Prolapsus /

Urinary incontinence

Pathologie à la limite entre gynécologie et urologie, sa prise en charge nécessite une équipe pluridisciplinaire et hautement spécialisée. Nous vous offrons un plateau technique complet et une approche globale.

Prolapse Surgery

 

The organs within a woman’s pelvis are maintained by a set of muscles and ligaments that make up the pelvic floor. The pelvic floor functions like a hammock on which the bladder, the uterus (the womb) and the rectum (the final section of the large intestine) rest.

We talk about a ‘prolapse’ when these organs are no longer sustained and protrude either into the vagina to differing degrees or even beyond the vulva when the prolapse is externalised. It may involve any or all of: the bladder (cystocele), the uterus (hysteroptosis) or the rectum (rectocele).

 

 

The treatment will depend on the type of prolapse and its severity, while the age of the patient and their medical history will naturally also be taken into account.

To provide the best treatment possible, most often, it is necessary to make a complete preoperative assessment:

  • A pelvic ultrasound
  • A urodynamic assessment to see if there is associated urinary incontinence
  • Sometimes a colpocystogramme (dynamic radiography of the pelvic organs) is also required

 

 

  • Why is an operation necessary?

 

Prolapse is responsible for a set of various symptoms. It may cause pelvic heaviness or a ball-like protrusion outside the vulva, or it may lead to urinary, sexual or digestive symptoms.

 

The operation suggested by your gynaecologist aims to correctly reposition the bladder, vagina and rectum in the pelvis.

In addition to this, the means that provide support to these organs are often strengthened using synthetic reinforcing tissue (a prosthetic implant) that is compatible with the human body.

 

Finally, an operation may be carried out to complete the treatment of stress urinary incontinence.

 

Depending on your medical profile, it may be necessary to remove the uterus (in whole or in part), and/or the ovaries. This has to be discussed with your surgeon.

 

 

  • Are there other options?

 

Rehabilitation is possible, but it is only effective when the prolapse is not significant.

 

Using a pessary can be a solution: this is a device which is placed in the vagina and is designed to contain the prolapse. It is often used when an operation cannot be carried out as quickly as would be desirable. It may be worn temporarily or permanently.

 

The operation can be carried out either via the abdomen or the vagina and there are different techniques available. Your surgeon will explain the different options to you.

 

It is not vitally important to treat a prolapse. However, if it is not treated, the prolapse will get worse, up to the point of externalisation. Further consequences may include urinary retention, a dilation of the kidneys with renal impairment, and ulceration of the vagina and the cervix.

 

Nevertheless, these complications are rare, and the decision to have an operation is more likely to be motivated by the discomfort caused by the prolapse.

 

 

L'Institut de Gynécologie et d'Obstétrique

121 A route d'Arlon / L-1150 LUXEMBOURG