Materiały źródłowe

• #1 Prevention and management of pelvic organ prolapse

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4166938/

  Pelvic organ prolapse is a highly prevalent condition in the female population, which impairs the health-related quality of life of affected individuals. […] Despite the lack of robust evidence, selective modification of obstetric events or other risk factors could play a central role in the prevention of prolapse. […] While the value of pelvic floor muscle training as a preventive treatment remains uncertain, it has an essential role in the conservative management of prolapse. […] Vaginal childbirth is probably the most important factor in the aetiology of pelvic organ prolapse. However, the concept of a planned caesarean section for the prevention of pelvic floor dysfunction is controversial, due to the risks associated with caesarean section and the obvious resource implications for health care systems.

• #1 Cystocele (Prolapsed Bladder): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15468-cystocele-fallen-bladder

  Can a cystocele be prevented? […] You can control certain cystocele risk factors, including: […] Maintaining a healthy weight for you. Talk to a healthcare provider about what a healthy weight means for you. […] Avoiding constipation. You can help prevent constipation by eating a high-fiber diet, drinking plenty of water each day and exercising regularly. […] Protecting your pelvic floor muscles during heavy physical activity. Don’t try to lift heavy objects by yourself. If you’re lifting a heavy object on your own or working out, use proper form: bend your hips and knees to squat and keep your back straight. Don’t twist your torso while you lift. […] However, you can’t modify other risk factors, like your family history or age.

• #1

• #1 Cystocele – NIDDK

  https://www.niddk.nih.gov/health-information/urologic-diseases/cystocele

  Can I prevent a cystocele? Usually a cystocele cannot be prevented, but you can take steps to relieve your symptoms and help prevent your cystocele from getting worse. […] Do pelvic floor muscle exercises Strong pelvic floor muscles help hold the pelvic organs in place. Kegel exercises can make the pelvic floor muscles stronger. […] Maintain a healthy weight Being overweight puts pressure on your pelvis. Make changes to your diet and lifestyle, such as eating more fruits and vegetables and getting regular physical activity. […] Avoid heavy lifting and lift correctly When lifting heavy objects, use your legs instead of your waist or back. […] Prevent and treat constipation Get enough fiber in your diet, drink plenty of water and other liquids, and get regular physical activity. […] Control chronic cough Get treatment for a chronic cough or bronchitis and avoid smoking.

• #1 Mayo Clinic Health Library – Anterior vaginal prolapse (cystocele) | Swiss Medical Network

  https://www.swissmedical.net/it/healtcare-library/con-20369433

  Kegel exercises are exercises you can do at home to strengthen your pelvic floor muscles. A strengthened pelvic floor provides better support for your pelvic organs and relief from symptoms associated with anterior prolapse. […] To help keep an anterior prolapse from progressing, you can also try these lifestyle modifications: […] Treat and prevent constipation. High-fiber foods can help. […] Avoid heavy lifting, and lift correctly. When lifting, use your legs instead of your waist or back. […] Control coughing. Get treatment for a chronic cough or bronchitis, and don’t smoke. […] Manage your weight. Talk to your doctor to determine your ideal weight and get advice on weight-loss strategies, if you need them.

• #1

  https://step2.medbullets.com/gynecology/121754/uterine-prolapse

  Weight […] maintain healthy body weight […] Exercise […] regular physical activity […] kegel exercises […] Smoking cessation […] prevents chronic cough.

• #1

  https://www.hingehealth.com/resources/articles/exercises-for-pelvic-organ-prolapse/

  Pelvic organ prolapse is a type of pelvic floor disorder. The pelvic floor is a group of muscles and tissues that stretch like a hammock from your pubic bone in the front to your tailbone in the back. It helps hold pelvic organs (such as your bladder, uterus, and rectum) in place, and plays a role in bladder control, bowel control, and sexual function. […] Because pelvic floor muscle weakness can contribute to organ prolapse, pelvic organ prolapse exercises and physical therapy is often the first line of treatment. Strengthening pelvic floor muscles can help reduce symptoms of prolapse, such as heaviness in your pelvis or the feeling that something is bulging out of your vagina. Pelvic organ prolapse exercises which strengthen the pelvic floor can also help improve other conditions that can occur along with pelvic organ prolapse, such as urinary incontinence (or leakage) and fecal incontinence.

• #1

  https://www.nhs.uk/conditions/pelvic-organ-prolapse/treatment/

  If you do not have any symptoms or the prolapse is mild, making some lifestyle changes may help and could stop the prolapse getting worse. […] They can also help reduce your risk of getting a prolapse in the first place. […] Doing pelvic floor exercises will strengthen your pelvic floor muscles and may well relieve your symptoms. […] A GP or specialist may recommend a programme of supervised pelvic floor muscle training for at least 16 weeks before you move on to other treatments or surgery. […] Vaginal pessaries allow you to get pregnant in the future. They can be used to ease the symptoms of moderate or severe prolapses and are a good option if you cannot or would prefer not to have surgery. […] If non-surgical options have not worked or the prolapse is more severe, surgery may be an option.

• #1

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=tw12334

  Do not lift heavy objects or do anything that puts pressure on your pelvic muscles. […] Try pelvic floor (Kegel) exercises. These tighten and strengthen pelvic muscles. […] Ask your doctor about a vaginal pessary. You can place this in your vagina. It supports the bladder. Your doctor can teach you how and when to remove, clean, and reinsert it.

• #1 Practical Use of the Pessary | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/0501/p2719.html

  The pessary is an effective tool in the management of a number of gynecologic problems. The pessary is most commonly used in the management of pelvic support defects such as cystocele and rectocele. […] Complications can be minimized with simple vaginal hygiene and regular follow-up visits. […] Although surgical repair of certain pelvic support defects offers a more permanent solution, some patients may elect to use a pessary as a temporary management option. […] While many of these patients are poor candidates for surgery, most of them can safely use a pessary. […] A cystocele occurs when the tissues between the bladder and the vagina weaken, leading to a herniation of the bladder. […] In patients with a mild cystocele, treatment using a ring with support, a dish with support, a Hodge with support or a donut pessary will suffice.

• #1 Pelvic organ prolapse | RCOG

  https://www.rcog.org.uk/for-the-public/browse-our-patient-information/pelvic-organ-prolapse/

  Prolapse symptoms can be reduced with lifestyle changes, including stopping smoking, weight loss, avoiding constipation where possible and heavy lifting. […] Even if you do not currently have any symptoms, you may wish to consider pelvic floor exercises and lifestyle changes to prevent your prolapse from getting worse. […] Your options for treatment will depend on the type and degree of prolapse you have and your individual circumstances, such as age, general health, whether you are sexually active and whether you have completed your family. […] Identifying the correct pessary may take more than one attempt as there are many different sizes and shapes. […] Pessaries do not usually cause any problems but can sometimes cause infection, discharge, bleeding or ulceration. […] If you plan to have children, you may be advised to delay surgery until your family is complete. This is because another pregnancy and birth may increase the chance of your prolapse happening again. […] Approximately 25-30 in 100 women having surgery for prolapse will develop another prolapse in the future. There is a higher chance of the prolapse returning if you are overweight, constipated, have a long-standing cough or undertake heavy physical activities.

• #1 Prevention and management of pelvic organ prolapse

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4166938/

  Based on the recent epidemiological studies, a scoring system (UR-CHOICE) has been proposed to predict the risk of future pelvic floor dysfunction. […] Pelvic floor muscle training (PFMT) has been proposed as a measure to prevent pelvic organ prolapse. However, a recently published study, comparing a nurse-led intervention (pelvic floor muscle training and bladder training) at 5, 7, and 9 months after delivery to standard care, showed that the prevalence of prolapse symptoms or objectively measured pelvic organ prolapse did not differ between the groups at the 12-year follow-up. […] As pelvic organ prolapse has been associated with urogenital atrophy, it is possible that oestrogens, alone or in conjunction with other measures, may prevent its development by improving the strength of weakened supporting ligaments, muscles and vaginal mucosa. […] Modification of other risk factors could also reduce the risk of pelvic organ prolapse. Reduction of straining and intra-abdominal pressure could help prevent the development of prolapse. […] Weight loss with diet or bariatric surgery has also been suggested as a preventive measure.

• #1 Practical Use of the Pessary | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/0501/p2719.html

  To manage a large prolapse of the anterior vaginal wall, the Gellhorn pessary may be the best choice, although insertion and removal can be difficult. […] A Hodge pessary with support is also effective in the prevention of exercise incontinence. […] Treatment with estrogen cream can make the vaginal mucosa more resistant to erosion and should be used before or concurrently with the fitting of the pessary in such patients. […] Pessaries should never be placed in elderly, debilitated patients without excellent follow-up.

• #1 Pelvic Organ Prolapse | The Pelvic Clinic

  https://thepelvicclinic.co.uk/conditions-treatments/pelvic-organ-prolapse/

  Mild prolapse with minimal symptoms probably doesnt require any treatment. Lifestyle changes such as losing weight, avoiding straining when on the toilet, avoiding heavy lifting and pelvic floor exercises may be all that is required. […] The use of vaginal oestrogen or even HRT can be very effective in strengthening the pelvic floor and reversing the weakening effect of the menopause. […] If you only have mild symptoms, doing pelvic floor exercises may help to support your prolapse and resolve urinary stress incontinence. Pelvic floor exercises will generally not help significant prolapse. […] If you have mild symptoms of prolapse or urinary leakage I would always recommend a consultation with a specialised pelvic floor physiotherapist who will properly asses your pelvic floor, identify muscle weakness and will then recommend a tailored treatment to maximise success.

• #1

  https://www.nhs.uk/conditions/pelvic-organ-prolapse/treatment/

  Your doctor will discuss the benefits and risks of different treatments, and you’ll decide together which is best for you. […] If you’d like to have children in the future, your doctors may suggest delaying surgery because pregnancy can cause the prolapse to happen again. […] This treatment is only offered to women who have advanced prolapse, when other treatments have not worked and they’re sure they do not want to have sex again in the future. […] Your doctor should have an in-depth discussion with you about the risks and benefits of the 4 different types of surgery, including mesh surgery, before you decide together whether one of them could be an option. […] You should be offered a check-up 6 months after surgery that includes a vaginal examination.

• #1 Pelvic organ prolapse – a review

  https://www.racgp.org.au/afp/2015/july/pelvic-organ-prolapse-a-review

  FPOP is a common condition requiring surgery in 10-20% of women. […] Primary prevention is feasible through modification of obstetric management. The main modifiable risk factor for pelvic floor trauma and later pelvic organ prolapse is forceps, whereas vacuum is not associated with increased risk. […] The use of forceps, the primary risk factor for levator avulsion, is entirely avoided in some countries and institutions, demonstrating that this risk factor is eminently modifiable. […] Until recently, it seemed that forceps delivery was becoming obsolete. […] The first is not practicable except in individual cases, and attempts at selecting high-risk patients have been unsuccessful. […] The second approach seems feasible, but first attempts at preventing trauma via antenatal intervention have failed.

• #1 Genitourinary Prolapse (Causes, Symptoms, and Treatment)

  https://patient.info/doctor/genitourinary-prolapse-pro

  Possible preventative measures are listed below, although the evidence base for some is more supportive than for others: […] The lifestyle advice for women with pelvic organ prolapse outlined above (eg, a balanced diet, physical exercise) also applies to those who wish to reduce their risk of developing this condition. […] Women of all ages should be encouraged to do pelvic floor exercises, including women who are pregnant and those who have just given birth. […] Smoking cessation will reduce chronic cough (and therefore intra-abdominal pressure). […] Weight loss if overweight or obese (although studies suggest subjective benefits are not borne out by objective examination). […] Treatment of constipation throughout life (though evidence from systematic evidence is lacking). […] Royal College of Obstetricians and Gynaecologists (RCOG) guidelines advise that the following at the time of hysterectomy may help to prevent subsequent post-hysterectomy vault prolapse (PHVP):

• #1 Genitourinary Prolapse (Causes, Symptoms, and Treatment)

  https://patient.info/doctor/genitourinary-prolapse-pro

  Suturing the cardinal and uterosacral ligaments to the vaginal cuff at the time of hysterectomy is effective in preventing PHVP following both abdominal and vaginal hysterectomies. […] Sacrospinous fixation at the time of vaginal hysterectomy should be considered when the vault descends to the introitus during closure.

• #1 Cystocele – Wikipedia

  https://en.wikipedia.org/wiki/Cystocele

  Cystocele may be mild enough not to result in symptoms that are troubling to a woman. In this case, steps to prevent it from worsening include: […] smoking cessation […] losing weight […] pelvic floor strengthening […] treatment of a chronic cough […] maintaining healthy bowel habits […] eating high fiber foods […] avoiding constipation and straining.

• #1 Bladder prolapse (cystocele) | healthdirect

  https://www.healthdirect.gov.au/bladder-prolapse

  Bladder prolapse can happen when your pelvic floor muscles become weak and your bladder bulges into your vaginal wall. […] You can help prevent bladder prolapse by doing pelvic floor exercises, maintaining a healthy weight, avoiding heavy lifting and avoiding constipation. […] There are some things you can do that may help prevent a bladder prolapse: Do pelvic floor exercises regularly. Avoid lifting heavy objects. Maintain a healthy weight to prevent extra stress on your pelvic floor. Eat foods rich in dietary fibre and drink plenty of water every day to help prevent constipation and straining. Get some exercise every day include exercise that strengthens your core muscles and avoid high-impact exercise such as jumping and running.

• #1 Pelvic organ prolapse | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/bladder-prolapse

  There are things you can do to prevent or manage a pelvic organ prolapse. […] There are practical things you can do to reduce the risk of prolapse. These may also help you to recover well after a prolapse or surgery. For example you can: manage constipation by eating a balanced diet and drinking enough water […] do regular physical activity […] avoid heavy lifting […] make lifestyle changes, like quitting smoking. […] You can also do pelvic floor exercises every day. For example, squeeze up pelvic floor muscles before lifting, coughing, laughing or sneezing. A pelvic floor physiotherapist can show you how to do this.

• #1

  https://www.hingehealth.com/resources/articles/exercises-for-pelvic-organ-prolapse/

  Learning to manage abdominal pressure with proper breathing techniques is key to treating prolapse, says Kandis Daroski, PT, DPT, a Hinge Health pelvic floor physical therapist. Avoid holding your breath or straining with any daily activities that increase pressure in your abdomen, like exercising, lifting something, or having a bowel movement. Instead, focus on breathing deeply and evenly to help reduce pressure on your pelvic organs.

• #1 Cystocele – Alaska Urology

  https://www.alaskaurology.com/womens-health/cystocele/

  To reduce your risk of developing anterior prolapse, try these self-care measures: […] Perform Kegel exercises on a regular basis. These exercises can strengthen your pelvic floor muscles, and this is especially important after you have a baby. […] Treat and prevent constipation. High-fiber foods can help. […] Avoid heavy lifting, and lift correctly. When lifting, use your legs instead of your waist or back. […] Control coughing. Get treatment for a chronic cough or bronchitis, and dont smoke. […] Avoid weight gain. Talk to your doctor to determine your ideal weight and get advice on weight-loss strategies, if you need them.

• #2 Bladder Prolapse (Cystocele) | CommonSpirit Health

  https://www.commonspirit.org/conditions-treatments/bladder-prolapse-cystocele

  A cystocele is a type of pelvic organ prolapse. It occurs when the bladder moves from its normal position and presses against the front wall of the vagina. This is also called anterior vaginal wall prolapse. A cystocele can happen when the muscles and tissues that hold your bladder in place get weak or damaged. […] Kegel exercises, which strengthen the pelvic floor muscles, may help relieve some symptoms. […] Do not lift heavy objects or do anything that puts pressure on your pelvic muscles. […] Try pelvic floor (Kegel) exercises. These tighten and strengthen pelvic muscles. […] Ask your doctor about a vaginal pessary. You can place this in your vagina. It supports the bladder. Your doctor can teach you how and when to remove, clean, and reinsert it.

• #2 Cystocele – NIDDK

  https://www.niddk.nih.gov/health-information/urologic-diseases/cystocele

  Can I prevent a cystocele? Usually a cystocele cannot be prevented, but you can take steps to relieve your symptoms and help prevent your cystocele from getting worse. […] Do pelvic floor muscle exercises Strong pelvic floor muscles help hold the pelvic organs in place. Kegel exercises can make the pelvic floor muscles stronger. […] Maintain a healthy weight Being overweight puts pressure on your pelvis. Make changes to your diet and lifestyle, such as eating more fruits and vegetables and getting regular physical activity. […] Avoid heavy lifting and lift correctly When lifting heavy objects, use your legs instead of your waist or back. […] Prevent and treat constipation Get enough fiber in your diet, drink plenty of water and other liquids, and get regular physical activity. […] Control chronic cough Get treatment for a chronic cough or bronchitis and avoid smoking.

• #2 Mayo Clinic Health Library – Anterior vaginal prolapse (cystocele) | Swiss Medical Network

  https://www.swissmedical.net/it/healtcare-library/con-20369433

  Kegel exercises are exercises you can do at home to strengthen your pelvic floor muscles. A strengthened pelvic floor provides better support for your pelvic organs and relief from symptoms associated with anterior prolapse. […] To help keep an anterior prolapse from progressing, you can also try these lifestyle modifications: […] Treat and prevent constipation. High-fiber foods can help. […] Avoid heavy lifting, and lift correctly. When lifting, use your legs instead of your waist or back. […] Control coughing. Get treatment for a chronic cough or bronchitis, and don’t smoke. […] Manage your weight. Talk to your doctor to determine your ideal weight and get advice on weight-loss strategies, if you need them.

• #2 Bladder prolapse (cystocele) | healthdirect

  https://www.healthdirect.gov.au/bladder-prolapse

  Bladder prolapse can happen when your pelvic floor muscles become weak and your bladder bulges into your vaginal wall. […] You can help prevent bladder prolapse by doing pelvic floor exercises, maintaining a healthy weight, avoiding heavy lifting and avoiding constipation. […] There are some things you can do that may help prevent a bladder prolapse: Do pelvic floor exercises regularly. Avoid lifting heavy objects. Maintain a healthy weight to prevent extra stress on your pelvic floor. Eat foods rich in dietary fibre and drink plenty of water every day to help prevent constipation and straining. Get some exercise every day include exercise that strengthens your core muscles and avoid high-impact exercise such as jumping and running.

• #2 Vaginal Hysterectomy for Uterine Prolapse and Vaginal Repair – Milton Keynes University Hospital

  https://www.mkuh.nhs.uk/patient-information-leaflet/vaginal-hysterectomy-for-uterine-prolapse-and-vaginal-repair

  Pelvic floor exercises (PFE) can strengthen the pelvic floor and therefore give more support to the pelvic organs. […] Keeping your weight normal for your height, avoiding unnecessary heavy lifting, and not straining on the toilet, will help prevent a further prolapse although even adhering to this sometimes does not prevent a further prolapse. […] Avoiding constipation: Drink plenty of water / juice Eat fruit and green vegetables especially broccoli Plenty of roughage e.g. bran / oats.

• #2 Pelvic Organ Prolapse: Types, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/24046-pelvic-organ-prolapse

  Do pelvic floor exercises daily. Having muscle control in your pelvic floor provides stronger support for your organs. […] Maintain a healthy weight. Talk to your provider about what a healthy weight means for you. […] Prevent constipation. Chronic constipation can strain your pelvic floor muscles. Choosing high-fiber foods and drinking plenty of fluids can help prevent constipation. […] Don’t smoke. Smoking can lead to chronic coughing, which can put undue pressure on your abdominal cavity and strain your pelvic floor muscles. […] Protect your pelvic floor when you lift. Get help lifting heavy objects. When lifting alone, bend your hips and knees to squat while keeping your back as straight as possible. Don’t twist your torso while you’re lifting. Correctly positioning your body prevents injury to your lower back and protects your pelvic floor, too.

• #2 Cystocele (Prolapsed Bladder) – Symptoms, Causes and Treatment PACE Hospitals – Best Hospitals in Hitech City, Hyderabad, India | Near Madhapur, Kukatpally, KPHB, Kondapur, Gachibowli, Jubilee Hills, Banjara HillsPACE Hospitals Contact Nu

  https://www.pacehospital.com/cystocele-prolapsed-bladder-symptoms-causes-prevention-and-treatment

  Cystocele prevention […] Here are some lifestyle changes that may help prevent a prolapsed bladder: […] Indulging in pelvic floor exercises: Pelvic floor exercises, such as Kegels, can help strengthen the pelvic floor muscles and nerves, thereby controlling bladder prolapse symptoms and preventing them from worsening. […] Maintaining a healthy weight: Being overweight causes pressure on the pelvic region. Changing the diet and lifestyle by eating more fruits and vegetables and exercising on a regular basis may help to maintain the ideal body weight to prevent bladder prolapse. […] Avoiding heavy lifting and lifting correctly: Heavy lifting could damage the pelvic floor’s muscles and connective tissues that support the bladder, uterus, and intestines. […] Preventing and treating constipation: Constipation can result in pelvic organ prolapse. It can also be a symptom caused due to bladder prolapse. Trying to prevent constipation and straining when defecating may help. […] Controlling chronic cough: Coughing causes the pelvic floor to shift downward. Repeated or aggressive coughing can stretch the pelvic floor tissues.

• #2 Genitourinary Prolapse (Causes, Symptoms, and Treatment)

  https://patient.info/doctor/genitourinary-prolapse-pro

  Possible preventative measures are listed below, although the evidence base for some is more supportive than for others: […] The lifestyle advice for women with pelvic organ prolapse outlined above (eg, a balanced diet, physical exercise) also applies to those who wish to reduce their risk of developing this condition. […] Women of all ages should be encouraged to do pelvic floor exercises, including women who are pregnant and those who have just given birth. […] Smoking cessation will reduce chronic cough (and therefore intra-abdominal pressure). […] Weight loss if overweight or obese (although studies suggest subjective benefits are not borne out by objective examination). […] Treatment of constipation throughout life (though evidence from systematic evidence is lacking). […] Royal College of Obstetricians and Gynaecologists (RCOG) guidelines advise that the following at the time of hysterectomy may help to prevent subsequent post-hysterectomy vault prolapse (PHVP):

• #2 Pelvic Organ Prolapse: Causes, Complications, Prevention

  https://www.webmd.com/women/vaginal-prolapse

  There are things you can do to tighten your pelvic muscles and reduce your risk. For instance, Kegel exercises can help strengthen the nerves and muscles in your pelvis. Making certain lifestyle changes might help, too. […] Daily Kegel exercises can help strengthen your pelvic floor muscles and prevent your pelvic organs from dropping.

• #2 Cystocele Causes and Prevention

  https://www.affiliatedurologists.com/blog/cystocele-causes-and-prevention

  Cystocele may seem like a difficult condition to prevent because the causes are often unavoidable. However, the Affiliated Urologists team created a list of preventative measures patients can practice. […] They suggest performing Kegel exercises regularly to strengthen the pelvic floor muscles so they are less prone to weakening. Kegel exercises are simple and can prevent numerous urological conditions including incontinence and prolapse. Another easy way to prevent cystocele is to incorporate plenty of fiber into the diet, which can make bowel movements easier and more frequent and effectively eliminate the need to strain. […] If the preventative measures do not effectively mitigate the condition, we advise getting immediate treatment.

• #2 Pelvic organ prolapse | Jean Hailes

  https://www.jeanhailes.org.au/health-a-z/vulva-vagina/pelvic-organ-prolapse

  Pelvic floor exercises and changes in your daily routine, along with weight management, may be all you need. […] Do pelvic floor exercises every day and remember to squeeze up pelvic floor muscles before lifting, coughing, laughing or sneezing. […] It’s important to see your doctor as soon as possible if you notice any symptoms. Early treatment will prevent or reduce the severity of prolapse. […] If you have reached menopause, you can ask your doctor about hormone therapy to increase your levels of oestrogen. This may help to strengthen your vaginal walls and pelvic floor muscles.

• #2 Pelvic Organ Prolapse | The Pelvic Clinic

  https://thepelvicclinic.co.uk/conditions-treatments/pelvic-organ-prolapse/

  Mild prolapse with minimal symptoms probably doesnt require any treatment. Lifestyle changes such as losing weight, avoiding straining when on the toilet, avoiding heavy lifting and pelvic floor exercises may be all that is required. […] The use of vaginal oestrogen or even HRT can be very effective in strengthening the pelvic floor and reversing the weakening effect of the menopause. […] If you only have mild symptoms, doing pelvic floor exercises may help to support your prolapse and resolve urinary stress incontinence. Pelvic floor exercises will generally not help significant prolapse. […] If you have mild symptoms of prolapse or urinary leakage I would always recommend a consultation with a specialised pelvic floor physiotherapist who will properly asses your pelvic floor, identify muscle weakness and will then recommend a tailored treatment to maximise success.

• #2 Prevention and management of pelvic organ prolapse

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4166938/

  Based on the recent epidemiological studies, a scoring system (UR-CHOICE) has been proposed to predict the risk of future pelvic floor dysfunction. […] Pelvic floor muscle training (PFMT) has been proposed as a measure to prevent pelvic organ prolapse. However, a recently published study, comparing a nurse-led intervention (pelvic floor muscle training and bladder training) at 5, 7, and 9 months after delivery to standard care, showed that the prevalence of prolapse symptoms or objectively measured pelvic organ prolapse did not differ between the groups at the 12-year follow-up. […] As pelvic organ prolapse has been associated with urogenital atrophy, it is possible that oestrogens, alone or in conjunction with other measures, may prevent its development by improving the strength of weakened supporting ligaments, muscles and vaginal mucosa. […] Modification of other risk factors could also reduce the risk of pelvic organ prolapse. Reduction of straining and intra-abdominal pressure could help prevent the development of prolapse. […] Weight loss with diet or bariatric surgery has also been suggested as a preventive measure.

• #2

  https://www.nhs.uk/conditions/pelvic-organ-prolapse/treatment/

  If you do not have any symptoms or the prolapse is mild, making some lifestyle changes may help and could stop the prolapse getting worse. […] They can also help reduce your risk of getting a prolapse in the first place. […] Doing pelvic floor exercises will strengthen your pelvic floor muscles and may well relieve your symptoms. […] A GP or specialist may recommend a programme of supervised pelvic floor muscle training for at least 16 weeks before you move on to other treatments or surgery. […] Vaginal pessaries allow you to get pregnant in the future. They can be used to ease the symptoms of moderate or severe prolapses and are a good option if you cannot or would prefer not to have surgery. […] If non-surgical options have not worked or the prolapse is more severe, surgery may be an option.

• #2 Practical Use of the Pessary | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/0501/p2719.html

  To manage a large prolapse of the anterior vaginal wall, the Gellhorn pessary may be the best choice, although insertion and removal can be difficult. […] A Hodge pessary with support is also effective in the prevention of exercise incontinence. […] Treatment with estrogen cream can make the vaginal mucosa more resistant to erosion and should be used before or concurrently with the fitting of the pessary in such patients. […] Pessaries should never be placed in elderly, debilitated patients without excellent follow-up.

• #2 Step-by-step approach to managing pelvic organ prolapse | The College of Family Physicians of Canada

  https://www.cfp.ca/content/53/3/485

  Most women are asymptomatic so no treatment is needed. A trial of lifestyle modification might be beneficial: Kegel exercises, weight loss, smoking cessation, treatment of constipation, electrical stimulation, or biofeedback. […] Use estrogen (oral or vaginal) for mild cystocele. Consider a pessary. […] Pessaries should be removed regularly for cleaning by patient or health care professional. […] Women are often reluctant to discuss prolapse symptoms. While there are no randomized controlled trials of treatment, pessaries are a good option for those who wish to remain fertile or avoid surgery. […] There is no evidence or consensus on which pessary is best, how often to clean it, or how often to visit a health professional. […] Long-term use carries a risk of vaginal erosion, so vaginal examinations should be done every 3 to 6 months.

• #2 Pelvic floor and urinary incontinence – gynsurgery.org

  https://www.gynsurgery.org/prolapse-urinary-incontinence/

  Pelvic floor prolapse and/or urinary incontinence is frequent in over 10% of older women. […] Prevention, therefore, is hormone replacement therapy. […] Predisposing factors are those of prolapse of the anterior vaginal wall, i.e. vaginal deliveries and a decreased quality of the support without hormone replacement.

• #2 Advanced Gynecology – Cystocele

  https://www.advancedgynecology.com/conditions-symptoms/cystocele

  Treatments for cystocele may include: Avoiding certain activities that could cause the cystocele to worsen, such as heavy lifting or straining during bowel movements. Regular, daily exercises of the pelvic floor muscles (Kegel exercises), may be recommended to make the pelvic floor muscles stronger. Placement of a small, silicone medical device called a pessary into the vagina to hold the bladder in place. Surgery may be necessary to relocate the bladder into its normal position. Hormone replacement therapy may be suggested as a way to strengthen the muscles around the vagina and bladder. If you are thinking about hormone replacement therapy, talk to your healthcare provider about the risks and benefits first.

• #2 Pelvic organ prolapse – a review

  https://www.racgp.org.au/afp/2015/july/pelvic-organ-prolapse-a-review

  FPOP is a common condition requiring surgery in 10-20% of women. […] Primary prevention is feasible through modification of obstetric management. The main modifiable risk factor for pelvic floor trauma and later pelvic organ prolapse is forceps, whereas vacuum is not associated with increased risk. […] The use of forceps, the primary risk factor for levator avulsion, is entirely avoided in some countries and institutions, demonstrating that this risk factor is eminently modifiable. […] Until recently, it seemed that forceps delivery was becoming obsolete. […] The first is not practicable except in individual cases, and attempts at selecting high-risk patients have been unsuccessful. […] The second approach seems feasible, but first attempts at preventing trauma via antenatal intervention have failed.

• #2 Pelvic organ prolapse – a review

  https://www.racgp.org.au/afp/2015/july/pelvic-organ-prolapse-a-review

  Informed consent for performance of obstetric interventions needs to be considered. […] Adverse events in childbirth are common. […] Box 2 lists potential preventive measures. […] Avoidance of forceps (risk reduction by about 20-40%) […] Avoidance of vaginal delivery (risk reduction by 60-80%).

• #2 Genitourinary Prolapse (Causes, Symptoms, and Treatment)

  https://patient.info/doctor/genitourinary-prolapse-pro

  Suturing the cardinal and uterosacral ligaments to the vaginal cuff at the time of hysterectomy is effective in preventing PHVP following both abdominal and vaginal hysterectomies. […] Sacrospinous fixation at the time of vaginal hysterectomy should be considered when the vault descends to the introitus during closure.

• #2 A novel suturing technique for natural tissue repair in cystocele treatment | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-024-03317-3

  The rug-weaving plication technique may offer a viable alternative for cystocele repair without mesh, using natural tissue and potentially reducing mesh-related complications and recurrence rates. […] Recent years have seen an increased emphasis on native tissue repair, and surgeons have explored various mesh-free surgical techniques in anterior vaginal repair, aiming to mitigate the recurrence and complications associated with conventional mesh-free native tissue repair. […] In conclusion, our findings suggest that the rug-weaving plication technique may represent a mesh-free approach using natural tissue in cystocele repair, avoiding mesh-related complications and potentially reducing recurrence rates.

• #2 Cystocele: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.cystocele-care-instructions.tw12334

  Cystocele can happen when the muscles and tissues that hold the bladder in place are weak or damaged. This can be caused by pregnancy and childbirth, being overweight, or frequent constipation. Or the muscles and tissues may get weaker as you age. […] You may find relief by making lifestyle changes and doing exercises to make the pelvic muscles stronger. […] Do not lift heavy objects or do anything that puts pressure on your pelvic muscles. […] Try pelvic floor (Kegel) exercises. These tighten and strengthen pelvic muscles. […] Ask your doctor about a vaginal pessary. You can place this in your vagina. It supports the bladder. […] If your doctor prescribes vaginal estrogen cream, use it exactly as prescribed. […] Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

• #2 Pelvic organ prolapse | RCOG

  https://www.rcog.org.uk/for-the-public/browse-our-patient-information/pelvic-organ-prolapse/

  Prolapse symptoms can be reduced with lifestyle changes, including stopping smoking, weight loss, avoiding constipation where possible and heavy lifting. […] Even if you do not currently have any symptoms, you may wish to consider pelvic floor exercises and lifestyle changes to prevent your prolapse from getting worse. […] Your options for treatment will depend on the type and degree of prolapse you have and your individual circumstances, such as age, general health, whether you are sexually active and whether you have completed your family. […] Identifying the correct pessary may take more than one attempt as there are many different sizes and shapes. […] Pessaries do not usually cause any problems but can sometimes cause infection, discharge, bleeding or ulceration. […] If you plan to have children, you may be advised to delay surgery until your family is complete. This is because another pregnancy and birth may increase the chance of your prolapse happening again. […] Approximately 25-30 in 100 women having surgery for prolapse will develop another prolapse in the future. There is a higher chance of the prolapse returning if you are overweight, constipated, have a long-standing cough or undertake heavy physical activities.

• #2 Pelvic organ prolapse | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pelvic-organ-prolapse/

  There are things you can do to reduce the risk of pelvic organ prolapse. […] regular pelvic floor exercises to strength pelvic floor muscles […] maintain a healthy weight […] eat a high-fibre diet to avoid constipation or straining when you go to the toilet for a poo […] adopt good toilet habits […] avoid heavy lifting.

• #2 Pelvic organ prolapse | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/bladder-prolapse

  There are things you can do to prevent or manage a pelvic organ prolapse. […] There are practical things you can do to reduce the risk of prolapse. These may also help you to recover well after a prolapse or surgery. For example you can: manage constipation by eating a balanced diet and drinking enough water […] do regular physical activity […] avoid heavy lifting […] make lifestyle changes, like quitting smoking. […] You can also do pelvic floor exercises every day. For example, squeeze up pelvic floor muscles before lifting, coughing, laughing or sneezing. A pelvic floor physiotherapist can show you how to do this.

• #2 Best Cystocele Bladder Prolapse Treatment at Urogynecology Clinic

  https://urogynecology.in/cystocele-bladder-prolapse/

  Cystocele (bladder prolapse) also called ‘Anterior Prolapse’ is a condition when the bladder of a female bulges and falls onto the vaginal track / vagina. This happens when the pelvic floor muscles, tissues and the supporting ligaments become weak and can’t hold the bladder in it’s place. This is also called ‘Prolapsed Bladder’. […] Mitigating the risk of bladder prolapse: Regular exercise, especially ‘Kegels Exercise’ to strengthen pelvic muscles. Watch our video below (after this article) to know how. […] Avoid heavy lifting and lift weights correctly with your legs instead of your back. […] Avoid weight gain – proper diet, regular workout can keep you physically and mentally strong even as you age.

• #3 Advanced Gynecology – Cystocele

  https://www.advancedgynecology.com/conditions-symptoms/cystocele

  Cystocele can be caused by straining the muscles that support the pelvic organs — anything that weakens the supportive tissue between a woman’s bladder and vaginal wall that causes the bladder to bulge into the vagina unnaturally. This type of straining can occur during vaginal childbirth, chronic constipation, violent coughing or heavy lifting. The decrease in estrogen levels that happens during menopause can also be a contributor to forming a cystocele. A woman’s chance of developing a cystocele increases with age, possibly because aging tends to weaken the muscles and supportive tissues of the pelvic floor. Whether menopause increases a woman’s chances of developing a cystocele is unclear. […] Treatment for anterior prolapse depends on the grade of the cystocele. There are three grades of cystocele: Grade 1: The mildest grade of cystocele, characterized by the bladder dropping only a little into the vagina. Grade 2: More moderate grade characterized by the bladder having dropped far enough into the vagina to reach the vaginal opening. Grade 3: Most advanced of all the stages, characterized by the bladder bulging out through the opening of the vagina. For a mild or moderate anterior prolapse (grade 1 or 2), nonsurgical treatment is often sufficient. In more severe cases (grade 3), surgery may be necessary to keep the vagina and other pelvic organs in their proper positions.

• #3 Pelvic organ prolapse | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/bladder-prolapse

  There are things you can do to prevent or manage a pelvic organ prolapse. […] There are practical things you can do to reduce the risk of prolapse. These may also help you to recover well after a prolapse or surgery. For example you can: manage constipation by eating a balanced diet and drinking enough water […] do regular physical activity […] avoid heavy lifting […] make lifestyle changes, like quitting smoking. […] You can also do pelvic floor exercises every day. For example, squeeze up pelvic floor muscles before lifting, coughing, laughing or sneezing. A pelvic floor physiotherapist can show you how to do this.

• #3 Cystocoele/Anterior Repair | Continence Matters

  https://continencematters.com/surgery-and-procedures/surgery-for-prolapse/cystocoele-anterior-repair/

  A cystocoele is a prolapse or falling down of the bladder, which is slipping into the vagina. […] Avoiding heavy lifting or straining can be recommended for all patients. […] These strengthen the muscles surrounding the openings of the urethra, vagina, and rectum. They can help reduce stress incontinence, urgency to pass urine and protect against prolapse. […] Constipation should be treated to avoid straining. Caffeine found in coffee, tea, and soft drinks may aggravate bladder symptoms and should be reduced. […] A pessary is a device that may be inserted into the vagina to support the bladder and other pelvic organs, holding them in place. […] Oestrogen as a cream or pessary inserted into the vagina, can improve and strengthen the tissues around the bladder and vagina and improve symptoms of stress incontinence and urge to pass urine. […] Avoiding heavy lifting longterm will help prevent prolapse recurrence. […] You should continue with your pelvic floor exercises for life.

• #3 Vaginal Prolapse – Symptoms, Treatment Options, and ICD 10 Codes

  https://www.outsourcestrategies.com/resources/documenting-and-coding-vaginal-prolapse-symptoms-and-treatment-options/

  Woman who experience any specific symptoms of vaginal prolapse (including a feeling of fullness in the lower belly or a bulge in the vagina), must visit a gynecologist for a detailed examination. […] Women at risk for vaginal prolapse (including those who have had corrective surgery) should try to avoid heavy lifting or any other activity that increases pressure within the abdominal cavity. […] As obesity can put extra stress on the muscles and ligaments within the pelvis and vagina, it is important to reduce body weight to prevent this condition from developing or recurring.

• #3 Cystocele (Anterior Prolapse) Treatment | Best Gynecologists in NYC (Brooklyn, Manhattan, Harlem)

  https://www.centurymedicaldental.com/cystocele-anterior-prolapse/

  If youre susceptible to a prolapse or have recovered from a previous prolapse incident, you must do whats necessary to prevent another episode. Reduce your risk of further prolapse conditions by: […] Performing Kegel exercises regularly […] Using proper lifting techniques or refusing to lift heavy items at all […] Treating and controlling any coughing conditions, such as bronchitis […] Ceasing cigarette smoking.

• #3 Step-by-step approach to managing pelvic organ prolapse | The College of Family Physicians of Canada

  https://www.cfp.ca/content/53/3/485

  Most women are asymptomatic so no treatment is needed. A trial of lifestyle modification might be beneficial: Kegel exercises, weight loss, smoking cessation, treatment of constipation, electrical stimulation, or biofeedback. […] Use estrogen (oral or vaginal) for mild cystocele. Consider a pessary. […] Pessaries should be removed regularly for cleaning by patient or health care professional. […] Women are often reluctant to discuss prolapse symptoms. While there are no randomized controlled trials of treatment, pessaries are a good option for those who wish to remain fertile or avoid surgery. […] There is no evidence or consensus on which pessary is best, how often to clean it, or how often to visit a health professional. […] Long-term use carries a risk of vaginal erosion, so vaginal examinations should be done every 3 to 6 months.

• #3

  https://www.nhs.uk/conditions/pelvic-organ-prolapse/treatment/

  If you do not have any symptoms or the prolapse is mild, making some lifestyle changes may help and could stop the prolapse getting worse. […] They can also help reduce your risk of getting a prolapse in the first place. […] Doing pelvic floor exercises will strengthen your pelvic floor muscles and may well relieve your symptoms. […] A GP or specialist may recommend a programme of supervised pelvic floor muscle training for at least 16 weeks before you move on to other treatments or surgery. […] Vaginal pessaries allow you to get pregnant in the future. They can be used to ease the symptoms of moderate or severe prolapses and are a good option if you cannot or would prefer not to have surgery. […] If non-surgical options have not worked or the prolapse is more severe, surgery may be an option.

• #3 Practical Use of the Pessary | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/0501/p2719.html

  To manage a large prolapse of the anterior vaginal wall, the Gellhorn pessary may be the best choice, although insertion and removal can be difficult. […] A Hodge pessary with support is also effective in the prevention of exercise incontinence. […] Treatment with estrogen cream can make the vaginal mucosa more resistant to erosion and should be used before or concurrently with the fitting of the pessary in such patients. […] Pessaries should never be placed in elderly, debilitated patients without excellent follow-up.

• #3 Pelvic organ prolapse | Jean Hailes

  https://www.jeanhailes.org.au/health-a-z/vulva-vagina/pelvic-organ-prolapse

  Pelvic floor exercises and changes in your daily routine, along with weight management, may be all you need. […] Do pelvic floor exercises every day and remember to squeeze up pelvic floor muscles before lifting, coughing, laughing or sneezing. […] It’s important to see your doctor as soon as possible if you notice any symptoms. Early treatment will prevent or reduce the severity of prolapse. […] If you have reached menopause, you can ask your doctor about hormone therapy to increase your levels of oestrogen. This may help to strengthen your vaginal walls and pelvic floor muscles.

• #3 Pelvic organ prolapse – a review

  https://www.racgp.org.au/afp/2015/july/pelvic-organ-prolapse-a-review

  Informed consent for performance of obstetric interventions needs to be considered. […] Adverse events in childbirth are common. […] Box 2 lists potential preventive measures. […] Avoidance of forceps (risk reduction by about 20-40%) […] Avoidance of vaginal delivery (risk reduction by 60-80%).

• #3 Cystocele (Prolapsed Bladder) – Symptoms, Causes and Treatment PACE Hospitals – Best Hospitals in Hitech City, Hyderabad, India | Near Madhapur, Kukatpally, KPHB, Kondapur, Gachibowli, Jubilee Hills, Banjara HillsPACE Hospitals Contact Nu

  https://www.pacehospital.com/cystocele-prolapsed-bladder-symptoms-causes-prevention-and-treatment

  Cystocele prevention […] Here are some lifestyle changes that may help prevent a prolapsed bladder: […] Indulging in pelvic floor exercises: Pelvic floor exercises, such as Kegels, can help strengthen the pelvic floor muscles and nerves, thereby controlling bladder prolapse symptoms and preventing them from worsening. […] Maintaining a healthy weight: Being overweight causes pressure on the pelvic region. Changing the diet and lifestyle by eating more fruits and vegetables and exercising on a regular basis may help to maintain the ideal body weight to prevent bladder prolapse. […] Avoiding heavy lifting and lifting correctly: Heavy lifting could damage the pelvic floor’s muscles and connective tissues that support the bladder, uterus, and intestines. […] Preventing and treating constipation: Constipation can result in pelvic organ prolapse. It can also be a symptom caused due to bladder prolapse. Trying to prevent constipation and straining when defecating may help. […] Controlling chronic cough: Coughing causes the pelvic floor to shift downward. Repeated or aggressive coughing can stretch the pelvic floor tissues.

• #3 Cystocele: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.cystocele-care-instructions.tw12334

  Cystocele can happen when the muscles and tissues that hold the bladder in place are weak or damaged. This can be caused by pregnancy and childbirth, being overweight, or frequent constipation. Or the muscles and tissues may get weaker as you age. […] You may find relief by making lifestyle changes and doing exercises to make the pelvic muscles stronger. […] Do not lift heavy objects or do anything that puts pressure on your pelvic muscles. […] Try pelvic floor (Kegel) exercises. These tighten and strengthen pelvic muscles. […] Ask your doctor about a vaginal pessary. You can place this in your vagina. It supports the bladder. […] If your doctor prescribes vaginal estrogen cream, use it exactly as prescribed. […] Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

Zobacz więcej