Therapy | Lowering of the pelvic floor and organs

Therapy

Depending on the degree of pelvic floor prolapse, a different form of therapy must be chosen. First, however, we always try to treat pelvic floor prolapse conservatively. Slight depressions do not necessarily have to be operated on, while severe pelvic floor depressions require surgery.

Medication: In addition to gymnastics, a cream with estrogens can be applied to the vaginal area. This can help to alleviate symptoms. However, severe pelvic floor depressions cannot be treated adequately with physiotherapy.

In these cases or if training by pelvic floor exercises fails, surgery is usually necessary to treat the pelvic floor depression. Here, the aim is to reconstruct the pelvic floor with fixation of the surrounding organs. There are various surgical procedures that can be used for this operation.

The surgical access can be through the vagina or through the abdomen. Some large clinics, such as university hospitals, also offer a surgical procedure using the modern DaVinci robot. However, the principle of the operation is similar in most cases: the aim is to fix the displaced organs in their original position, the pelvic floor muscles are gathered and the vagina is fixed in its original position. In addition, a kind of net can be inserted, which then takes over the support function of the muscles. Removal of the uterus may be necessary in some cases, but nowadays we also try to preserve the uterus according to the patient’s wishes.

Forecast

Even after a treated pelvic floor prolapse, renewed urinary incontinence can occur. The risk of this is approximately up to 20%.

Prophylaxis

Regular physiotherapy is advisable to prevent a lowering of the pelvic floor. Gymnastics with exercises to strengthen the pelvic floor muscles can also be used as a prophylaxis against a lowering of the pelvic floor. Particularly in women who have risk factors for pelvic floor prophylaxis can help to counteract the development of pelvic floor prolapse.

Slight depressions of the pelvic floor can often be treated adequately by physiotherapy. The aim of physiotherapy, but also of pelvic floor training or pelvic floor gymnastics, is to strengthen the muscles of the pelvic floor. Furthermore, there are therapy methods in which the muscles of the pelvic floor can be consciously controlled, for example, in order to be able to close the urethra consciously by contracting the muscles in the event of urine loss.

This method is called biofeedback. However, it is important that the exercises learned in physiotherapy are continued at home. Because only continuous training of the pelvic floor muscles can achieve success.

In summary, it can be said that every sport that is practiced strengthens the pelvic floor and therefore regular exercise can also serve as a good prophylaxis. Pelvic floor programmes train the pelvic floor muscles in a more targeted way and can therefore also be recommended. After a pregnancy, there are often special gymnastics programmes for the recovery of the uterus. Women who take advantage of these show a lower risk of subsequent pelvic floor prolapse.