What "women" can do

Help, the pelvic floor is sagging!

Typical symptoms include pain, a foreign body sensation and involuntary loss of urine.

(Bild: stock.adobe.com/leszekglasner)

If organs in a woman's abdomen slip out of place, this has unpleasant consequences for those affected.

Many women may not know the problem by name ("pelvic floor prolapse"), but they do know the unpleasant symptoms such as a constant foreign body sensation (as if there were a ping-pong ball or an egg in the vagina), pain in the lumbar spine, bladder problems (especially urination problems), pain and less desire for sex. "All of these symptoms can indicate pelvic floor prolapse. This pelvic floor prolapse occurs when the pelvic organs collapse and descend," explains Prim. Prof. Dr. Zoltan Nemeth, Head of the Department of Gynecology at the Hospital of the Brothers of Mercy in Vienna.

The pelvic floor is a muscle plate that closes off the abdominal cavity and the pelvic organs from below (see diagram). The muscles extend from the pubic bone backwards to the sacrum and coccyx, and laterally the muscles attach to both ischial tuberosities. If the pelvic floor sinks and the organs slip out of place, this causes a great deal of psychological stress. Shame in particular has a negative effect on sex life and restricts it. But the physical pressure should not be underestimated either. The "obstacle" in the vagina often causes pain.

Every second mother over 50 is affected"
 Every second woman who has given birth vaginally is affected around the age of 50. 20 percent of them are operated on by the age of 80. Even very young women are affected," reports Dr. Nemeth. "However, the number of unreported cases is high because pelvic floor prolapse is still a taboo subject. Many women don't want to talk about it - not even to their doctor."

Eine Patientin berichtet

Erfahrungen mit Würfelpessar

Karin W. (59) erzählt: „Ich hatte eine starke Gebärmuttersenkung, was v. a. beim Sport zu Urinverlust führte. Mein Gynäkologe riet mir zur Verwendung eines Würfelpessars oder zu einer Operation. Ich entschied mich, Ersteres auszuprobieren, war anfangs jedoch skeptisch. Das kleine, günstige ,Plastik-Ding‘ überzeugte mich jedoch rasch, weil es das Gewebe in meinem Körper stützt.

Pessare gibt es in unterschiedlichen Größen, Formen (im Bild Würfelpessare) und Anwendungsarten.

(Bild: Praher-Ennöckl/KH der Barmherzigen Brüder)

Seitdem trage ich abwechselnd drei Würfel: Jeden Tag in der Früh schiebe ich einen davon tief in die Scheide (er fühlt sich wie ein großer Tampon an), abends nehme ich ihn wieder heraus und reinige ihn. Das mache ich seit mittlerweile zehn Jahren und habe damit keine Probleme im Alltag: Ich kann schwere Taschen tragen und auch jeden Sport treiben, ohne dass Urin abgeht. Bei meinem letzten Frauenarzt-Termin wurde sogar eine Besserung der Beckenbodensenkung festgestellt. Darüber habe ich mich wirklich gefreut.“

As already briefly mentioned, vaginal birth is the most common cause, as it causes considerable stretching of the muscles and connective tissue. The gynecologist therefore advises new mothers to train their pelvic floor. Birth injuries (such as an episiotomy or tear) also need to be treated properly.

What can help with vaginal or uterine prolapse or incontinence? "Surgery is not always necessary," says the head of the department reassuringly. He recommends so-called pessaries, which support the pelvic floor and realign the organs. "While copper and porcelain pessaries used to be available, rubber ring pessaries have become the standard in recent decades. However, patients were unable to place these in the vagina and remove them themselves. In addition, there were purulent, bloody discharges due to tissue problems," explains Prim. Nemeth.

Surgery is not always necessary. Simple aids such as pessaries usually help against pelvic floor prolapse.

Prim. Prof. Dr. Zoltan Nemeth, Vorstand der Abteilung für Gynäkologie im Krankenhaus der Barmherzigen Brüder Wien

Bild: Praher-Ennöckl/KH der Barmherzigen Brüder

However, new cube pessaries made of medical silicone are suitable for self-therapy: "Women" insert the cube in the morning and take it out again in the evening. During the day, she feels neither the pessary nor the effects of the prolapse. At night, the tissue has time to recover. "From a medical point of view, surgery is only necessary in cases of pronounced pelvic floor prolapse, rejection of the pessary or if someone is cognitively unsuitable for a pessary or is no longer mobile enough," says the specialist.