Difficult childbirth, chronic cough, constipation: “30% to 50% of women may be affected by organ descent”
Toulouse University Hospital offers a dedicated care pathway for organ transplant patients. A pathology that affects 30% to 50% of women during their lifetime, suggests Charlotte Cholet, gynecological surgeon.
What is genital prolapse, more often called organ descent?
This is a pelvic static disorder characterized by downward sliding of one or more pelvic organs – the uterus, bladder and more rarely the rectum. Symptoms vary depending on the organ concerned, be it gynecological, urinary or digestive. The most classic remains a vaginal lump externalization.
What can promote organ descent?
Not just age and menopause! It is estimated that this functional disorder can affect 30 to 50% of women and is caused by multiple factors. Multiple pregnancies, difficult childbirth, chronic cough, constipation, practice of certain sports and regular carrying of heavy loads are identified as contributing factors.
What treatment is given?
As a first objective, we propose the implementation of healthy-diet rules in the form of remedial education associated with weight gain, chronic constipation, education on heavy load carrying, locking the perineum in case of coughing, pelvic perineal rehabilitation sessions. Then the installation of a pessary, a medical silicone device inserted into the vagina to support the organs in place of the ligaments. If these solutions are not enough, two types of surgery exist. The first is promotofixation, which is carried out laparoscopically. It involves installing an artificial prosthesis that augments the pelvic organs. Another is the so-called autologous vaginal surgery, because it allows reinforcement with the patients own tissue without an external device.
What changes does this new treatment pathway offer at University Hospitals?
We have organized ourselves into a multidisciplinary team with gynecology and digestive surgery, urology, medical imaging and midwife consultation. Indeed, depending on the symptoms (difficulty or urgent urge to urinate, constipation, lumps in the vagina, pelvic heaviness, etc.) patients come through one or the other of these services. Rapid treatment is discussed in multidisciplinary consultation meetings (RCP) and includes dedicated therapeutic education consultations with midwives.
