Incontinence & Prolapse

Incontinence and prolapse are conditions which are commonly thought of as only affecting older women and those who have had children. This isn’t the case, and in fact the incidence of prolapse and incontinence is greater than we realise. However, many women delay presenting to their doctor with these concerns due to feeling self conscious or embarrassed.

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 Your Evoca GP will work with you to create a tailored plan to treat your diagnosis, considering your future pregnancy plans, lifestyle, symptoms and treatment choices

Urinary Incontinence

Urinary incontinence affects one in three women of all ages1 . It causes significant distress and can impact your quality of life. More than 40% of women 2 will also experience sexual dysfunction because of these symptoms however 70% 3  of women won’t seek help. Whether you’re experiencing a slight leak when you cough, jump or run or you’re really struggling to hold on when you need to go, we offer treatment options for all. Recurrent urinary tract infections and problems passing urine are also common problems which can be linked to sexual and general gynaecological health, and can be assessed and treated by your Evoca GP.4 Common conditions which may apply and can be addressed include:

  1. Stress incontinence – leaking urine when coughing, sneezing, running, jumping or laughing
  2. Urge incontinence – leaking with the urge to pass urine, not being able to hold on, and often triggered by seeing or listening to running water, or even putting your key in the front door
  3. Mixed urinary incontinence – a combination of stress and urge urinary incontinence
  4. Detrusor instability – a condition of overactivity of the bladder whereby the urge to pass urine occurs before the bladder reaches what should be full capacity, resulting in urgent and frequent bathroom trips to pass urine more than 8 times daily and waking in the night as well
  5. Post coital UTIs – urinary tract infections related to intercourse
  6. Interstitial cystitis and painful bladder syndrome – chronic pain in the bladder area and on passing urine but in the absence of bacterial urine infections often underdiagnosed and over treated with antibiotics

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Vaginal Prolapse

Vaginal prolapse is a common condition not restricted to post-menopausal life. It can occur during and after pregnancy, and when left untreated can have significant impacts on your health and wellbeing, including:

  • Problems with bladder and bowel function
  • Sexual dysfunction
  • Lower pelvic/vaginal dragging pains
  • Lower back pain

In your consultation with your GP, your pelvic floor and vagina will be assessed for strength and tone, and your prolapse will be diagnosed, graded and a treatment plan created. This plan will be tailored to you, considering your future pregnancy plans, lifestyle, symptoms and treatment choices.

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References

1 https://www.continence.org.au/incontinence/understanding-incontinence

2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8437582/#:~:text=More%20than%2040%25%20of%20women,during%20penetration%20and%20during%20orgasm.

3 https://www.continence.org.au/about-us/our-work/key-statistics-incontinence#:~:text=statistics%20on%20Urinary%20incontinence&text=65%25%20of%20women%20and%2030,from%20a%20health%20professional3.

4 https://www.continence.org.au/types-incontinence/urinary-incontinence

 

How to prepare for your visit

Be able to give us an idea of your daily fluid intake, how much and what kind of fluids

If you have incontinence think about the circumstances in which this occurs

Think about your bowel function as well as your bladder function

Sexual function can be affected by prolapse, so consider if sex feels different and if so how

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Dr Ekhlas Nasser

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Dr Jessica Murphy

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Dr Rita Almohty

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Dr Salina Ahmed

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Dr Vecerka Skovrlj

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Dr Amatun Rashid

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Dr Elahe Arbabiaval

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Dr Rahul Verma

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Dr Sudhish Sudhan

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Dr Sue-Ann Steer

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FAQ’s

  • Do nothing – if the prolapse is not causing significant problems then treatment may not be required
  • Vaginal pessary – supportive removable devices inserted in the vagina which hold up the prolapse. These can be fitted by your Evoca doctor, and should be changes 6 monthly. Pessaries are usually used as a temporary measure but may be used as a more permanent option.
  • Pelvic floor physiotherapy – can help with mild or moderate prolapse to reduce severity and improve symptoms
  • Surgery – a variety of surgical options are available depending on the type and severity of prolapse.
  • Vaginal delivery
  • Family history of prolapse
  • Menopause 
  • Chronic cough (for example, asthma)
  • Obesity
  • Family history of vaginal prolapse
  • Neurological diseases
  • Forceps delivery

1 Reference: https://www.nhs.uk/conditions/pelvic-organ-prolapse/#:~:text=Pelvic%20organ%20prolapse%20is%20when,can%20cause%20pain%20and%20discomfort.

  • A lump or bulge felt in the vagina
  • Pressure feeling in the vagina
  • Dragging sensation in the vagina
  • Sense of something falling out
  • Urinary incontinence
  • Difficulty passing urine
  • Difficulty opening bowels
  • Faecal incontinence
  • Low back pain
  • Discomfort or lack of sensation during intercourse

1 Reference: https://www.nhs.uk/conditions/pelvic-organ-prolapse/#:~:text=Pelvic%20organ%20prolapse%20is%20when,can%20cause%20pain%20and%20discomfort.

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