Why should surgery always be the last resort for incontinence & pelvic organ prolapse.

Incontinence and pelvic organ prolapse are more common that you might think.

The trouble is, women rarely talk about whats going on ‘down there’, BUT that needs to change. By reading this blog you are already helping to break the taboo surrounding pelvic health, but he end of this blog you will have more knowledge, and THAT, is power.

Share your knowledge with the next women you see, start a healthy conversation, and break the taboo.    I hope you will.

Image from NICE

Today, 9th Oct 2018, the National Institute of Health, NICE, released an update on their guidelines for urinary incontinence & pelvic organ prolapse. It clear states that non surgical options should be offered first.

The non-surgical options for urinary incontinence include:

Lifestyle interventions
Physical therapies
Behavioural therapies
Non-surgical options for pelvic organ prolapse include:

Lifestyle modification
Topical oestrogen
Pelvic floor muscle training
Pessary management [1]

Full disclosure! I am a Holistic Core Restore® Coach and coach the forward thinking Holistic Core Restore​® programs designed by Jenny Burrell form Burrell Education.

I was as thrilled to see that our programs already include ALL of the suggestions recommended by NICE, but to be honest, I’d expect nothing less! Jenny’s passion for women health is not only infectious, its THOROUGH. Our coaches cover most of the recommendations directly, and provide support and guidance to women that require referral via strong referral pathways. Holistic Core Restore® coaches work closely with Maria Elliot of The Mummy MOT and and her team, as well as the many excellent Women Health Physiotherapists within the NHS.

How common is urinary incontinence and pelvic organ prolapse?

The NHS estimates that 3 – 6 million people in the UK have some degree of urinary incontinence, just think about that for a moment, thats huge isn’t it. Within those numbers are postnatal mums. 49% of postnatal mums are still suffering with incontinence 1 year after giving birth. [2]

When is comes to pelvic organ prolapse , POP,  50% of women that have birthed experience [4] POP, so that’s one in two of us that will suffer from some degree of prolapse and of course it is not only women that birth that can experience POP. All women can suffer from POP, wether they have birthed or not, including women who have a hysterectomy.

So as you can see it is COMMON, but that doesn’t mean it is NORMAL. We don’t have to accept it, there is so much we can do.

What are the signs of pelvic dysfunction? 

Women often think they have to be experiencing significant symptoms before they need to seek help, but in fact the reverse is true. We can be, and should be, proactive about our pelvic health and the earlier that we do seek help, the better the outcome. Proactive and preventative is always better.

Historically women have been told, or feel, that surgery is the easy option, it has often been sold as a ‘simple day case’ procedure. Perhaps opinions would change if we were given the failure rate of surgery as 30-50% in the first two years. We only need to listen to the enormous cohort of women who have been through POP surgery and now form a group called Sling The Mesh to realise that surgery needs a lot of consideration.

Signs of pelvic dysfunction include:

  • Pelvic pain during intercourse or at any time
  • Leaking when coughing, sneezing, running or at anytime
  • Difficulty in starting or stopping  peeing
  • Difficulty in holding onto gas
  • Constipation & self voiding
  • Difficulty in inserting tampons
  • Unexplained hip pain
  • Low back pain
  • Diastasis Recti (mummy tummy or tummy gap)
  • Doming of the tummy muscles during activity or loading
  • Waking at night to pee
  • Sudden urgency to pee

Surgery should always be the last resort.

In the very simplest of terms;

If an area is weak, and becomes damaged the questions to ask are;

  • WHY is the area weak?
  • HOW has the area become damaged?
  • WHY are the symptoms getting worse?
  • WHAT are my options?

We need to change our behaviours, our habits and our movement patterns, we need to free up stuck areas and create space and mobility to resolve the issue Otherwise it’s like sticking your finger in a leaking pipe (so to speak)

WHAT can I do to improve my pelvic health?

Pelvic health is benefited by the simplest exercise, breathing.

Every breath you take should drive activity in your pelvic floor. After birth or pelvic floor surgery that reflex action needs to be retrained so that the pelvic floor can work as it should do.

So this is where we start. Learning to breathe well.

Visiting a postnatal specialist, a Holistic Core Restore® coach is the best way to achieve this. Please don’t be tempted to follow random online videos, or attend general fitness classes, it could be counter productive and damage your long term pelvic health. We get one pelvic floor, and we need to look after it.

Alarmingly, a recent study showed that one in four women were unable to perform a Kegel exercise correctly even after instruction [3]  By joining a specialist class taught by an expert, you can be sure you will be in safe hands and wont become that one in four.

About Holistic Core Restore®

The Holistic Core Restore® Every Woman program is the foundation pelvic health & fitness program, and is the gold standard in pelvic health. Supported by leading professionals including  Michelle Lyons Women’s Health Physiotherapist and global educator, Jessica Drummond Founder of The Integrative Women Health Institute and Maria Elliot Woman’s Health Physiotherapist & founder of Mummy MOT.

Using an in-depth pre screening form Holistic Core Restore® coaches ask the questions that tease out all the information we need to enable us to offer you the very best in pelvic health care, and provide you with a program that WILL meet you where you are at,  changing your life for the better.

Using a scientific tried and tested formula of Soft Tissue Release, Intrinsic Core Synergy, The Kegel Continuum, Functional Movement Patterns, Nutrition & those absolutely key Lifestyle Modifications as cited in NICE recommendations, we support you to support yourself.

If you would like to find out more about how I can support you to improve your pelvic health, or if you are interested in educating yourself to ‘future proof’ your pelvic function so that it keeps serving you well, you can find more info on my website www.sammiemcfarland.co.uk or follow me on facebook Sammie Mcfarland Pilates & Health Dorset 

There are Holistic Core Restore® coaches worldwide. You can find your nearest Holistic Core Restore® coach HERE.

[1] NICE October 2018

[2] K.Bo et al 2016

[3] Kandadai P, O’Dell K, Saini J -2105

[4] J Burrell 2018