|
Prolapse — Symptoms and Diagnosis
A bladder or urethra prolapse may cause incontinence (leaking urine), frequent or urgent need to urinate or difficulty urinating. A prolapse of the small or large bowel (rectum) may cause constipation or difficulty defecating. Some women may need to insert a finger in their vagina and push the bowel back into place in order to empty their bowels. Women with uterine prolapse may feel a dragging or heaviness in their pelvic area, often described as feeling 'like my insides are falling out'. With severe prolapse, when the uterus is bulging out of the vagina, the skin may become irritated, raw and infected. |
|
Symptoms that may be occur with all types of prolapse:
Diagnosis If you have any of the symptoms of prolapse, particularly if you can see or feel something near or at the opening of your vagina, make an appointment to see your GP. Many women with prolapse avoid going to the doctor because they are embarrassed or afraid of what the doctor might find, but prolapse is very common and is nothing to be ashamed of. Before you see your doctor, it may help to make a list of symptoms, concerns and questions. Take the list with you to your appointment. It may be difficult at first to talk about your symptoms, and some women find the examination uncomfortable, but it only takes a few minutes and, by having your symptoms checked, you are taking an active role in your health and well-being. What to expect at your appointment To look for signs of prolapse your doctor will need to do a thorough pelvic examination. If you prefer this to be done by a female doctor, ask for this when you make your appointment. You will be asked to undress from the waist down and lie on your back on the examination table. You should be given a blanket or sheet to put over yourself but if you aren't, just ask for one. The doctor will ask you to bend your knees and let them fall open. Some women find this position difficult, so if you can't lie this way, say so. The doctor can do the examination with you lying on your side with your knees drawn up in the foetal position. In fact, many doctors will do this anyway when looking for prolapse as it's a good way to check the front and back walls of the vagina. The doctor will feel for any unusual lumps or bumps in your pelvic area by inserting two fingers in your vagina and pushing gently on your abdomen. You will be asked if you feel any pain or discomfort. Tell the doctor if it hurts even if you are not asked. The doctor may also insert a special speculum (called a Sims speculum) to examine the walls of the vagina for bulges. You may be asked to cough or strain during the examination. This enables the doctor to see if any urine leaks or if any of the pelvic organs prolapse into the vaginal walls. Some prolapse symptoms go away when you're lying down, so your doctor may also want to examine you while you're standing. If you have bowel symptoms the doctor may need to feel for bowel prolapse by placing one finger in your rectum and another in your vagina and asking you to strain or bear down. If you have urinary symptoms, the doctor should take a urine sample to check for a urinary infection. A good doctor will explain what s/he is doing throughout the examination but if you have any questions, ask for an explanation. If you have a mild prolapse that isn't causing you any pain or discomfort, you don't need treatment. There are, however, some steps you can take to help improve your prolapse and prevent it from getting any worse, see Preventing Prolapse. If you develop any new symptoms or your existing symptoms get worse, contact your doctor. Because symptoms often develop gradually it may be difficult to judge when you should go back to the doctor. There's no right or wrong answer, but as a general guideline, tell your doctor if:
If your prolapse is moderate or severe and is causing pain or discomfort, you should be referred to a gynaecologist or urologist for further investigations and possible treatment. The specialist will ask you about your symptoms and health history and will examine you again to make sure the diagnosis is as precise as possible. If you have bladder symptoms the specialist may do additional urine and bladder tests to check if the symptoms are related to your prolapse or separate from it. Incontinence will need to be treated in addition to treating your prolapse. |
|
|
Written by Tamara Beus and published in printed format (2003) by Women's Health
|
|
Women with mild prolapse may have no symptoms or discomfort at all and may not be aware they have a prolapse. When symptoms do occur, however, they tend to be related to the organ that has prolapsed.
