What Can Be Done About Urinary Incontinence or Pelvic Organ Prolapse?

Pelvic health issues, such as urinary incontinence and pelvic organ prolapse, can significantly impact a person’s quality of life. These conditions are more common than many people realize and affect individuals of all ages, especially those who have experienced childbirth or hormonal changes.

The good news is that effective treatments and management strategies are available to help reduce symptoms and improve daily functioning. Below, we’ll explore these conditions, their causes, and the options for addressing them.

Urinary incontinence and pelvic organ prolapse are two of the most common pelvic health issues.

Urinary Incontinence refers to the loss of bladder control, which leads to involuntary leakage of urine. It can range from occasional leaks to more frequent and disruptive episodes. There are several types of urinary incontinence:

• Stress Incontinence: This occurs when physical movements or activities like coughing, sneezing, laughing, or exercising put pressure on the bladder, causing urine leakage.
• Urge Incontinence: Also known as overactive bladder, this type is characterized by a sudden and intense urge to urinate, often followed by leakage before reaching the restroom.
• Mixed Incontinence: A combination of both stress and urge incontinence.

Pelvic Organ Prolapse happens when one or more pelvic organs, such as the bladder, uterus, or rectum, descend from their normal position due to weakened pelvic floor muscles. This can cause discomfort, a feeling of pressure or heaviness in the pelvic area, and challenges with bowel or bladder function.

Both urinary incontinence and pelvic organ prolapse are often linked to a combination of factors that weaken the pelvic floor muscles or increase pressure on the pelvic organs.

These include:

1. Childbirth

The process of pregnancy and vaginal delivery can stretch and weaken the pelvic floor muscles. Women who have had multiple pregnancies or delivered large babies may be at a higher risk. Additionally, the use of forceps or vacuum assistance during delivery can increase the likelihood of pelvic floor trauma.

2. Aging

As we age, muscle tone naturally decreases, including in the pelvic floor muscles. This can make it more difficult for these muscles to support the bladder and other pelvic organs.

3. Hormonal Changes

Menopause causes a significant drop in estrogen levels, which can lead to thinning and weakening of the tissues in the pelvic region. These hormonal changes can contribute to both incontinence and prolapse.

4. Chronic Strain

Conditions that cause chronic pressure on the pelvic floor, such as chronic cough, obesity, constipation, or frequent heavy lifting, can increase the risk of pelvic health issues. Repeated straining can wear down the muscles over time.

5. Surgery

Certain surgical procedures, like hysterectomy (removal of the uterus), can impact the structural support of the pelvic organs and increase the likelihood of pelvic organ prolapse.

Managing urinary incontinence or pelvic organ prolapse often starts with conservative treatments and progresses to more advanced interventions if necessary. Here are the most effective options for addressing these conditions:

1. Pelvic Floor Physical Therapy

Pelvic floor exercises, commonly known as Kegels, can help strengthen the muscles that support the bladder and other pelvic organs. Working with a trained pelvic health physical therapist ensures proper technique and personalized guidance.

• Kegel Exercises: These exercises involve contracting and relaxing the pelvic floor muscles. While it may seem straightforward, many individuals benefit from professional guidance to ensure they are engaging the correct muscles.
• Biofeedback: This technique uses sensors to monitor pelvic muscle activity and provide real-time feedback. It helps individuals learn how to better control and strengthen their pelvic muscles.

2. Lifestyle Modifications

Simple lifestyle changes can go a long way in managing symptoms and preventing further complications.

• Weight Management: Carrying excess weight puts additional pressure on the pelvic floor. Losing even a small amount of weight can significantly reduce symptoms of incontinence and prolapse.
• Bladder Training: This involves scheduling regular bathroom visits and gradually increasing the time between voids to help retrain the bladder.
• Dietary Adjustments: Reducing caffeine, alcohol, and acidic foods can help minimize bladder irritation. Staying well-hydrated with water is essential, but it’s important to balance hydration to avoid overloading the bladder.

3. Pessary Devices

A pessary is a non-surgical option for managing pelvic organ prolapse. It is a removable device inserted into the vagina to provide support to the prolapsed organs.

• Pessaries come in various shapes and sizes and are typically fitted by a healthcare provider to ensure a comfortable and effective fit.
• They are a good option for individuals who are not ready for surgery or who have mild to moderate prolapse symptoms.

4. Medications

Certain medications can help manage urinary incontinence, particularly urge incontinence.

• Anticholinergics: These medications reduce bladder overactivity and help manage sudden urges to urinate.
• Topical Estrogen: Applied as a cream or vaginal insert, topical estrogen can help strengthen vaginal and urethral tissues in postmenopausal individuals, improving bladder control.

5. Surgical Interventions

For individuals with more severe symptoms or for whom conservative treatments are not effective, surgery may be recommended.

• Sling Procedures: A sling made from synthetic material or the patient’s own tissue is placed under the urethra to provide additional support and reduce stress incontinence.
• Colporrhaphy: This surgery involves repairing weakened vaginal walls to help address pelvic organ prolapse.
• Sacral Neuromodulation: A small device is implanted to stimulate the sacral nerves, which play a role in bladder control. This treatment is often used for individuals with urge incontinence who have not responded to other treatments.

While not all pelvic health issues can be prevented, certain lifestyle habits can help reduce the risk of developing these conditions:

• Perform regular pelvic floor exercises to maintain muscle strength.
• Maintain a healthy weight to reduce pressure on the pelvic floor.
• Avoid heavy lifting and manage chronic conditions like constipation or coughs that increase pelvic pressure.
• Seek early treatment for symptoms to prevent worsening of the condition.

Early intervention can greatly improve quality of life and restore confidence. If you’re experiencing symptoms, don’t hesitate to reach out to us at Northwest Women’s Clinic. Contact our offices on Portland’s West Side today to learn more about pelvic health and find the best treatment plan for you.