Treatments
Prolapse
A prolapse means that one or more organs in the pelvis drop down. This can be the womb, the bladder or the bowel.
Not every prolapse needs treatment, and not every prolapse needs surgery. Sometimes a simple solution is enough.
What is it?
What is a prolapse?
The organs in the pelvis are normally held in place by the muscles and connective tissue of the pelvic floor. When these weaken, a prolapse can develop.
Many women experience this at some point, especially after childbirth or around and after the menopause.
Womb, bladder or bowelOne or more of these organs can prolapse. Sometimes several problems occur at once.
In figures
You are not alone
Prolapse is common. By no means everyone has symptoms, and when they do, treatment without surgery often helps.
- Over 40%of women over 40 have a prolapse.
- 11%of women with a prolapse are significantly troubled by it.
- 57%of women with a mild, symptomatic prolapse improve after 3 months of pelvic floor training, compared with 13% without treatment.
- Halfof women with a prolapse choose not to have surgery.
Sources: Dutch guideline Prolaps (NVOG/Federatie Medisch Specialisten); Huisarts en Wetenschap, December 2023.
Symptoms
Which symptoms can you have?
A prolapse can cause a range of symptoms, such as:
- A heavy or dragging feeling in the vagina
- A feeling that “something is coming down”
- Difficulty passing urine, or needing to pass urine often
- Difficulty opening your bowels
- Pain during sex
- Lower back pain
Sometimes you can actually see or feel a bulge at the entrance to the vagina. Not every prolapse needs treatment: this depends on your symptoms and how much they trouble you.
Your visit
How do we make the diagnosis?
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A conversation
At Femmecare we always start with a conversation. We discuss:
- your symptoms
- previous births and operations
- the physical demands of your daily life
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Gynaecological examination
We then carry out a gynaecological examination. This allows us to assess:
- which organ has prolapsed
- how severe the prolapse is
- whether several problems are occurring at once
Sometimes further tests are needed, for example for urinary symptoms.
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Treatment plan
We always start with a calm, clear explanation. Together we discuss how much the symptoms affect you, what you would like and what makes medical sense.
Treatment
Treatment at Femmecare
Treatment depends on your situation and your wishes. Together we look at the best and most suitable step for you.
Pelvic floor physiotherapy
Targeted training of the pelvic floor muscles can reduce symptoms. For this we work together with a pelvic physiotherapist.
A pessary
A silicone ring or cup placed in the vagina to support the organs. Many women benefit from this. We fit the pessary here at the clinic.
Lifestyle advice
For example advice about lifting, weight, bowel habits and the strain on the pelvic floor.
Good to know
Surgery for a prolapse
We do not perform prolapse surgery
If surgery is medically necessary, or if you would like it, we discuss this carefully with you. In that case we work together with several hospitals.
What we do arrange
- A clear referral
- Transfer of all your medical records
- Agreement on the treatment plan
See also
For GPs
Referring patients with a prolapse
Assessment and conservative management of genital prolapse. Prolapse surgery is not performed at Femmecare; where surgery is indicated we refer on, with full handover.
ZorgDomein: ‘Femmecare Clinics’
Reasons to refer
- Symptomatic prolapse where a pessary is being considered
- Problems with an existing pessary
- Prolapse combined with urinary or bowel symptoms
- Assessment of whether there is an indication for surgery
What we offer
- History and gynaecological examination, with further tests if needed
- Pessary fitting
- Pelvic floor physiotherapy in collaboration with a pelvic physiotherapist
- Where surgery is indicated: referral, handover and liaison with the hospital
Sometimes a simple solution is enough
If you have symptoms that could fit with a prolapse, you can discuss a referral to Femmecare with your GP.