Why should mild prolapse be treated after childbirth?

In a previous article we talked about prolapse, the loss of organs, and we said that they are the result of pressure, that they are “cooked over a slow fire”, except those that occur as a result of postpartum.

As it is a slow process, early detection is key. An initial prolapse is perfectly reeducable, that is, we can return it to your site. A prolapse detected because it appears through the vagina, we can only resort to surgery or pessaries (we will talk about them).

Why should postpartum prolapse be treated?

There are several professionals who can detect a prolapse, but the key is not to detect it, the key is to give it the importance it has.

Most women rely on their gynecological check-ups to know that everything is fine. These visits tell us that everything is fine at the tissue, sample and analytical level, that there is no disease in the area. And that’s good, very good. But those visits may not see a mild prolapse. I correct: yes they see it, but it is possible they do not value it as something remarkable, of interest.

Classic case: postpartum woman who comes to a pelvic floor physiotherapy consultation for an assessment. She explains that she went to the gynecological check-up and that she is very happy. They told him that everything was fine. That her uterus or bladder was a little low, but nothing, that everything was fine. For her, her grade I prolapse was a pure anecdote.

Although in the specific case of postpartum tissues tend to return to their initial situation over the months, it is true that if a woman knows that her uterus is lower, she should be impeccable with the management of her pressures and I would have to do postural work, among other things. Because a tissue stretched by the maternity process can return to its place physiologically, but it can also not.

Currently motherhood has acquired a different bodily dimension. The lifestyle of our culture postpones the arrival of children. Each one has its reasons: job instability, relationship instability, desire to live life… the reality is that there are many mothers who are around 40. Is that bad? Not at all, but you have to know that it has a price. Being a mother at 40 has nothing to do with being a mother at 25, at all levels, but I am only speaking at the tissue level.

With age, the ability to recover is lost.

Although it is light years from our cultural and vital reality, biologically speaking, the body is in splendor for maternity from approximately 18 to 25. A 25-year-old girl with a slight loss of organs postpartum would not be worrying at all, the most normal thing is that the organ returns home alone. The body is prepared to recover from a normal birth, the tissues are young and elastic.

The elastic and recovery capacity of a tissue of a 39-year-old woman is very different. Will she be able to recover? Sure she would, but she probably won’t do it so spontaneously. The small postpartum prolapse of this woman will be much more relevant than that of 25. Starting to treat it as soon as possible will be decisive.

This “silence” about the prolapse in the gynecological visit, is it a medical error? Not at all, it’s a different view. A prolapse in its initial stages is a fact without medical interest. It doesn’t cause any problems, it doesn’t give symptoms… it’s not a medical problem at all.

Medicine will consider prolapse as pathological, that is, as a disease that must be treated, when it generates symptoms and/or appears through the vagina. Then surgery will replace the fallen organ.

The vision of pelvic floor physiotherapy is different. For us, a mild prolapse is a very remarkable fact. Not only for what it represents, but above all because it is recoverable. I insist, a prolapse is recoverable if it is seen in time.

Early detection is crucial, and This early detection is done better than anyone else by pelvic floor physiotherapists, not because we have a better eye, but because for us it is something that we specifically look for.

Pessaries are an alternative to surgery

I take advantage of this article to publicize pessaries, a very unknown tool and very important to take into account to avoid surgery.

Pessaries are devices (usually silicone) that are placed inside the vagina and serve to elevate and support the structure or structures that have descended (uterus, bladder, vagina, or rectum). Pessaries do not cure, but they alleviate the symptoms and prevent the situation from getting worse.

There are a variety of shapes: cubes, rings with various shapes, “pacifiers”, etc., which they adapt to the different types and degrees of prolapse. There are some that allow you to have sex with them on. Pessaries can be placed by gynecologists, but also by pelvic floor physiotherapists.

The main difficulty is the choice of size. It is necessary to try them to choose. We will be governed by the rule of “the three no”:

Doesn’t moveNot noticeableDoesn’t fall off

The feeling of wearing a pessary should be similar to that of a tampon or a menstrual cup: the woman does not notice that she is wearing it.

The prolapse is silent, but predictable. Give yourself a pelvic floor assessment. In the face of a prolapse, prevention is the best solution.