pelvic floor repair dysfunction can be caused by problems such as urinary and fecal incontinence, feeling like something is falling out of the vagina or during bowel movements, pain or difficult intercourse. The good news is that these problems can often be corrected without having to undergo surgery. Pelvic floor prolapse is the most common cause of these symptoms. This is when the uterus, bladder and/or rectum protrude into the vagina. It may be a mild protrusion or a large bulge in the vagina and can interfere with normal activity and quality of life.
If the uterus is prolapsing it can be stabilized with laparoscopic colposuspension. This is a minimally invasive procedure using fine instrumentation through 4 keyhole incisions in the abdomen. This is in contrast to a traditional open abdominal hysterectomy requiring a large lower abdomen incision.
Other surgeries used to correct prolapse include anterior (front) vaginal repair, posterior (back) vaginal repair or a hysterectomy. Anterior and posterior repair stabilise the front or back wall of the vagina by either stitching them together or putting in a synthetic mesh to support them. A hysterectomy removes the uterus but there are also uterus-sparing procedures that allow women to try for another pregnancy. These are gaining in popularity but more research is needed to determine their effectiveness.
Various exercises can be performed to strengthen pelvic floor muscles including squeezing the muscles with fingers and relaxing them between squeezes. Women are also encouraged to do these exercises while seated or lying on their backs. It is important to perform these exercises correctly so that the correct muscles are exercised and not other muscles in the body which could increase the risk of damage. It is common to tighten other muscles when trying to locate the correct ones. This is why it is important to see a physiotherapist who specialises in women’s health and is trained to recognise these muscles.