Regular free movement of the pelvic floor can improve the problems caused by prolapse of pelvic organs. Vaginal pessary can also help, but it is not suitable for every woman.
In mild or moderate conditions (uterine prolapse), surgery can usually be avoided. Most women’s organs will move back to the correct position on their own, or at least will not deteriorate further. Many women find that free pelvic floor exercise and/or vaginal vaginal care are sufficient to improve symptoms.
But there is no guarantee that these treatments will make the symptoms disappear. If the uterus slips far, especially in patients who have been sick for more than 3 years. Pelvic floor exercise has its limitations. In the study of pelvic floor exercise, 30% to 10% of women over 3 years finally decided to undergo surgery. 50% of patients over 5 years undergo surgery.
My decision-making aid can help you determine whether surgery is right for you. It summarizes the main pros and cons of different treatment options
Table of Contents
What is pelvic free exercise?
Pelvic floor exercise (sometimes called Kegel exercise) strengthens the muscles in the lower part of the pelvis. They are particularly suitable for women with mild incontinence. In Kegel exercises, you will learn how to actively tighten (squeeze) the muscles of the pelvic floor. These short-term exercises can be easily completed in daily life, for example, three times a day. It is best to learn exercises from a physical therapist to make them suitable for your specific symptoms.
How effective is pelvic free exercise?
Pelvic floor exercise can improve the symptoms of mild and moderate conditions (uterine prolapse). After a few weeks, its beneficial effects may already be obvious. But these exercises are not always helpful. Although some women are doing Kegel exercises, they still have problems.
These differences come from the individual’s different body repair capabilities.
In order to increase the chance of success, it is very important to follow the instructions, especially regularly. To prevent pelvic floor problems from recurring, you must practice for a long time. Therefore, it is best to make them an integral part of your daily life. They will not have any negative effects.
If the prolapsed organ is located in the front of the pelvis, where the bladder and urethra are found, pelvic floor movement will be more effective. Research in this area has found that pelvic floor exercise has no negative impact on women who have improved prolapse. But these exercises should be continued for a long time to prevent the organs from falling again.
What is a vaginal pessary?
A vaginal pessary used to treat prolapse. It is a small square, ring or dish made of rubber or silicone. They are inserted into the vagina in order to provide support for the pelvic organs.
Readers are not to be confused with contraceptive pessaries, which are used to prevent sperm from entering the uterus and are closed. The vaginal pessary for prolapse is not closed, the purpose is to let menstruation pass, in order to achieve the purpose of long-term wear.
The pessary comes in different shapes and sizes. People often have to try a few different pessaries before they can find a viable pessary. If possible, doctors usually prescribe pessaries, and women can insert, remove, and clean their pessaries.
How effective is the pessary?
A proper pessary can reduce bladder and bowel problems, or even eliminate them completely, thus supporting the pelvic organs. They cannot solve the prolapse. But it can relieve the symptoms of urinary incontinence.
If a woman wishes to delay surgery, consider using a pessary. 80% of all women who use pessary use it so well that they have used it for several years. If pelvic floor exercise does not provide enough help by itself, pessary can also be a good idea.
Uterine pessary can only relieve the symptoms, can not be treated! ! !
Are there any disadvantages of pessary?
Women using vaginal pessaries need regular appointments to check the pessary, and a doctor checks the vaginal area.
As the pessary pushes the lining of the vagina, it will irritate the mucous membranes there and even cause ulcers. These can cause symptoms such as pain and bleeding. The pessary also causes difficulty in bowel movements. Wearing pessary, you can not have sex, they may cause discomfort. Before sex, the pessary can be removed.
In order to avoid side effects, it is important to ensure that the position of the pessary is correct and that it is replaced and cleaned regularly. The pessary may be exposed to bacteria during the wearing process, and it is easy to contract vaginitis.
Lubricant gel can make the pessary easier to insert. After menopause, women who use pessary are recommended to use hormonal cream to protect the vaginal endometrium-unless they already have genital cancer or breast cancer.
- Barber MD. Pelvic organ prolapse. BMJ 2016; 354: i3853. [PubMed]
- Bugge C, Adams EJ, Gopinath D, Reid F. Pessaries (mechanical devices) for pelvic organ prolapse in women. Cochrane Database Syst Rev 2013; (2): CD004010. [PMC free article] [PubMed]
- Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG), Österreichische Gesellschaft für Gynäkologie und Geburtshilfe (OEGGG), Schweizerische Gesellschaft für Gynäkologie und Geburtshilfe (SGGG). Diagnostik und Therapie des weiblichen Descensus genitalis (S2e-Leitlinie). AWMF-Registernr.: 015-006. April 2016. (AWMF Leitlinien).