From the Guidelines
Yes, if you have a history of rectal uterine prolapse from 20 years ago, you are at increased risk for recurrence if you strain or become constipated. According to the most recent study 1, risk factors for pelvic floor dysfunction include advanced age, menopause, vaginal multiparity, obesity, chronic straining, and conditions that result in chronic increase in intra-abdominal pressures.
Key Points to Consider
- Straining during bowel movements puts significant pressure on your pelvic floor muscles and can weaken the supportive tissues that hold pelvic organs in place 1.
- To reduce this risk, maintain regular bowel habits by consuming 25-30 grams of fiber daily, drinking 6-8 glasses of water, and exercising regularly.
- Stool softeners like docusate sodium (100mg once or twice daily) can help prevent constipation.
- Pelvic floor exercises (Kegels) performed 3 times daily with 10-15 repetitions per session can strengthen supporting muscles.
- When using the bathroom, avoid straining, use a footstool to elevate your knees above your hips, and give yourself adequate time.
- If you notice symptoms like pressure, bulging, or discomfort in your vaginal area, consult your healthcare provider promptly as early intervention can prevent worsening of prolapse.
Reducing the Risk of Recurrence
It is essential to be aware of the risk factors and take preventive measures to reduce the likelihood of recurrence.
- Maintaining a healthy weight and avoiding chronic straining can help alleviate pressure on the pelvic floor muscles.
- Regular exercise, including pelvic floor exercises, can help strengthen the supportive tissues.
- A balanced diet rich in fiber and adequate hydration can help prevent constipation and reduce straining during bowel movements.
Importance of Early Intervention
Early intervention is crucial in preventing the worsening of prolapse.
- If you experience any symptoms such as pressure, bulging, or discomfort in your vaginal area, consult your healthcare provider promptly.
- Regular check-ups and monitoring can help identify any potential issues early on, allowing for timely intervention and prevention of complications.
From the Research
Risk of Recurrence
- A history of rectal uterine prolapse 20 years ago may increase the risk of recurrence, especially if strain or constipation occurs 2, 3.
- Straining or constipation can put additional pressure on the pelvic floor, which may lead to a recurrence of prolapse 4.
- It is essential to maintain good bowel habits and avoid straining during bowel movements to reduce the risk of recurrence 4.
Management Options
- Treatment options for pelvic organ prolapse include observation, pelvic floor physical therapy, pessary use, and surgery 2, 3, 5.
- Pelvic floor physical therapy (PFPT) can improve or cure symptoms of urinary incontinence, pelvic organ prolapse, and fecal incontinence 6.
- Surgery can be performed through transvaginal, laparoscopic/robotic, or open approaches, using either the patient's own tissue or mesh augmentation 2, 3.