Pelvic Floor Dysfunction

It feels like it is going to fall out!

In the antenatal period commonly women in their second or more ongoing pregnancy and occasionally women in their first ongoing pregnancy will say “it feels like it is going to fall out” as pregnancy advances.

Stress incontinence is common especially in advanced pregnancy. Actual utero-vaginal prolapse can rarely occur and if so will be in early pregnancy.

In early postnatal period prolapse symptoms are not uncommon especially if there has been prolonged pushing and a more difficult vaginal birth. Urinary stress incontinence is not uncommon especially if more difficult birth. Some women have very little control of their bladder and leak urine involuntarily in the early postnatal period.

What can be done?

In the antenatal period pelvic floor exercises are probably of no value as there is increasing pressure on pelvic floor with pregnancy.

A Vinyl ring pessary can be inserting if there is actual prolapse. But this is self limiting as uterus is pulled up as pregnancy advances.

You will need to wear a liner in urinary incontinence

In the postnatal period pelvic floor exercises are a must. Learn to do them properly and do them frequently. You cannot do them too often.
pelvic floor1
At the six weeks postnatal visit even most severe cases are a lot better. Continue to do pelvic floor exercises. Also focus on toning up your core muscles. Palates classes can help. Sometime the help of a physiotherapist who specialists in pelvic floor problems is needed.

There is a familial tendency to pelvic floor dysfunction.
As well some women are aware of issues even before their first pregnancy.

Sometimes a Caesarean section delivery is indicated, especially if problem with previous delivery is pronounced and you have ongoing issues or you have had successful pelvis floor repair surgery.

Pelvic floor dysfunction is very uncommon after a Caesarean section delivery.

Posted by Dr Gary Sykes on -

Leave a comment