Continence & prolapse
The Women’s Continence and Prolapse Clinic is a specialist clinic, composed of doctors, nurses and physiotherapists, serving all of Victoria.
The clinic is designed to help women of all ages who have pelvic floor problems. These problems can cause leakage of urine or faeces, or even the prolapse of the uterus or vagina (when the uterus or vagina slip down).
Health issues treated
The Continence and Prolapse Clinic treats many disorders, but the majority are related to pelvic floor dysfunction, which causes:
- bladder dysfunction, which is usually urinary incontinence. This is when you leak urine when you cough, sneeze or laugh, when you suddenly and urgently need to go to the toilet or when you leak before you get to the toilet.
- vaginal dysfunction, which is usually prolapse of uterus and/or vagina. This occurs when the muscles around the vagina become weak. Symptoms may include vaginal or lower back pain, feeling a lump in the vagina & difficulty emptying the bladder
- lower abdominal dysfunction, which is usually faecal incontinence. This is when you are unable to control your bowel motions.
What we do
Treatments vary from pelvic floor exercises and lifestyle modifications to surgery, depending on the problem detected. Remember that even the smallest amount of leakage can be treated successfully, but early intervention is very important.
The Continence and Prolapse Clinic uses a variety of sophisticated tests to measure bladder function and understand the underlying cause of the symptoms.
Information for patients
Not sure where your pelvic floor is, or how to tone it once you’ve found it? Watch Dr Marg Sherburn from the Women’s as she demonstrates how to take care of those pelvic muscles.
Incontinence and prolapse are very treatable
Some type of pelvic floor dysfunction affects nearly half of all Australian women. Even though incontinence and prolapse symptoms can be difficult to discuss, early treatment gives the best outcomes so don’t be embarrassed to speak to your doctor or GP.
Leaking urine or faeces can make your personal life and relationships very difficult, so it’s important to speak up and to remember that, in nearly every case, the problem can be treated.
Your visits to the clinic
You will initially be seen by a specialist continence nurse or physiotherapist who will give you a thorough continence assessment. This could take up to 45 minutes. Based on the information collected, we may be able to start some treatment straight away. You may require several appointments in the continence clinic depending on the type of issues you’re having.
You will receive a bladder diary with your initial appointment. We would encourage you to take the time to complete this prior to your appointment as this assists us greatly in identifying any problems with your bladder.
You will also be seen by a urogynaecologist, a doctor specialising in pelvic floor dysfunction. The doctor might suggest further medical treatment, discuss surgical options or require you to have tests looking at the function of your bladder. These tests might include:
- Urodynamics – a test to diagnose urinary incontinence and bladder dysfunction
- Uroflow - a test to assess if the bladder is emptying well
- Cystoscopy – an examination of the bladder where a camera is used to look inside the bladder
Treatments for continence
The treatments for continence might include:
What is vaginal prolapse?
Vaginal prolapse is a common condition where the bladder, uterus and/or bowel slip out of place and hang into the vagina. This can cause symptoms such as a sensation of a vaginal lump, pain/pressure, constipation, difficulty emptying the bowel or bladder, or problems with sexual intercourse.
Treatment of prolapse
When the prolapse causes symptoms such as those above, it’s best to try to treat the problem.
Depending on the severity of your symptoms and the type of prolapse your doctor may suggest you use a pessary. A vaginal pessary is a device that supports the vagina and needs to be changed every three to six months. Vaginal pessaries have been proven to be as successful as surgery in relieving prolapse symptoms in some women. We also have a prolapse pessary clinic to help you manage your pessary.
Some women, though, will require surgery to provide support for your vagina or uterus. Most women (about 70%) will have improvement of symptoms following vaginal prolapse surgery.
You will need a referral from a GP to attend this clinic.
What to bring
Normal bowel function
The pelvic floor is made up of a network of muscles and nerves which control both bladder and bowel function. Good bowel habits help to protect these muscles and mimimise the risk of both bladder and bowel incontinence. (see also Preventing Constipation)
- Normal bowel function
Pelvic floor exercises
The pelvic floor is a group of muscles and ligaments which support the bladder, uterus (womb) and bowel. It is important that all women exercise their pelvic floor muscles everyday throughout life, to prevent weakness or improve strength.
- Pelvic floor exercises