Pelvic organ descent and treatment of incontinence – 50 years old and more
Pelvic organ descent or prolapse may occur to different degrees depending on tissue quality and any post-childbirth troubles which may accentuate the issue.
A detailed medical history, a specific gynaecological examination and a urine analysis allow the identification of a diagnosis and the characterisation of the condition’s origin. Urodynamic testing will show any possible weaknesses of sphincter muscles in the bladder (low pressure urethra). A cystoscopy allows for the examination of the mucous membrane conditions inside the bladder (chronic inflammation, polyps, other damage). An ultrasound of the bladder will also provide additional information.
Generally, there exist two types of incontinence:
- Urge incontinence: involuntary contraction of the bladder muscle provoking urinary leakage and a constant feeling of needing to urinate, or a feeling of incomplete emptying. Treatment is medicinal, based on medication intake (anticholinergic medication or β2 mimetics). For cases resistant to treatment, we recommend a botulinum toxin Botox injection in the bladder wall during a cystoscopy.
- Stress incontinence: the cause is physical. Urinary leakage is provoked by an insufficiency in the support and closure mechanism of the bladder.
A form of incontinence may be identified in over 30% of women having given birth naturally.
If necessary, during this examination, we evaluate the presence of possible anal conditions (anal skin tags, haemorrhoids, anal fissures). Anal conditions may effectively occur spontaneously or following childbirth. They sometimes develop simultaneously with pelvic organ descent or prolapses.