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 What Doctors Don't Tell You: Tinnitus and bladder prolapse 
What Doctors Don't Tell You © (Volume 14, Issue 10)

Colporraphy comes with its own problems. It is a very complicated procedure, and so it is even more important than with hysterectomy to fully know the experience level of the surgeon. Painful sex and incontinence are common problems after surgery, which throws into question the purpose of undergoing the procedure in the first place.

Your concerns about surgery are well founded. Surgical outcomes can be very hit-or-miss, and can often make the problem worse in the long run, if not immediately. Around one in three women need additional and corrective surgery at some stage later on.

Mild prolapse is usually treated without surgery, especially if the patient is not experiencing too much discomfort or pain. Your described symptoms suggest that yours is a mild condition, or grade-1 prolapse, although the physical evidence from your surgeon suggests it is more serious. A grade-2 prolapse is when the uterus has dropped into the vagina and the cervix is visible at the vaginal opening. Grade 3 is when more of the uterus has fallen through the vaginal opening, and is also known as ‘procidentia’.

A new technique is being tried in the US to help bladder control, although it does not correct the prolapsed organs. Intestim therapy, approved in the US a year ago, is an implant described as a ‘bladder pacemaker’. It can be fitted to men and women who experience a sudden and pressing urge to urinate, and involves placing an electrode in the lower back that sends mild electrical pulses to the sacral nerve. This, in turn, controls the bladder and surrounding muscles that manage urinary function. Unfortunately, Intestim is too new to be assessed in terms of its safety, reliability or efficacy.

A variety of non-surgical options can control and improve the problem. Physiotherapy can help even moderate (grade-2) prolapse, and usually involves pelvic floor, or Kegel, exercises. These exercises can stop the prolapse from worsening, and can also ease backache, pelvic pain and incontinence.

It’s better that a trained physiotherapist instructs you at the beginning, and checks your progress with biofeedback. The pelvic floor muscles act as a ‘hammock’ to support the pelvic organs, and the exercises involve tightening just the muscles around the anus and vagina - not those of the stomach, legs or buttocks.

The exercises should form part of your daily routine, but it’s essential to be patient and to persevere. It may take up to six months before you start noticing any improvements.

You can ‘supercharge’ the exercises by using a vaginal cone - a small weight placed in the vagina. The pelvic floor muscles are then used to keep it in place for up to 20 minutes a day.

Another option is the vaginal pessary, a device, similar to a diaphragm or cervical cap, that is inserted into the vagina to keep the prolapsed organs in place. They can be a good option if you have elected not to have surgery.

A pessary needs to be fitted by your doctor, and you should be monitored to ensure that the fit is correct and that it’s doing its job. A two-ring pessary is often recommended for women with severe (grade-3) prolapse. Pessaries are usually also removed by a doctor or nurse.

As with surgery, pessaries are not for everyone. They can interfere with sexual intercourse, and there can sometimes be a smelly discharge. Some women are also allergic to latex, from which the pessary is made.

Because prolapse is a physical condition, alternative and complementary therapies do not offer many options. There is a range of herbs that can help strengthen the body’s tissues, such as false unicorn root (Chamaelirium luteum), white oak bark (Quercus alba), pond lily root (Nymphaea), black walnut hull (Juglans nigra), stone root (Collinsonia canadensis) and goldenseal root (Hydrastis canadensis).

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What Doctors Don't Tell You What Doctors Don’t Tell You is one of the few publications in the world that can justifiably claim to solve people's health problems - and even save lives. Our monthly newsletter gives you the facts you won't......more
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