a change of habits, including: dietary, if there is overweight or constipation; eliminate tobacco if the woman has respiratory diseases, such as chronic cough; limit physical overexertion; lead an active life performing exercises that do not aggravate the existing prolapse, etc.

The surgery usually is needed in grade III and IV . Sometimes you have to remove the organ that has gone outside (in the case of the uterus), and other times the defect is reconstructed through the placement of meshes made of synthetic material that act as supportive tissue and counteract the weakened pelvic floor ( it is the case of the bladder or rectum). After surgery, it is equally convenient to follow a routine of pelvic floor exercises  as well as guidelines for postural hygiene and healthy lifestyle habits, to contribute to the success of the surgical intervention and prevent a prolapse from occurring again.

 

Prevent and diagnose

I would like to say goodbye highlighting two important aspects in relation to the fight against prolapse: the prevention and early diagnosis . As for the first, it is essential that you maintain your pelvic floor exercise routine  to avoid problems in the future. As far as diagnosis is concerned, detecting a prolapse as soon as possible will help not increase its severity and have to resort to surgery to repair it.

 

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