Why Does Post-natal Incontinence Happen?

In many cases incontinence is something which occurs during pregnancy, but for some mums the issue can linger long after childbirth. Post-natal incontinence is actually very common among mums, especially for women who have delivered their baby vaginally.

It is estimated that incontinence following pregnancy and childbirth affects up to 50 percent of women. Although most problems resolve themselves within a year of giving birth, there are many women who suffer with lingering issues. Fortunately, there are treatment options available to solve the issue, including sacrohysteropexy surgery and intensive courses of physiotherapy from a qualified pelvic floor physiotherapist.

Why do some women suffer from post-natal incontinence?

Incontinence is caused either by an increased urge to urinate or through stress from laughing, sneezing, coughing, running or jumping. In the third trimester of pregnancy the growing uterus starts to put increased pressure on the bladder, the body also begins to release hormones to improve the elasticity of joints for delivery. Together these changes in the body reduce the support provided to the bladder, so occasionally it can begin to leak.

Many of the women who suffer from stress incontinence also suffer from urge incontinence, which is caused by an overactive bladder. Those who are over 35 or obese are at a greater risk of developing both stress and urge incontinence during pregnancy. But, following childbirth the most likely sufferers are those who have delivered vaginally or suffered with uterine prolapses, especially following delivery interventions such as forceps which can damage pelvic muscles.

When should treatment be sought?

Incontinence is something which can interfere very quickly with your daily life, impacting everything from your career to your love life. If you notice even a small amount of urine leaking while coughing or sneezing, it is worth talking to your doctor as it’s rare that the issue will cure itself.

How do the pelvic floor muscles work?

The first step to curing incontinence is to establish the cause, which in most cases is weakened pelvic floor muscles. The pelvic floor is a set of muscles which are located in the pelvis between the frontal pubic bone and the base of the spine. The muscles create a hammock to hold the uterus, vagina, bowel and bladder in place, and they also provide control to the bladder during urination. During urination the muscles relax to release urine, they then tighten to re-close the bladder.

What are the treatment options?

For those who suffer from stress incontinence due to uterine prolapse or pelvic floor weakness, it may seem like there are no options. In mild cases, many professionals will recommend working on behaviour and lifestyle choices, such as examining your activities and losing weight if you BMI is higher than it should be. In all cases, physiotherapy is always recommended this can positively impact the pelvis floor muscles. In the first three months post delivery, it is always beneficial to seek help with pelvic floor physiotherapy.

If after three months of daily physiotherapy, there seems to be little difference, then this is the time to come and see Mr Broome. He is a gynaecologist specialising in pelvic floor repair and has had many ladies visit him due to incontinence after delivery. He can advise a way forward to regain your quality of life. Nobody wants to be young, with young children and suffering from incontincence. Mr Broome, at a consultation, will examine you for the causes of your incontinence and also check to see if uterine prolapse  might be a factor. If so, he will talk through the prospect of having sacrohysteropexy surgery, which is a permanent solution to repositioning the uterus and subsequently enabling other organs in the abdomen to realign.

What is sacrohysteropexy surgery?

Sacrohysteropexy surgery is a highly effective solution for those who have suffered a uterine prolapse. As it is such a delicate procedure it is essential that patients choose a qualified and experienced surgeon. There are many women who fear the only option is to undergo a hysterectomy, but Mr Broome has enabled many young women to have more children with no further prolapses or incontinence issues.

The procedure involves using a strip of synthetic mesh to hold and lift the uterus in place. This is NOT vaginally inserted but instead carefully inserted via tiny keyhole wounds in the stomach wall as it is a keyhole procedure. Sacrohysteropexy surgery has significantly less side effects as a consequence and Mr Broome will be happy to talk these through with you. During the procedures, Mr Broome will attach one end of the mesh to the sacral bone, with the other end attached to the cervix or top of the vagina.

How can a physiotherapist help?

By working on strengthening the pelvic floor muscles, the root cause of post-natal incontinence can often be removed. It is very common for women to perform pelvic floor exercises at home, but for many people there is a lack of knowledge which can prevent results. A qualified physiotherapist will have the skills needed to assess, treat and educate women so they are cured of post-natal incontinence.

The sessions would start with an initial consultation to establish whether the patient is ready to begin a physiotherapy programme. The physiotherapist will then assess strength, flexibility and posture, which could all have an impact on muscle control following pregnancy. A programme will then be established which teaches the patient how to perform exercises which safely and effectively improve pelvic floor strength.

Mr Jonathan Broome is a highly regarded surgeon who regularly carries out pelvic floor repairs through physiotherapy and Sacrohysteropexy. To find out more about how Mr Broome can help you with your incontinence problem, please contact our team.

 

vaginal mesh surgery

No Vaginal Mesh Surgery in Sacrohysteropexy!

Regarding Vaginal Mesh Surgery and Sacrohysteropexy

Very sadly, there has been considerable adverse news concerning vaginal mesh surgery in the United Kingdom. Women’s lives have been affected and there has been discussion about why this happened and the risks concerned. Understandably there is much concern surrounding the outcomes and increasingly, there are articles in the press that are not necessarily clear and specific about the types of uterine prolapse surgery affected. This is a primary concern for ladies trying to work out the best course of action to take and very worrying for those who have already had surgery.

Following the recent press coverage of potential litigation regarding vaginal mesh implants:-

Mr Broome would like to reassure all his patients who have undergone or are due to have a sacrohysteropexy operation for utero-vaginal prolapse that there is absolutely no risk of vaginal mesh erosion following this procedure.

Unlike vaginal mesh surgery implants a sacrohysteropexy prolapse repair is an abdominal procedure (usually keyhole) whereby mesh is used as a sling to support the womb permanently. There are no vaginal incisions and the sling is attached between the cervix and sacral bone at the back of the pelvis. The mesh will never erode through these attachments and will never come into contact with the vagina.

Mr Broome has undertaken over 2000 sacrohysteropexy procedures over the past 14 years and has had no cases of vaginal mesh erosion and he is confident that this will remain the case in the future due to the very different anatomical approach used when compared to vaginal mesh implants.

life after prolapse surgery

Life after prolapse surgery

A prolapse can be a common medical condition, especially among women who have given birth, and is due to the tissues supporting the pelvic muscles becoming weak. The forces bearing down on the pelvis and uterus are stronger than the muscles holding them up which leads to the prolapse itself. Luckily, prolapse surgery can solve this issue for you and help get your life back to normal.

What to expect from life after prolapse surgery

Whatever type of prolapse you have and the surgery needed to correct it, we are confident here at The Pelvic Clinic that you will experience great benefits from undergoing the procedure. Our surgeon, Mr Jonathan Broome, is an expert in his field and has seen just how fabulous life after prolapse surgery can be, from the patients he has treated.

The number one thing to expect is that you will get your quality of life back and be able to fully enjoy yourself again. Any pain or discomfort related to the prolapse will have been eliminated by the procedure, leaving you to return to how your life was pre-prolapse.

It can help you get healthier.

If you suffer from a prolapse, then it can severely limit some of the leisure activities you can do, particularly in relation to exercising. After prolapse surgery and the relevant recovery time, you should be able to take part in any exercise you like which will, in turn, benefit your future general health. This can even be true for past-times such as horse-riding which would be too painful prior to prolapse surgery.

Many ladies can return to doing the things they love the most more quickly than they anticipated. For others who are of child-rearing age, they can consider having another child – as a few of Mr Broome’s patients have decided to do. However, there is still a period of convalescence required by all.

Remember to take it easy at first.

As with all surgery, you must follow the recovery advice post-surgery to ensure you heal fully. Don’t lift anything heavy for around 6 weeks and drink plenty of water along with eating plenty of fruit and vegetables. If you happen to develop a cough, then see your GP straight away as this can cause a strain on the ligaments within your body.

If you need any further advice on prolapse surgery and how The Pelvic Clinic can help transform your life, get in touch today. Mr Broome has a very high success rate on the Sacrohysteropexy operation and has performed over 2000 prolapse repair operations with great results, to give you total peace of mind.

safe sacrohysteropexy

Is a uterine prolapse causing your symptoms?

Although a prolapse isn’t uncommon, it can take an inordinate amount of time for patients to obtain the correct diagnosis. Despite numerous women suffering from uterine prolapse, the path to treatment can be slow and, in some cases, ineffective.

Unfortunately, this delay can lead to a worsening of a patient’s symptoms. As well as dealing with pain and discomfort, women may find that they experience incontinence due to the increased pressure on their bladder. With the uterus unsupported, the additional pressure on the surrounding areas can result in both urge and stress incontinence.

Clearly, these symptoms can be very distressing for patients. Upon receiving a diagnosis, however, many are told that a hysterectomy is the only viable option. Whilst many are reluctant to commit to such invasive surgery, a significant number of women suffering from prolapse symptoms want to have children in the future. Due to this, a hysterectomy is not the right option for them.

Treating prolapse symptoms without a hysterectomy

A sacrohysteropexy is a form of prolapse surgery which is far less invasive than a traditional hysterectomy. In addition to this, it doesn’t prevent women from carrying a child, so is suitable for women who wish to conceive in the future.

Rather than removing the uterus, sacrohysteropexy surgery for prolapse problems simply supports the uterus and prevents it from placing undue pressure on the surrounding muscles and tissues. Although this form of prolapse surgery is not well-known, it is an extremely effective form of prolapse surgery.

Whether women are suffering from a prolapsed uterus after childbirth or are experiencing a prolapse due to naturally weak muscles, a sacrohysteropexy can provide a permanent solution to the problem. Having performed over 1000 procedures with a 100% success rate, Consultant Gynaecologist, Mr Jonathan Broome, is able to diagnose and treat uterine prolapses quickly and effectively.

As a sacrohysteropexy is a far less invasive procedure than a hysterectomy, patients generally find that they recover more quickly and are able to return to their normal routines within a matter of days. To find out if a sacrohysteropexy is the right treatment option for you, contact The Pelvic Clinic on 01204 772400.

why hysterectomy

Is a hysterectomy always the best option?

When women are diagnosed with a uterine prolapse, they are often advised that a hysterectomy is the only viable treatment option for them. Unfortunately, this can lead to many women undergoing surgery unnecessarily. Whilst a hysterectomy can provide relief from prolapse symptoms, there are other, less invasive, uterine prolapse treatments available.

Although many women are willing to undergo surgery for prolapse problems, a hysterectomy has permanent consequences and will prevent the patient from carrying children in the future. Due to this, many women of childbearing age are unwilling to commit to this type of treatment. As they aren’t always advised of the alternative prolapse treatments which are available, they can be left dealing with severe prolapse symptoms.

In addition to this, a hysterectomy can require a lengthy period of recovery. Whilst the operation is considered to be fairly routine in many cases, patients may find that it takes weeks or months for them to fully recover from the invasive procedure. By exploring other options and different forms of prolapse surgery, women can find far less invasive treatment methods at The Pelvic Clinic.

Can a sacrohysteropexy alleviate prolapse symptoms?

Designed to support the uterus, a sacrohysteropexy can be used to alleviate prolapse symptoms permanently. During the procedure, surgical mesh is placed under the uterus in order to prevent it from placing unnecessary pressure on the surrounding muscles and tissues. As a result, prolapse symptoms are relieved and patients no longer suffer from the painful and embarrassing issues associated with the condition. Mr Broome enters the mesh abdominally which is a cleaner method than through the vagina.

Whilst many women experience a prolapsed uterus after childbirth, they may still want to have additional children in the future. Unlike a hysterectomy, a sacrohysteropexy needn’t prevent patients from conceiving or carrying children.

With many women struggling to cope with uterus pain and discomfort caused by a prolapse, a sacrohysteropexy offers an effective, permanent and minimally invasive solution.

Having performed over 1,000 procedures, with a success rate of 100%, Mr Jonathan Broome, Consultant Gynaecologist, is well-equipped to carry out the sacrohysteropexy procedure on patients. By using uterine prolapse staging to determine the severity of the condition, an appropriate treatment plan can be put in place quickly and efficiently.

uterine prolapse

The four stages and symptoms of uterine prolapse

A lady’s uterus, or womb, is similar in shape to an upside-down pear. Along with the bowel and bladder, the uterus is supported by a set of muscles running between the pubic bone and tailbone (or coccyx). The muscles function rather like a hammock, collectively referred to as your pelvic floor, or levator ani muscles. The pelvic organs, including the uterus, as suspended by connective tissue and ligaments, all working together to hold everything in place.

In the event this system of muscles and tissues are damaged or weakened, the uterus is at risk of moving out of place and dropping down, towards the vagina. This is known as uterine prolapse.

Common causes of prolapse

Several elements commonly cause a uterus to prolapse, including vaginal childbirth, severe coughing, obesity, hormonal changes following the menopause, and straining on the toilet. Initial treatment for a prolapse is strengthening the pelvic floor muscles using exercises like Kegels.

Additional support can be provided by a pessary inserted into the uterus. This will reduce the symptoms of prolapse. If a combination of pelvic floor exercises and pessary are unsuccessful, the prolapse is more severe and will require surgical intervention.

Symptoms of uterine prolapse

Several signs indicate a prolapsed uterus, including:

– The feeling of pressure or heaviness in the vagina
– A distinct bulge, or lump inside, or protruding from, the vagina
– Pain during sexual intercourse.

The four stages of uterine prolapse

There are four steps to a uterine prolapse, which indicate the extent to which the uterus has descended. It’s possible that the bladder and bowel, as part of a group of pelvic organs, may also drop as a result of the prolapse. The four stages of uterine prolapse are:

Stage 1: The uterus has descended into the upper part of the vagina
Stage 2: The uterus is almost at the vaginal opening
Stage 3: The uterus is protruding from the vagina
Stage 4: The uterus has descended to the point it is entirely outside the vagina.

If you need help or advice on uterine prolapse, please get in touch – we’re here to help.

Recovering from prolapse surgery

Uterine prolapse is a condition that can occur in women after a particularly difficult vaginal delivery of a child. The pelvic floor muscles lose their ability to support the uterus properly, and it slips down; this impairs sexual functions and can cause bleeding, constipation and other symptoms. Often, prolapse surgery is the only way to treat the condition.

An alternative to hysterectomy, sacrohysteropexy is a surgery that mitigates uterine prolapse by resuspending the uterus using a synthetic mesh to lift it back into place, and Mr Jonathan Broome, our Consultant Gynaecologist, is one of the UK’s leading surgeons in this procedure. The corrective procedure comes in the form of open surgery or the less-invasive laparoscopic surgery using keyhole incisions. Mr Broomes method of inserting mesh is done through the abdomen which is a cleaner way than inserting it vaginally.

Whether you have a hysterectomy or sacrohysteropexy, some people tend to fear surgery not only because of the risks involved but because of its effect on daily life. Of course, any operation takes time to heal, but there are ways to help your recovery along.

First of all, nutrition is vital. While you are still in the hospital, they will recommend a specific diet, often liquid, that will help you to get better. Even though you might not be hungry, remember that your body needs the nutrients to heal. Sipping something sour or tangy like teas and bitters helps improve the appetite. Find something that suits your taste to get you in the mood for the essential act of eating.

Secondly, look after your immune system. Some drugs administered around surgery like antibiotics and general anaesthesia can lower your t-cell count. Be sure to have a proper intake of vitamins to keep your immune system healthy to defend your body against infections that will only extend your period of recovery. This is something you can do in the weeks and months prior to surgery by engaging in a healthy diet.

Finally, remember to exercise your body but not to strain yourself. Exercise helps blood flow and boosts your metabolism. It can be something as simple as taking a walk once in a while or stretching your legs and arms. Just to be careful; ask your physician when considering what form of exercise you want to undertake to avoid injuring yourself.

Most of all, exercise a measure of patience. The body needs time to heal and you will be happier if you let it do it properly. If you’d like to discuss the options for prolapse surgery available to you, contact us at The Pelvic Clinic today.

prolapsed uterus

Is a hysterectomy the right treatment for me?

If you’ve suffered a difficult labour with your children, you may be suffering symptoms of a prolapsed uterus. This can often be very uncomfortable, and prevent you from doing activities that you’d normally enjoy. In some cases, it could prevent you from having more children. Often, doctors will recommend a hysterectomy to remove the uterus, but this isn’t your only option.

Why your doctor may have recommended a hysterectomy

A prolapsed uterus can result in some nasty symptoms, ranging from mildly uncomfortable to very painful and sometimes debilitating. Some women may experience a constant feeling of pressure on the pelvis or a dull backache. Other symptoms include spotting or bleeding from the vagina, or even bladder leakage, which can often be embarrassing and stop you doing sports or enjoying intercourse. When these symptoms are present, a doctor may diagnose a prolapsed uterus. They may suggest removing the uterus – and sometimes the ovaries – using a surgical procedure called a hysterectomy.

Is a hysterectomy right for me?

Making the decision to have a hysterectomy needs to be taken very seriously. Although a fairly common surgical procedure, it will take you a little while to recover and you may feel tired and unwell for some time afterwards. The biggest thing to consider is whether or not you would like to have more children, as a hysterectomy will leave you unable to conceive.

What are my other options?

You may have been told by your doctor that a hysterectomy is your only option, but here at The Pelvic Clinic, we can offer you the chance to choose a treatment to suit you. Our Consultant Gynaecologist Mr Broome is an experienced surgeon who can perform a variety of minor surgical procedures that may relieve your symptoms. You could choose to have a sacrohysteropexy, which is performed via low-risk keyhole surgery and allows you to keep your uterus, or even vaginal wall repair. Our experts are here to advise you on a procedure that is right for you. At The Pelvic Clinic, a hysterectomy is not your only choice when it comes to surgery for your prolapse.

no to hysterectomy for prolapse

Do I need a hysterectomy after a prolapse?

Uterine prolapse occurs when the tissue around the pelvic organs becomes weak and the uterus and vagina are pushed down. Childbirth commonly causes this and around 50% of cases occur this way. Weakening ligaments as someone ages, or factors which cause stress, such as constipation or coughing, can also trigger a prolapse.

To understand it, simply imagine the pelvic organs are housed in a large bag. If there was a hole in the bottom of the bag, then things could slip out and fall down. The strength of the bag – or the muscles in the pelvic floor – are the deciding factor in avoiding a prolapse.

Once a prolapse occurs the traditional method of treatment would be to go straight to a hysterectomy. However, a prolapsed uterus after childbirth or other conditions requiring prolapse surgery can be effectively managed with a sacrohysteropexy performed by an expert.

What is a sacrohysteropexy?

This is a laproscopic (or keyhole) operation which is not well known among the general public. As a result, women who may still have fertile years ahead of them choose to have their reproductive organs removed. This need not be the case and women can go on to have further, or initial pregnancies.

During a sacrohysteropexy procedure, small cuts are made in the stomach and around the bikini line before a telescope and instruments are inserted to look around the pelvis. Once they are properly positioned, a mesh is inserted and fixed to the cervix and backbone with metal staples to support the pelvic organs. This is a much cleaner way to insert mesh rather than through the vagina.

Because there are no more than four small cuts used to insert the mesh, recovery time is fast. Patients would usually need to stay for just one night in hospital.

This is a highly specialised procedure and can only be completed by highly skilled surgeons. Mr Jonathan Broome, Consultant Gynaecologist at The Pelvic Clinic, is one of the leading surgeons in the sacrohysteropexy procedure in Britain. He has performed over 1,000 of these operations and has a 100% success rate. Contact us today for more information on how you can avoid a hysterectomy following prolapse.

sacrohysteropexy

What is a sacrohysteropexy?

Sacrohysteropexy is a medical procedure for dealing with uterine prolapse. Although the procedure has been around for many years, it is still relatively unheard of by many women. However, it can be an effective way of treating prolapse, and most importantly, it is far less invasive than undergoing a full hysterectomy.

One of the main problems with having a hysterectomy (apart from the intense trauma and long recovery period) is that in up to 50% of cases, it results in urinal incontinence. This is due to the close proximity of the bladder to the uterus. Uterus removal also takes away any support the bladder has and as a result, can interfere with bladder function.

Uterine prolapse is a widely experienced condition

A prolapse of the uterus is something that many women experience. It can happen because of childbirth, as a result of the enormous stretching of the muscle tissue. Also, in later life, when women go through the menopause, the lack of oestrogen that typifies menopause, results in the floor of the pelvis losing its elastic strength.

Although uterine prolapse is not dangerous, it is extremely uncomfortable. When the womb descends, it will rub on any underwear and this can result in the area becoming infected and an ulcer forming on the cervix.

A sacrohysteropexy is far less invasive than a hysterectomy.

While a hysterectomy is an effective prolapse surgery procedure, it is very invasive. It leaves patients very weak and they can take months to fully recover. A sacrohysteropexy, on the other hand, is a laparoscopic procedure which, because it is far less invasive, has a fast recovery time – as quick as two weeks.

The sacrohysteropexy operation involves the insertion of a small piece of flexible mesh which is used to raise the uterus and hold it firmly in position so that it cannot drop.

Although there has been some adverse publicity in recent weeks, the insertion of a mesh sling is a procedure that is supported by the MHRA (Medicines and Healthcare products Regulatory authority). It is a cleaner entry method, entered abdominally and not vaginally. It is especially relevant to women who have pelvic problems but still wish to have babies.

It’s important to find the right clinic and use a top surgeon

Finding the right clinic and the right surgeon to carry out the procedure is important. Many women choose to use the services The Pelvic Clinic; a clinic where Mr Jonathon Broome has carried out in excess of 1,000 successful sacrohysteropexies. To find out more about how we can help you or the women in your life, contact us today.