Loosing control of your bladder when running, jumping or coughing?

Mrs Deepali Sinha, a Consultant Gynaecologist at Spire London East Hospital, speaks about Pelvic Organ Prolapse, the symptoms and treatments available to you.

1) What is Pelvic Organ Prolapse?

Pelvic organ prolapse is characterised by descent of pelvic organs from their normal positions. These organs are the uterus, vagina, bowel and bladder.

2) What is Urinary Incontinence?

You are Not Alone! Urinary incontinence is a very common problem and can affect up to 33% of the adult female population. 

Urinary incontinence is involuntary loss of urine. It can happen with running or coughing, called Stress Incontinence or some women may feel a strong sudden need, or urgency to urinate just before losing control, called Urge Incontinence. Many women experience both symptoms, called Mixed incontinence.

3) What are the symptoms?

Usually symptoms include:

• A sensation of a bulge or something coming down or out of the vagina, which sometimes needs to be pushed back
• Deep pelvic discomfort
• Difficulty in bowel evacuation
• Having discomfort during sex
• Involuntary passage of urine

4) What are the treatments available?

Treatments depend on appropriate assessment of symptoms to determine the type and severity. Pelvic floor exercises are the mainstay of initial management. Significant symptom relief can be achieved by regular pelvic floor exercises that strengthen the muscles around your bladder and vagina. This can result in improvement of continence, symptoms of prolapse and a better sex life.

If the symptoms require treatment, a prolapse may be treated effectively using a device inserted into the vagina, called a vaginal pessary to keep the prolapsed organ in place.

Surgery becomes an option after failure of conservative measures.

Type of surgical treatment depends on the assessment and investigation of symptoms and include:

• For Prolapse: Pelvic floor repair surgery, Vaginal Hysterectomy, Laparoscopic procedures for Vault Prolapse (Laparoscopic Sacrocolpopexy & Laparoscopic Hysteropexy) and Sacrospinous fixation
• For Urinary Incontinence: Urethral bulking agents, electrical nerve stimulation, Botox injections and TVT

5) Are the treatments successful?

Symptoms of Prolapse and urinary incontinence can be embarrassing and complex. A proper assessment and management of symptoms results in significant improvement in the majority of cases.

6) What is the current situation about the use of mesh in surgical treatment of Pelvic Floor problems?

The use of mesh for the correction of pelvic floor and incontinence problems has significant benefits and low risk of complications in most instances. The exception is the use of mesh in Trans Vaginal procedures for the correction of prolapse, where there is good evidence to show that its use is associated with significant complications and is not recommended outside the research setting.

Mrs Deepali Sinha’s clinic hours at Spire London East Hospital are:

• Wednesdays 1.00pm - 3.00pm
• Thursday 9.00am - 1.30pm

To book please call 020 709 7817.