Prolapse, more commonly known as organ descent, affects mostly women. With uncomfortable and sometimes disabling symptoms on a daily basis, this gynecological disorder can however be easily diagnosed and consequently treated. However, it is important to know which professional to consult! We explain here how prolapse manifests itself, and to which doctor you should refer for appropriate treatment.
What is prolapse?
Prolapse is a downward movement of the pelvic organs. We are talking about a descent of organs, concerning the uterus, the bladder and/or the rectum. Depending on the specific organs affected, we speak of genital prolapse or genitourinary prolapse.
This phenomenon mainly concerns women, especially because of pregnancies and vaginal deliveries. Multiple or repeated pregnancies are aggravating factors, as is a delivery with the use of forceps. Menopause also plays a role, due to a significant decrease in estrogen.
However, men can also be affected. Indeed, prolapse can also be caused by physical activity (if it is too intensive or causes significant impact), overweight problems or genetic factors.
What are the signs leading to consultation?
At an early stage, prolapse does not cause any obvious or uncomfortable symptoms. But when it evolves and intensifies, it causes discomfort, more or less important depending on your activities, but which clearly reduces your quality of life on a daily basis.
It is very frequently expressed by pain or discomfort felt in the lower abdomen, with a feeling of heaviness. The descent of organs can also manifest itself by a ball, either in the vagina, or outside the vagina at the vulvar level. Sometimes this ball is even clearly visible and must be moved manually to go to the bathroom.
Urinary discomfort is common, even urinary incontinence. The prolapse can cause digestive problems (such as chronic constipation), which can lead to anal incontinence. Finally, discomfort during sexual relations is often cited, with pain or bleeding for example.
Which doctor to consult?
Talking to a health care professional about these symptoms is an important step in making a true diagnosis and then getting a treatment proposal. Therefore, any health professional with whom you feel confident enough can help you.
Your attending physician or your gynecologist are privileged interlocutors, whom you can consult at any time, within a short time. In addition, these two doctors in your usual care path are generally professionals with whom you feel comfortable enough, without stress during your consultation and without embarrassment, to talk about this intimate subject.
Your doctor will then refer you to the most appropriate specialist for your type of prolapse. This can be an obstetrician-gynecologist or a urologist, but also a physiotherapist or a midwife for rehabilitation.
How is prolapse diagnosed and treated?
The diagnosis of prolapse is made by a gynecological examination. It will allow to verify if it is indeed a prolapse (and not an ovarian cyst, for example), to estimate its extent and to identify the organs affected by this phenomenon. The doctor will also perform a vaginal and rectal examination to confirm his observations and to test the contraction of the perineum and associated muscles. These examinations are not painful.
The treatment of the prolapse depends mainly on its importance and the organs concerned. If it is advanced and very disabling, the prolapse can be corrected by surgery. However, this treatment is not suitable for everyone, because of the contraindications of anesthesia or if you wish to become pregnant for example.
Perineal rehabilitation (with a physiotherapist or a midwife) greatly improves the comfort of life in case of genital prolapse. This can be coupled with the use of a pessary, which is a device inserted at the bottom of the vagina. The pessary will keep the organs in place, thus reducing the pain and discomfort felt.