Uroogynae Blogs

Rectocele or posterior vaginal wall prolapse

12th September 2023 by Kelly Filed Under: Surgical Blogs, Uroogynae Blogs, Vaginal symptoms

Rectocele or posterior vaginal wall prolapse

Understanding Rectocele

Rectocele is a common condition that affects many women. It occurs when the posterior vaginal wall becomes weakened and the rectum bulges into the vagina. This can cause discomfort, pain, and difficulty with bowel motion. Below, we’ll discuss the causes, symptoms, and treatment options for Rectocele.

What is Rectocele?

Rectocele is a condition that occurs when the posterior vaginal wall becomes weakened and bulges into the rectum. This is a form of hernia. The weakened vaginal wall can occur due to a variety of reasons, including childbirth, ageing, chronic constipation, obesity, and previous pelvic surgery. When the weakened wall bulges into the vagina.

Symptoms of Rectocele:

The symptoms of Rectocele can vary from woman to woman. Some women may experience no symptoms at all, while others may experience pelvic pressure or discomfort, difficulty passing stool, or a bulge in the vagina. Women with Rectocele may also experience difficulty with intercourse, and urinary or bowel incontinence may also occur.

Non-Surgical Treatment Options:

If Rectocele is mild, non-surgical treatment options may be recommended. Pelvic floor exercises, such as Kegels, can help to strengthen the pelvic floor muscles and reduce symptoms. Women may also be advised to make dietary changes, such as increasing fiber intake, to help with bowel movements. Bowel management techniques, such as scheduling regular bowel movements, can also be helpful in managing symptoms. In some cases, rectal water irrigation can also be of benefit.

Surgical Treatment Options:

If non-surgical treatment options are not effective, surgical treatment may be recommended. The most common surgical procedure for Rectocele is posterior vaginal wall repair. This surgery involves tightening the weakened vaginal wall and repositioning it to its original location. Another surgical option is sacrocolpopexy in women with previous hysterectomy, which involves using abdominal mesh to support the weakened vaginal wall from inside.

Recovery:

After surgery, women can expect to have some discomfort and may need to avoid strenuous activities for several weeks. Follow-up care is important to monitor for any potential complications or recurrent prolapse. Women should follow their surgeon’s instructions regarding post-operative care and should discuss any concerns they have with their healthcare provider. Specialist pelvic physio is also an important part of post-op recovery.

Women should discuss treatment options with their healthcare provider and follow their instructions for post-operative care. With proper care and treatment, women with Rectocele can achieve relief from their symptoms and improve their quality of life.

If you are struggling with any symptoms and would like to discuss these with a specialist, please get in touch today on 07805 354110 or email info@practiceforwomen.co.uk

Uterine Prolapse and Uterine Suspension Surgery as a treatment option

3rd May 2023 by Kelly Filed Under: Blog, Surgical Blogs, Symptoms, Uroogynae Blogs

Uterine Prolapse and Uterine Suspension Surgery as a treatment option

Uterine prolapse is a condition where the uterus falls from its normal position in the pelvis into the vaginal canal, sometimes protruding outside the vagina. It is usually caused by weakened pelvic floor muscles and ligaments, which can be due to multiple factors such as childbirth, ageing, obesity, chronic constipation, or a history of pelvic surgeries.

Symptoms of uterine prolapse can vary, but may include:

A feeling of pressure or heaviness in the pelvis
Pain or discomfort during sexual intercourse
Difficulty urinating or having a bowel movement
Vaginal bleeding or discharge
A visible bulge or lump in the vaginal area

Treatment options for uterine prolapse depend on the severity of the condition, the woman’s overall health, and her desire to have children in the future.

Non-surgical treatment options for uterine prolapse may include:

Pelvic floor exercises: To strengthen the muscles and ligaments that support the uterus and vaginal canal
Pessaries: A medical device inserted into the vagina to provide support to the uterus
Oestrogen replacement therapy: This may help to strengthen vaginal tissues, reducing prolapse symptoms.

Surgical options for uterine prolapse may include:

Uterine suspension: Surgery to restore the uterus to its proper position within the pelvis and hold it in place.
Hysterectomy: Surgery to remove the uterus if the woman is past childbearing age or if she does not wish to have children.
Obliterative procedures: Procedures that narrow or close the vaginal canal, reducing prolapse symptoms, but will make vaginal delivery impossible in the future.

The choice of treatment depends on several factors, and it is important to consult with a healthcare professional such as a Gynaecologist or Urogynaecologist to determine the best option for each individual woman.

Uterine suspension as a treatment option for uterine prolapse

Uterine suspension is a surgical procedure that is performed to correct uterine prolapse. Uterine suspension aims to restore the uterus to its proper position within the pelvis.

The procedure may be recommended for women who have uterine prolapse symptoms that are severe enough to impact their quality of life, such as vaginal bulging, difficulty with sexual intercourse, or difficulty with urination or bowel movements. It may also be suggested if less invasive treatment options have been exhausted without any improvement.

There are several types of uterine suspension surgeries, including sacrospinous ligament suspension, uterosacral ligament suspension, and sacro-hysteropexy. These surgeries differ in the approach, the type of incision made, and the type of support used to hold the uterus in place.

How can uterine suspension help women?

Uterine suspension can have the following benefits:

Reducing symptoms of uterine prolapse, such as vaginal bulging, discomfort, and difficulty with sexual intercourse.
Restoring the uterus to its proper position, which may improve urinary and bowel function.
Preventing the condition from worsening and reducing the risk of complications associated with uterine prolapse.

The success of uterine suspension surgery depends on several factors, including the severity of the prolapse, the patient’s overall health, and the surgeon’s experience and expertise. It is important to discuss the risks and benefits of the procedure with a qualified healthcare professional before making a decision and seek advice from a highly experienced practitioner.

If you are experiencing any symptoms discussed above and would like to seek advice from a specialist, we offer appointments with a specialist Gynaecologist and Uro-gynaecologist Mr Philip Rahmanou in Cheltenham and Gloucester. Call us on 07805 354110 or email info@practiceforwomen.co.uk

Pelvic organ prolapse (POP) – types of POP and symptoms and treatment options of POP

28th April 2023 by Kelly Filed Under: Blog, Surgical Blogs, Symptoms, Uroogynae Blogs

Pelvic organ prolapse (POP) – types of POP and symptoms and treatment options of POP

Pelvic organ prolapse (POP) is a condition where one or more pelvic organs (such as the uterus, bladder, or rectum) bulge or descend into the vaginal canal due to weakened pelvic muscles and ligaments. There are different types of pelvic organ prolapse, depending on which organ is affected.

The types of pelvic organ prolapse include:

-Cystocele: This occurs when the bladder bulges into the vaginal wall. The anterior wall of the vagina is affected.

Symptoms of Cystocele: Symptoms of Cystocele may include a feeling of pressure in the pelvis, difficulty emptying the bladder, and urine leakage.

-Rectocele: This occurs when the rectum bulges into the back wall of the vagina. The posterior wall if the vagina is affected.

Symptoms of Rectocele: Symptoms of Rectocele may include constipation, difficulty passing stool, and pain during sexual intercourse.

-Uterine prolapse: This occurs when the uterus falls down into the vaginal canal.

Symptoms of Uterine prolapse: Symptoms of Uterine Prolapse may include a feeling of pressure in the pelvis, lower back pain, and difficulty with sexual intercourse.

-Enterocele: This occurs when the small bowel bulges into the vagina. The posterior wall if the vagina is affected.

Symptoms of Uterine prolapse: Symptoms of Uterine prolapse can include a feeling of pressure in the pelvis and pain during sexual intercourse.

Treatment options for pelvic organ prolapse (POP)

Treatment options for pelvic organ prolapse depend on the severity of the condition, the woman’s overall health, and her desire to have children in the future if she hasn’t already.

Non-surgical treatment options may include:

Pelvic floor exercises to strengthen the muscles and ligaments that support the pelvic organs
Vaginal pessaries: A medical device inserted into the vagina to provide support to the pelvic organs and prevent them from falling further
Oestrogen replacement therapy: This may help to strengthen vaginal tissues, reducing prolapse symptoms.

Surgical options for pelvic organ prolapse may include:

Uterine suspension: Surgery to restore the uterus to its proper position within the pelvis and hold it in place.
Hysterectomy: Surgery to remove the uterus if the woman is past childbearing age or if she does not wish to have any more children or any children.
Obliterative procedures: Procedures that narrow or close the vaginal canal, reducing prolapse symptoms, but will make vaginal delivery impossible in the future, so must be considered carefully.
Reconstruction procedures: Procedures that use grafts or sutures to provide support to the pelvic organs.

Diagnosing Pelvic Organ Prolapse

Diagnosis of pelvic organ prolapse usually begins with a physical examination by a healthcare professional, such as a gynaecologist or urogynaecologist. During the examination, the specialist will assess the degree of prolapse and the extent of the descent of the pelvic organs.

The physical examination may include:

Visual inspection of the external genitalia and vagina
Digital pelvic examination: The healthcare professional inserts one or two fingers into the vagina and may ask the patient to perform a “bearing down” manoeuvre to assess the degree of prolapse
Pelvic ultrasound: An imaging test that uses sound waves to create an image of the pelvic organs
Urodynamics: A test to measure the function of the bladder and urethra
In some cases, additional imaging tests may be recommended, such as magnetic resonance imaging (MRI) or computed tomography (CT) scans.

It is important for women to report any symptoms of pelvic organ prolapse, such as a feeling of pressure or discomfort in the pelvic area, urinary or faecal incontinence, and pain during sexual intercourse, to the specialist during the consultation. Early diagnosis and treatment can help prevent further progression of the condition and improve quality of life.

Following a consultation with a specialist, they would then determine the best option of treatment with dependant on your symptoms, lifestyle, life plans, health, specialist’s recommendations and personal preferences.

Living with an overactive bladder? You don’t have to…

3rd February 2022 by Kelly Filed Under: Blog, Uroogynae Blogs

Living with an overactive bladder?

When you’re going out with friends, is the first thing you do when you arrive anywhere to check out where the toilet is, ready for when you need to go? Or do you get anxious about going out for walks or to venues where there may not be toilet facilities? You only went to the toilet half an hour ago, but already you’re dashing off because you feel the urge to go again and can’t hold it? Sound familiar? You may have an overactive bladder.

For many women, the sudden urges to go to the toilet and the anxiety associated with an overactive bladder can make it hard to enjoy a normal social, work and home life. An overactive bladder is a physical condition that is inconvenient for patients, but the emotional impact can also be huge. It can disrupt your day-to-day plans, affect your sleep patterns, and even make it hard to enjoy your sex life. But it doesn’t have to be this way. There are solutions to help rectify the problem and help ease the symptoms of an overactive bladder.

An overactive bladder can often be treated with lifestyle changes. If these don’t help, there are various medical treatments that can make a significant difference.

What are the symptoms of an overactive bladder?

The risk of an overactive bladder does increases with age, however, this does not make it a normal part of ageing. It is a more common problem in older women, but it is not an uncommon problem in women from 18 to menopause either, overactive bladder can affect any age. The symptoms include:

A sudden urge to urinate without warning
Frequency to go to the bathroom regularly, more than normal, with or without leakage
Urine leakage – not being able to hold urine in time to get to the toilet
Having to get up often during the night to go to the loo (nocturia)

An overactive bladder does not cause any pain. If you are experiencing any pain or burning when you urinate, you may have an infection and should go and see your GP.

What are the causes of an overactive bladder?

Increasing age
Being overweight
Over consumption of water
Over consumption of diuretics such as caffeine, tea, carbonated drinks or alcohol
Poor toilet habits
Urinary tract infection (UTI)
Spinal issues, spinal cord injury
Certain medications such as antidepressants, diuretics etc
Diabetes
Bladder tumour or stones
Neurological disorders – associated with sudden onset of symptoms – including multiple sclerosis, Parkinson’s disease, stroke, cerebral palsy

Finding the cause can help to identify the best treatment. So, a full assessment and total honesty with your specialist is vital to get to the root of the problem.

Treatments for overactive bladder symptoms

The good news is, there are treatments for an overactive bladder that can be very effective! Your doctor will start with the most conservative and holistic (lifestyle changes) and work down from there.

Changing drinking and nutritional habits
Bladder training – gradually increasing time between urinating
Pelvic floor muscle exercises
Stress and anxiety management
Medication
Surgery – used as a last option if other treatment options haven’t been successful

So many women, of all ages suffer in silence with an overactive bladder, because of embarrassment. But there is no need. There is support out there that can make a real difference. If you seek help from a specialist who can assess you and identify the cause of the symptoms, then this is the first step in finding the right solution for you. You won’t always have to plan your day around toilet stops, limit yourself to short journeys, think about where the bathroom is, rush to the toilet or worry about embarrassing leakages. Remember, it does not have to become your new normal, there are effective treatments out there and there are specialists to advise and treat you.

If you have any concerns on this topic and would like advice or a consultation in Cheltenham or Gloucester with our specialist Gynaecologist Consultant Mr Rahmanou, please contact us on 07805 354110 or info@practiceforwomen.co.uk

Vaginal Prolapse – The signs and symptoms to look out for

12th December 2021 by Kelly Filed Under: Blog, Uroogynae Blogs

Vaginal Prolapse – The signs and symptoms to look out for

Most of you will have heard of a vaginal prolapse or pelvic organ prolapse, but may not be sure exactly what the symptoms are or what to expect or to look out for. It is much more common than you might think. The problem is, because it’s not something that women talk about openly, it is something that often goes much longer than necessary without intervention or support.

There are common symptoms to look out for that can be identified with Vaginal prolapse, these include the following:

A feeling of pressure, dragging or heaviness around your vagina and inside your vagina walls
Women with vaginal prolapse often report a feeling of heaviness around the lower abdomen and genitals
Feeling or seeing a bulge or lump inside the vagina, or coming out of your vagina
A feeling like there’s something coming down into your vagina or ‘stuck’ in the vagina

Additional Vaginal Prolapse Symptoms

Discomfort or feeling loose during sexual intercourse
The pelvic organs all support one another. When one organ prolapses, it can have an impact on the functioning of other nearby organs. Due to this, women have also been known to experience:
Alterations in patterns of bowel movements – such as difficulty having a bowel movement and need to press in the vagina to assist with this
Changes in bladder function – this could include the inability to empty the bladder completely
Difficulty using tampons
Secondary prolapses

Vaginal Prolapse Causes

There are a number of notable causes of vaginal prolapse, but some of the main causes are as follows:

Women that have delivered children vaginally, especially repeat deliveries or if you have experienced difficult births
Women approaching or going through the menopause
Being overweight
Chronic need to strain such as constipation
Previous hysterectomy

Vaginal Prolapse treatment options

The treatment options available will be dependent on the severity of the condition, but these can include:

Lifestyle changes – These could include weight loss, improved diet, fluid intake and exercise
Physiotherapy and pelvic floor exercises -see Physiotherapy For Women
Learning good bowel and bladder habits
Pessaries can be fitted to provide internal support
Surgery to repair torn or stretched tissue and ligaments – see https://www.practiceforwomen.co.uk/gynaecology-surgery/

The best thing to do if you are experiencing any of these symptoms that could be attributed to vaginal prolapse, is to seek advice from an experienced professional. Book an appointment with your GP, an experienced pelvic physiotherapist such as Physiotherapy for Women or make an appointment with a Specialist Gynaecologist (Urogynaecologist). That way, you will be able to identify if there is a problem and establish a treatment plan. There are solutions to vaginal prolapse and there is no need to suffer in silence.