Many people who have incontinence do not seek treatment because they believe the only treatment available to them is surgery.
This is a misconception; treatments for incontinence include behavioral, medical, and surgical.
Generally, behavioral therapies are the first choice; because they are noninvasive and have no side effects, they are the safest. A variety of medical treatments are available. Surgery is usually reserved for people whose problem does not improve with behavioral and medical therapy.
Your overall medical condition, the type of bladder control problem you have, and your lifestyle will all determine which treatments are right for you. Talk to your health care provider; together you can come up with a treatment plan that works for you.
http://www.emedicinehealth.com/bladder_control_problems/page6_em.htm
Kamis, 07 Februari 2008
Bladder Control Problems Causes
Bladder Control Problems Causes
Incontinence is a symptom with a wide variety of causes. The most common causes include the following:
Incontinence is a symptom with a wide variety of causes. The most common causes include the following:
- Urinary tract infection
- Side effect of medication: Examples include alpha-blockers, calcium channel blockers, antidepressants, antihistamines, sedatives, sleeping pills, narcotics, caffeine-containing preparations, and water pills (diuretics). Occasionally, the medicines used to treat some forms of incontinence can also worsen the incontinence if not prescribed correctly.
Impacted stool: Stool becomes so tightly packed in the lower intestine and rectum that a bowel movement becomes very difficult or impossible. - Weakness of muscles in the bladder and surrounding area: This can have a variety of causes.
- Overactive bladder
- Bladder irritation
- Blocked urethra, usually due to enlarged prostate (in men) Many of the causes are temporary, such as urinary tract infection. The incontinence improves or goes away completely when the underlying condition is treated. Others are longer lasting, but the incontinence can usually be treated. Risk factors: Underlying causes or contributors to urinary incontinence include the following:
- Smoking: The connection with incontinence is not completely clear, but smoking is known to irritate the bladder in many people.
- Obesity: Excess body fat can reduce muscle tone, including the muscles used to control urination.
- Chronic constipation: Regular straining to have a bowel movement can weaken the muscles that control urination.
- Diabetes: Diabetes can damage nerves and interfere with sensation.
- Spinal cord injury: Signals between the bladder and the brain travel via the spinal cord. Damage to the cord can interrupt those signals, disrupting bladder function.
- Disability or impaired mobility: People who have diseases such as arthritis, which make walking painful or slow, may have "accidents" before they can reach a toilet. Similarly, people who are permanently or temporarily confined to a bed or a wheelchair often have problems because of their inability to get to a toilet easily.
- Neurologic disease: Conditions such as stroke, multiple sclerosis, Alzheimer disease, or Parkinson disease can cause incontinence. The problem can be a direct result of a disrupted nervous system or an indirect result of having restricted movement.
Surgery or radiation therapy to the pelvis: Incontinence can result from certain surgeries or medical therapies. - Pregnancy: One third to one half of pregnant women have problems controlling their bladder. In most of these women, incontinence stops after delivery. However, 4-8% of pregnant women experience renewed incontinence after delivery (postpartum). Risk factors for postpartum incontinence include vaginal delivery, long second stage of labor (the time after the cervix is fully dilated), and having large babies.
- Menopause: Studies have not demonstrated a consistent increase in risk of incontinence following menopause. The relationship between postmenopausal hormone replacement therapy and incontinence is unclear.
- Hysterectomy: Women who have had a hysterectomy may have incontinence later in life.
- Enlarged prostate: In men with an enlarged prostate, the prostate can block the urethra, causing urine leakage. However, less than 1% of men treated for benign (noncancerous) enlargement of the prostate report incontinence.
Prostate surgery: Up to 87% of men whose prostate has been removed report problems with incontinence. - Bladder disease: Certain disorders of the bladder, including bladder cancer, can sometimes cause incontinence. There are several types of urinary incontinence. Many people have more than one type. A combination of stress and urge incontinence is especially common.
- Stress and urge incontinence are the most common types.
- Stress incontinence: This occurs when you do anything that strains the muscles around the bladder, such as laughing, coughing, sneezing, bending, or even walking in some people. It is caused by weakness or injury to the muscles of the pelvis or the sphincters. The underlying causes include physical changes due to pregnancy, childbirth, or menopause. It is a frequent type of incontinence in women.
- Urge incontinence: This is a sudden uncontrollable desire to urinate regardless of how much urine is in the bladder. It is believed to be caused by inappropriate contractions of the bladder. The term "overactive bladder" has been adopted to describe urge incontinence, detrusor instability, and hypersensitive detrusor. Urgency, frequency, and urination at night (nocturia) are common in people with this condition. This is due to disruption of signals between the bladder and the brain. Environmental cues, such as running water or putting the key in the front door, may prompt urgency or leakage. It is a frequent type of incontinence in both men and women.
- Mixed incontinence: This is a mixture of stress and urge incontinence.
Overflow incontinence: This results when you retain urine in your bladder either because your muscle tone is weak or you have some sort of blockage below your bladder. Symptoms include dribbling, urgency, hesitancy, low-force urine stream, straining, and urinating only a small amount despite a sensation of urgency. It is a frequent type of incontinence in men. - Neuropathic incontinence: This results from a problem affecting one or more nerves. Either the detrusor muscle overcontracts or the interior sphincter lacks the tension to hold urine in.
- Fistula: This is an abnormal internal connection between organs or structures such as the bladder, ureters, or urethra. This can cause incontinence.
Traumatic incontinence: This is incontinence that occurs after injury to your pelvis (such as a fracture) or as a complication of surgery.
Congenital incontinence: This may occur in people born with their bladder or one or both ureters out of place. - Obstruction to urine flow: This may cause incontinence.
http://www.emedicinehealth.com/bladder_control_problems/page2_em.htm
Bladder Control Problems Causes
Incontinence is a symptom with a wide variety of causes. The most common causes include the following:
Urinary tract infection
Side effect of medication: Examples include alpha-blockers, calcium channel blockers, antidepressants, antihistamines, sedatives, sleeping pills, narcotics, caffeine-containing preparations, and water pills (diuretics).
Occasionally, the medicines used to treat some forms of incontinence can also worsen the incontinence if not prescribed correctly.
Impacted stool: Stool becomes so tightly packed in the lower intestine and rectum that a bowel movement becomes very difficult or impossible.
Weakness of muscles in the bladder and surrounding area: This can have a variety of causes.
http://www.emedicinehealth.com/bladder_control_problems/page2_em.htm
Urinary tract infection
Side effect of medication: Examples include alpha-blockers, calcium channel blockers, antidepressants, antihistamines, sedatives, sleeping pills, narcotics, caffeine-containing preparations, and water pills (diuretics).
Occasionally, the medicines used to treat some forms of incontinence can also worsen the incontinence if not prescribed correctly.
Impacted stool: Stool becomes so tightly packed in the lower intestine and rectum that a bowel movement becomes very difficult or impossible.
Weakness of muscles in the bladder and surrounding area: This can have a variety of causes.
http://www.emedicinehealth.com/bladder_control_problems/page2_em.htm
Bladder Leaking
The treatments you need to help stop your bladder leaking will depend upon the cause of your leaking.
There are two main causes of bladder leaking:
The urethra (the tube which carries urine from your bladder to the outside of your body) should act like a valve to hold urine in the bladder. If you leak urine when you cough, sneeze, laugh, run or lift, your urethra is not working properly. This is called stress incontinence.
If you have to go to the bathroom too often (frequency); if you get a strong urge to pee which makes you hurry to get to a toilet (urgency); if you start to leak urine before you can get your clothes off (urge incontinence), the bladder storage system is not working as it should.
Many women have a combination of stress and urge incontinence- we call this "mixed incontinence".
Diagram of the Female Bladder and Urethra
The urinary bladder stores urine prior to its elimination from the body (functions of the urinary system). At micturation/urination, the bladder expels urine into the urethra, leading to the exterior of the body. The bladder is a musculomembranous sac located on the floor of the pelvic cavity, anterior to the uterus and upper vagnia (in females).
Outer surfaces of the Bladder: The upper and side surfaces of the bladder are covered by peritoneum (also called "serosa"). This serous membrane of the abdominal cavity consists of mesthelium and elastic fibrous connective tissue. "Visceral peritoneum" covers the bladder and other abdominal organs, while "parietal peritoneum" lines the abdomen walls.
Ureters: The ureters deliver urine to the bladder from the kidneys (one ureter from each kidney - see components of human urinary system). The ureters pass through the posterior surface of the bladder at the Ureter Orifices (shown above). Urine drains through the ureters directly into the bladder as there are no sphincter muscles or valves at the ureter orifices.
Structure of Bladder (Detail): The bladder itself consists of 4 layers:
- (1) Serous - this outer layer being a partial layer derived from the peritoneum,
(2) Muscular - the detrusor muscle of the urinary bladder wall, which consists of 3 layers incl. both longitudinal and circularly arranged muscle fibres,
(3) Sub-mucous - a thin layer of areolar tissue loosely connecting the muscular layer with the mucous layer, and
(4) Mucous - the innermost layer of the wall of the urinary bladder loosely attached to the (strong and substantial) muscular layer. The mucosa falls into many folds known as rugae when the bladder is empty or near empty.
The features observable on the inside of the bladder are the ureter orifices, the trigone, and the internal orifice of the urethra.
The trigone is a smooth triangular region between the openings of the two ureters and the urethra and never presents any rugae even when the bladder is empty - because this area is more tightly bound to its outer layer of bladder tissue.
Exit from Bladder: When urine is released from the bladder is flows out via the neck of the bladder (in the trigone region). The internal urethral sphincter is a sphincter (circular) muscle located at the neck of the bladder and formed from a thickening of the detrusor muscle. It closes the urethra when the bladder has emptied.
At only about 1.5 inches (35 mm) long, the female adult urethra is shorter than the adult male urethra (approx. or 8 inches, or 200mm). The female urethra is located immediately behind (posterior to) the pubic symphysis and is embedded into the front wall of the vagina.
The urethra itself is a narrow membranous canal that consists of three layers:
Muscular layer - continuous with the muscular layer of the bladder, this extends the full length of the urethra.
Thin layer of spongy erectile tissue - including plexus of veins and bundles of smooth muscle fibres. Located immediately below the mucous layer.
Mucous layer - internally continuous with the bladder and lined with laminated epithelium that is transitional near to the bladder.
After passing through the urogenital diaphragm (as shown in the diagram), the female urethra ends at the external orifice of urethra - which is the point at which the urine leaves the body. This is located between the clitoris and the vaginal opening.
The passage of urine along the urethra through the urogenital diaphragm is controlled by the external urethral sphincter, which is a circular muscle under voluntary control (that is, it is innervated by the somatic nervous system, SNS). See the page about micturation for more about control of these structures by the nervous system.
The female urethra is a much simpler structure than the male urethra because it carries only urine (whereas the male urethra also serves as a duct for the ejaculation of semen - as part of its reproductive function).
Uterine Prolaps
DESCRIPTION
Pelvic organ prolapse is a very common condition, particularly among older women. It's estimated that half of women who have children will experience some form of prolapse in later life, but because many women don't seek help from their health care provider the actual number of women affected by prolapse is unknown. Prolapse may also be called uterine prolapse, genital prolapse, uterovaginal prolapse, pelvic relaxation, pelvic floor dysfunction, urogenital prolapse or vaginal wall prolapse. Pelvic organ prolapse occurs when the pelvic floor muscles become weak or damaged and can no longer support the pelvic organs. The womb (uterus) is the only organ that actually falls into the vagina. When the bladder and bowel slip out of place, they push up against the walls of the vagina. While prolapse is not considered a life threatening condition it may cause a great deal of discomfort and distress.
Urethrocele (Prolapse of the Urethra): When the urethra (the tube that carries urine from the bladder) slips out of place, it also pushes against the front of the vaginal wall, but lower down, near the opening of the vagina. This usually happens together with a cystocele (see above).
Pelvic organ prolapse is a very common condition, particularly among older women. It's estimated that half of women who have children will experience some form of prolapse in later life, but because many women don't seek help from their health care provider the actual number of women affected by prolapse is unknown. Prolapse may also be called uterine prolapse, genital prolapse, uterovaginal prolapse, pelvic relaxation, pelvic floor dysfunction, urogenital prolapse or vaginal wall prolapse. Pelvic organ prolapse occurs when the pelvic floor muscles become weak or damaged and can no longer support the pelvic organs. The womb (uterus) is the only organ that actually falls into the vagina. When the bladder and bowel slip out of place, they push up against the walls of the vagina. While prolapse is not considered a life threatening condition it may cause a great deal of discomfort and distress.
Uterine prolapse is a condition that develops when muscular support for the uterus is lost and the uterus has fallen or dropped from its normal location, causing it to bulge into the vagina. The uterus is normally held in place by the pelvic muscles and supporting ligaments. When these muscles become weakened or injured, uterine prolapse can occur. In mild cases, a portion of the uterus descends into the top of the vagina. In more serious cases, the uterus may even protrude through the vaginal opening and outside the vagina. A prolapse can be associated with or accompanied by a urethrocele and cystocele (urethra and/or bladder bulge along the front wall of the vagina) and rectocele (rectal wall bulges into the back wall of the vagina).
TYPES OF PELVIC PROLAPSE
There are a number of different types of prolapse that can occur in a woman's pelvic area and these are divided into three categories according to the part of the vagina they affect: front wall, back wall or top of the vagina. It is not uncommon to have more than one type of prolapse. Prolapse of the Anterior (Front) Vaginal Wall
Cystocele (Bladder Prolapse): When the bladder prolapses, it falls towards the vagina and creates a large bulge in the front vaginal wall. It's common for both the bladder and the urethra (see below) to prolapse together. This is called a cystourethrocele and is the most common type of prolapse in women.
Cystocele (Bladder Prolapse): When the bladder prolapses, it falls towards the vagina and creates a large bulge in the front vaginal wall. It's common for both the bladder and the urethra (see below) to prolapse together. This is called a cystourethrocele and is the most common type of prolapse in women.
Urethrocele (Prolapse of the Urethra): When the urethra (the tube that carries urine from the bladder) slips out of place, it also pushes against the front of the vaginal wall, but lower down, near the opening of the vagina. This usually happens together with a cystocele (see above).
Prolapse of the Posterior (Back) Vaginal Wall
Enterocele (Prolapse of the Small Bowel): Part of the small intestine that lies just behind the uterus (in a space called the pouch of Douglas) may slip down between the rectum and the back wall of the vagina. This often occurs at the same time as a rectocele or uterine prolapse (see below).
Rectocele (Prolapse of the Rectum or Large Bowel): This occurs when the end of the large bowel (rectum) loses support and bulges into the back wall of the vagina. It is different from a rectal prolapse (when the rectum falls out of the anus).
Enterocele (Prolapse of the Small Bowel): Part of the small intestine that lies just behind the uterus (in a space called the pouch of Douglas) may slip down between the rectum and the back wall of the vagina. This often occurs at the same time as a rectocele or uterine prolapse (see below).
Rectocele (Prolapse of the Rectum or Large Bowel): This occurs when the end of the large bowel (rectum) loses support and bulges into the back wall of the vagina. It is different from a rectal prolapse (when the rectum falls out of the anus).
Vaginal Vault Prolapse: The vaginal vault is the top of the vagina. It can only fall in on itself after a woman's womb has been removed (hysterectomy). Vault prolapse occurs in about 15% of women who have had a hysterectomy for uterine prolapse, and in about 1% of women who have had a hysterectomy for other reasons.
Pelvic Floor Exercises (Kegel Exercises)
Pelvic floor exercises help prevent prolapse by strengthening the muscles that support the pelvic organs. The exercises are easy and quick to do, but it's important to do them correctly, and many women benefit from guidance from a physiotherapist. Start by locating the muscles you need to exercise.
There are a few different ways to do this:
Place one or two fingers in your vagina and squeeze your muscles until you can feel your vagina tighten around your fingers. These are your pelvic muscles. Imagine you're trying to stop the flow of urine mid-stream. The muscles you tighten (contract) are your pelvic floor muscles.
The other way to identify the correct muscles is to imagine you are trying to stop yourself from passing gas. The muscles you squeeze to do this are your pelvic muscles. Once you've identified the correct muscles you're ready to begin. The exercises can be done while lying down, sitting or standing, with your knees together or slightly apart. Set 1 - Slowly tighten your pelvic floor muscles and count to four, then let the muscles relax for a count of four.
As your muscles get stronger gradually increase the count to 10. Try to repeat this 10 to 15 times. Check that you're not tightening the muscles in your legs, abdomen or buttocks, as it's important to use only your pelvic muscles. Remember to keep breathing. Set 2 - Now tighten and relax your pelvic muscles as quickly as you can, again 10 to 15 times. As a preventive measure, try to do the exercises two or three times a day. If you have a prolapse, you may be advised to increase the number of times you do the exercises, but don't overdo it. Excessive exercising of the pelvic muscles can cause muscle fatigue and make the exercises less effective.
You can do the exercises anywhere, anytime, but studies show that when women do them at home, they are more likely to do them correctly. Some women find it helps to set aside specific times to do the exercises, such as before getting out of bed in the morning and before going to sleep at night. If you think you're doing the exercises incorrectly or need help locating your pelvic floor muscles, a physiotherapist will be able to help you. Ask your health care provider for a referral.
Delapan Bulan Kencing Terus ----
Nasib Pasti makin tak Pasti
Amlapura (Bali Post) - Senin Paing, 17 September 2007
Musibah bertubi-tubi dialami korban Ni Wayan Pasti (56) warga Banjar Jungsri, Bebandem. Dia diduga menjadi korban malpraktik dokter. Saat menjalani operasi kanker rahim di RSUD Karangasem, kantung kemihnya bocor, tergores pisau operasi sehingga sampai kini dia kencing terus. Pasti dirujuk ke RS Sanglah untuk operasi menjahit kantung kemihnya, namun sudah delapan bulan menunggu sampai kini belum juga ditangani.
Ni Wayan Pasti, Minggu (16/9) kemarin, menceritakan penderitaannya di rumahnya didampingi suaminya I Nyoman Kani (58). Pasti yang sebelumnya berprofesi sebagai pedagang canang di Pasar Amlapura Timur itu 13 Juni 2006 menjalani operasi mengangkat rahimnya di RSUD Karangasem. Dia menderita kanker rahim. Setelah operasi dan pulang, ternyata air kencing terus merembes dari kemaluannya. Meski sudah dipasangi kateter (saluran kencing berupa pipa plastik), tetapi air seni tetap merembes.
Beberapa kali memeriksakan diri ke dokter, barulah diketahui kandung kemihnya bocor akibat terluka gores saat menjalani operasi kanker. Dokter kebidanan dan penyakit kandungan di RSUD Karangasem yang menangani pun mengaku heran. Selama ini ratusan operasi sejenis dilakukannya, namun baru pada korban Pasti yang terjadi kasus kantung kemihnya tergores pisau operasi.
Ibu lima anak itu tak mau lagi ditangani di RSUD Karangasem. Dia dirujuk ke RS Sanglah. Namun sudah delapan bulan menunggu giliran operasi, sampai kini belum mendapat giliran operasi. ''Saya dan keluarga bolak-balik mengecek ke RS Sanglah, ternyata dikatakan belum mendapat giliran operasi. Saya berharap segera menjalani operasi, agar bisa hidup lebih lama,'' harapnya.
Pasti kini mengaku tak bisa berjualan canang di pasar untuk menghidupi keluarganya. Soalnya, air seni merembes terus selain malu juga merasa tidak enak mengerjakan canang. Sejak sakit, ia mengaku tak tahan duduk berlama-lama. Kedua pasangan suami-istri itu kini mengaku tak bisa bekerja mencari nafkah.
Sementara suaminya, Kani, sudah belasan tahun menderita penyakit aneh. Kulit di sekujur tubuhnya muncul bercak-bercak putih. Bercak itu kini telah menyatu. Kani seperti orang bule. Dia tak tahan terkena matahari langsung. Penyakit itu dideritanya sudah puluhan tahun, saat baru beranak dua. Saat itu, dia bekerja sebagai buruh pembuat bata di Kayu Putih, Bebandem. Karena pasutri itu tak bisa mencari nafkah, beberapa anaknya tak bisa melanjutkan sekolah karena tak ada biaya. ''Ada yang kelas III SD putus sekolah, ada yang cuma sampai kelas II SMP,'' ujar Pasti. (013)
Amlapura (Bali Post) - Senin Paing, 17 September 2007
Musibah bertubi-tubi dialami korban Ni Wayan Pasti (56) warga Banjar Jungsri, Bebandem. Dia diduga menjadi korban malpraktik dokter. Saat menjalani operasi kanker rahim di RSUD Karangasem, kantung kemihnya bocor, tergores pisau operasi sehingga sampai kini dia kencing terus. Pasti dirujuk ke RS Sanglah untuk operasi menjahit kantung kemihnya, namun sudah delapan bulan menunggu sampai kini belum juga ditangani.
Ni Wayan Pasti, Minggu (16/9) kemarin, menceritakan penderitaannya di rumahnya didampingi suaminya I Nyoman Kani (58). Pasti yang sebelumnya berprofesi sebagai pedagang canang di Pasar Amlapura Timur itu 13 Juni 2006 menjalani operasi mengangkat rahimnya di RSUD Karangasem. Dia menderita kanker rahim. Setelah operasi dan pulang, ternyata air kencing terus merembes dari kemaluannya. Meski sudah dipasangi kateter (saluran kencing berupa pipa plastik), tetapi air seni tetap merembes.
Beberapa kali memeriksakan diri ke dokter, barulah diketahui kandung kemihnya bocor akibat terluka gores saat menjalani operasi kanker. Dokter kebidanan dan penyakit kandungan di RSUD Karangasem yang menangani pun mengaku heran. Selama ini ratusan operasi sejenis dilakukannya, namun baru pada korban Pasti yang terjadi kasus kantung kemihnya tergores pisau operasi.
Ibu lima anak itu tak mau lagi ditangani di RSUD Karangasem. Dia dirujuk ke RS Sanglah. Namun sudah delapan bulan menunggu giliran operasi, sampai kini belum mendapat giliran operasi. ''Saya dan keluarga bolak-balik mengecek ke RS Sanglah, ternyata dikatakan belum mendapat giliran operasi. Saya berharap segera menjalani operasi, agar bisa hidup lebih lama,'' harapnya.
Pasti kini mengaku tak bisa berjualan canang di pasar untuk menghidupi keluarganya. Soalnya, air seni merembes terus selain malu juga merasa tidak enak mengerjakan canang. Sejak sakit, ia mengaku tak tahan duduk berlama-lama. Kedua pasangan suami-istri itu kini mengaku tak bisa bekerja mencari nafkah.
Sementara suaminya, Kani, sudah belasan tahun menderita penyakit aneh. Kulit di sekujur tubuhnya muncul bercak-bercak putih. Bercak itu kini telah menyatu. Kani seperti orang bule. Dia tak tahan terkena matahari langsung. Penyakit itu dideritanya sudah puluhan tahun, saat baru beranak dua. Saat itu, dia bekerja sebagai buruh pembuat bata di Kayu Putih, Bebandem. Karena pasutri itu tak bisa mencari nafkah, beberapa anaknya tak bisa melanjutkan sekolah karena tak ada biaya. ''Ada yang kelas III SD putus sekolah, ada yang cuma sampai kelas II SMP,'' ujar Pasti. (013)
Hysterectomy - The Successful remedy for uterine disorders
Hysterectomy as you might have heard that it is a surgical procedure for treating enlarged uterus or uterine fibroids. Hysterectomy is supposed to be one of the last options for the treatment of uterine disorders. It is a surgical procedure wherein the affected uterus is removed. It is usually done by a gynecologist.
Hysterectomy is done in either of the two ways: partial also known as supra-cervical or total where in the whole of the uterus is removed. In several cases surgical removal of the ovaries is also done along with hysterectomy. Then the surgery is called "total abdominal hysterectomy with bilateral salpingo-oophorectomy" (sometimes abbreviated TAH-BSO). The type of surgery that is done depends on the reason for the surgery.
Most often hysterectomy is used colloquially yet mistakenly for referring the removal of any parts of the female reproductive system. Hysterectomy as I have mentioned earlier is done in two ways. The later one is seldom done as it is the radical method of treatment where the affected organ, not the affected parts is removed from the patient’s body.
Though it is a bit rare but facts are really surprising which have shown up after research. In the United States, 1 out of 3 women can be expected to have a hysterectomy by age 60. There are 22 million women alive in the United States whose female organs have been surgically removed. It is the second most common surgery among women in the United States.
You probably would like to know more about hysterectomy. More details about hysterectomy have been provided in the next sections. Our next section deals with Hysterectomy surgery. I Hope it will help you.
Laparoscopic Surgery for Uterovaginal and Vaginal Prolapse
The prolapse of uterus and vagina is one of the most frustrating and embarrassing disorders confronting the modern woman, who, with increased life expectancy, is interested in maintaining her femininity and capacity for sexual activity.
A prolapsed uterus or vagina is just a manifestation of the break down in the pelvic floor supporting system, and it is nearly coexists with other type of genital prolapse such as cystocele, rectocele, and enterocele. Therefore, the reconstructive surgery for uterovaginal or vaginal prolapse is just a part of the total repair of the pelvic floor, which is necessary for restoration of the normal anatomy and function. The length of the vagina in a normal adult female is approximately 10 - 12 cm.
In a standing female, her lower 1/3 of the vagina is pointing 90 degree to the floor and her upper 2/3 of vagina is in an angle almost parallel to the floor and directly toward her lower backbone. The vagina is basically supported on three different levels in the pelvis. The support of the upper 1/3 of vagina comes from the uterosacral ligaments, a pair of very strong fibromuscular structures that originate from lateral aspects of sacrum (the lowest part of our spine), going around the rectum and attaching to the cervix (the mouth of womb), and upper part of vagina.
These ligaments pull the top of vagina and cervix toward the sacrum and forms the normal axis of vagina. The middle third of the vagina is held in place by the lateral attachments of the fascia to the pelvic side wall. The lower third of vagina is blending into and merging with the fibromuscular tissue surrounding the opening of the vagina and anus.
It is of utmost importance for the readers to understand that the uterus, per se, has no bearing or effect on the vaginal support. In other words, a hysterectomy should not be considered as part of repair surgery for uterovaginal or vaginal prolapse unless there is distinct pathology of the uterus. In order to restore the vaginal depth and axis, all three levels of support must be attended at the time of surgery.
What is a Prolapsed Uterus?
Uterine prolapse, or a prolapsed uteus, is a specific type of pelvic organ prolapse that occurs when the uterus drops from its normal position in the pelvic cavity and descends into and sometimes outside the vagina in the most serious cases. To better understand uterine prolapse, it may be helpful to think of it as a type of hernia. For example, weakness in the abdominal wall can lead to intestines bulging through the muscular support causing an abdominal hernia.
Similarly, weakness in the muscles and ligaments of the pelvic floor can cause loss of uterine support and lead to uterine prolapse. Pregnancy, childbirth, obesity and chronic coughing and lifting are some of the factors that predispose a woman to developing uterine prolapse. Uterine prolapse is a progressive condition that gets worse over time, if not treated.
Hysterectomy has been considered the treatment of choice for women experiencing significant symptoms as a result of uterine prolapse. In fact, the significance of uterine prolapse as a woman's health care issue can be gauged by the fact that it was the third most frequently reported cause for hysterectomy in the U.S. from 1993-1998, accounting for 548,657 procedures during the time frame.
1 It was the most common reason for hysterectomy in women older than 55 years in a second large-scale survery.
2 . Although uterine prolapse typically occurs in post-menopausal women it also occurs in younger women. Definitive treatment has been difficult in women who have not completed childbearing. It has also been an issue in women who wish to preserve their uterus for other reasons.
http://www.inletmedical.org/prolapsed_uterus.asp
Similarly, weakness in the muscles and ligaments of the pelvic floor can cause loss of uterine support and lead to uterine prolapse. Pregnancy, childbirth, obesity and chronic coughing and lifting are some of the factors that predispose a woman to developing uterine prolapse. Uterine prolapse is a progressive condition that gets worse over time, if not treated.
Hysterectomy has been considered the treatment of choice for women experiencing significant symptoms as a result of uterine prolapse. In fact, the significance of uterine prolapse as a woman's health care issue can be gauged by the fact that it was the third most frequently reported cause for hysterectomy in the U.S. from 1993-1998, accounting for 548,657 procedures during the time frame.
1 It was the most common reason for hysterectomy in women older than 55 years in a second large-scale survery.
2 . Although uterine prolapse typically occurs in post-menopausal women it also occurs in younger women. Definitive treatment has been difficult in women who have not completed childbearing. It has also been an issue in women who wish to preserve their uterus for other reasons.
http://www.inletmedical.org/prolapsed_uterus.asp
Images : Uterine Prolaps
Anatomy of the pelvic floor showing the divisions of levator ani
ICS prolapse scoring system (POPQ)
Uterine prolapse. This photograph shows a woman with advanced uterine prolapse. Note the ulcerated, thickened vaginal mucosa which results from rubbing on underclothes
Source : http://www.indianjurol.com/getarticleimages.asp?a=IndianJUrol_2006_22_4_310_29113
Turun Peranakan tak Mengancam Jiwa
Minggu, 11 Januari 2004
SEJAK dulu turun peranakan yang di dunia medis disebut dengan istilah prolaps genetalia telah banyak dikenal orang. Keadaan ini disamakan dengan suatu hernia yaitu di mana bagian organ bagian dalam tubuh turun ke rongga kemaluan atau bahkan mungkin keluar dari liang kemaluan tersebut.
Turun peranakan terjadi karena adanya kelemahan pada otot besar panggul sehingga satu atau lebih organ didalam panggul turun. Kerusakan yang terjadi mulanya tanpa gejala (asimptomatik), tetapi dengan bertambahnya usia maka kadar hormon estrogen dalam tubuh akan menurun dan akan menyebabkan penurunan fungsi otot sehingga keadaan tersebut menjadi bergejala.
Menurut data di RSCM Jakarta tahun 1995-2000 telah dilakukan tindakan operasi pada 240 kasus yang mempunyai keluhan dengan rata-rata 60 hingga 70 tahun, sehingga tidak mengherankan bila di Indonesia yang usia harapan hidupnya meningkat kejadian turunnya peranakan meningkat, walaupun kadang-kadang riwayat melahirkan tidak lebih dari empat kali.
Dr H Amir Fauzi, SpOG, dari Subdivisi Uroginekologi dan Rekonstruksi Departemen Obstetri dan Ginekologi FK Unsri dan RSMH, mengatakan kebanyakan wanita yang pernah melahirkan terutama yang mempunyai riwayat melahirkan empat kali atau lebih akan mengalami kelemahan otot besar panggul sehingga terjadi penurunan organ panggul yang kadang tanpa gejala tergantung beratnya kelainan tersebut.
Menurutnya, derajat beratnya kelainan adalah tergantung pada posisi organ panggul di dalam liang kemaluan. Pada keadaan ringan dan sidang (tingkat I-II) kebanyakan tanpa gejala, pada keadaan berat (tingkat III) baru dirasakan adanya keluhan. Yang perlu diperhatikan dan dipahami adalah pada keadaan ini bukan merupakan suatu penyakit tetapi kelainan letak sehingga semua turun peranakan memerlukan pengobatan dan bila memerlukan pengobatan dapat dilakukan secara konservasi atau operasi.
Turun peranakan dapat berupa turunnya kandungan kemih ke dalam liang atau organ kemaluan (uretrokel), turunnya rahim bawah dan kandung kemih kedalam liang atau rongga kemaluan (uretrovesikokel), turunnya kandungan kemih ke dalam liang atau rongga kemaluan (vesikokel), turunnya rahim beserta jaringan penunjangnya kedalam liang atau rongga kemaluan (prolapsus uteri), turunyan usus besar bagian bahwa kedalam liang atau rongga kemaluan (rektokel) dan turunnya tunggul bekas operasi pengakatan rahim kedalam liang atau rongga kemaluan (prolaps puncak vagina).
Amir, mengatakan otot dasar punggung pada dasarnya berfungsi sebagi pembatas rongga perut dan menjaga agar organ panggul berada pada posisi yang benar dan sebagai sandaran organ panggul tersebut, sehingga pada keadaan normal organ pelvis tidak turun, fungsi lainnya adalah menjaga keseimbangan tekanan udara di dalam dan di luar perut. Bila otot dasar panggul rusak, maka pertahanan terakhir dari organ panggul tersebut adalah alat penggantungnya yang menyokong organ tersebut dengn melekatkan diri pada dinding samping rongga panggul.
Keistimewaan dari otot dasar panggul adalah tetap bekerja (kontraksi) meskipun dalam keadaan istirahat sehingga tidak ada celak yang memungkinkan terjadinya penurunan alat organ genetalia. (arsep pajario)
Cara Alamiah Atasi Masalah Kehamilan
Bila saat hamil Anda mengalami berbagai keluhan sebaiknya pergi ke rumah sakit atau ke dokter kandungan dan mintalah penjelasan dokter, apakah tekanan darah Anda normal atau tinggi. Tekanan darah yang terlalu tinggi patut diwaspadai, karena bisa menjadi tAnda peringatan, mungkin Anda mengalami preeklamsia.
Penyebab lain ialah kekurangan zat besi.
Sebaiknya Anda banyak mengandung makanan yang mengadung zat besi seperti, jagung, daging sapi, telur, kacang-kacangan dan buah-buah yang menolong menyerap zat besi secara baik.l Jika tekanan darah tinggi maupun darah rendah keduanya dapat menyebabkan sakit kepala. Karena itu setiap pagi secara teratur semprotkan air dingin dengan selang ke seluruh bagian kaki, di bawah lalu ke paha dan pantat, kemudian kembali dri atas ke bawah.
Selanjutnya pada kedua belah tangan, mulai dari telapak tangan ke bahu dan sebaliknya.l Bila Anda mengalami migren yang mendadak, atau sakit kepala karena tegang, maka dengan minyak lavender ketegangan tersebut dapat diatasi. Minyak tersebut dioleskan pada leher dan kening.l Perubahan hormon tidak dapat dihindari dan dapat dicegah melarnya kulit terutama dibagian perut, dada, dan pantat. Salah satu cara mencegahnya atau menguranginya adalah dengan menyikat kulit Anda terutama di bagian-bagian tersebut dengan sikat sangat lembut, kemudian memijatnya dengan baby oil.
l Makin dekat ke saat melahirkan, Anda akan sering terjaga pada saat malam hari. Perut yang membesar membuat Anda sulit untuk mendapatkan posisi tidur yang tepat. Sebaiknya Anda melatih pernapasan untuk persiapan kelahiran. Minuman yang hangat juga dapat menenangankan ketegangan. Campurlah air jeruk nipis ke dalam teh hangat.
l Beban fisik dan kejiwaan pada saat hamil dapat menimbulkan keputihan. Untuk mengatasi hal tersebut yakni dengan mencuci alat kelamin hanya dengan cairan pencuci bebas sabun, agar asam pelindung kulit tidak rusak. Dan pakailah pakaian yang terbuat dari kantun.
l Untuk memperlancar aliran darah ke seluruh tubuh saat hamil, dapat dilakukan dengan cara memprotkan air dingin dengan selang, mulai dari telapak kaki lalu naik ke lutut.
(arsep p/ayahbunda)
SEJAK dulu turun peranakan yang di dunia medis disebut dengan istilah prolaps genetalia telah banyak dikenal orang. Keadaan ini disamakan dengan suatu hernia yaitu di mana bagian organ bagian dalam tubuh turun ke rongga kemaluan atau bahkan mungkin keluar dari liang kemaluan tersebut.
Turun peranakan terjadi karena adanya kelemahan pada otot besar panggul sehingga satu atau lebih organ didalam panggul turun. Kerusakan yang terjadi mulanya tanpa gejala (asimptomatik), tetapi dengan bertambahnya usia maka kadar hormon estrogen dalam tubuh akan menurun dan akan menyebabkan penurunan fungsi otot sehingga keadaan tersebut menjadi bergejala.
Menurut data di RSCM Jakarta tahun 1995-2000 telah dilakukan tindakan operasi pada 240 kasus yang mempunyai keluhan dengan rata-rata 60 hingga 70 tahun, sehingga tidak mengherankan bila di Indonesia yang usia harapan hidupnya meningkat kejadian turunnya peranakan meningkat, walaupun kadang-kadang riwayat melahirkan tidak lebih dari empat kali.
Dr H Amir Fauzi, SpOG, dari Subdivisi Uroginekologi dan Rekonstruksi Departemen Obstetri dan Ginekologi FK Unsri dan RSMH, mengatakan kebanyakan wanita yang pernah melahirkan terutama yang mempunyai riwayat melahirkan empat kali atau lebih akan mengalami kelemahan otot besar panggul sehingga terjadi penurunan organ panggul yang kadang tanpa gejala tergantung beratnya kelainan tersebut.
Menurutnya, derajat beratnya kelainan adalah tergantung pada posisi organ panggul di dalam liang kemaluan. Pada keadaan ringan dan sidang (tingkat I-II) kebanyakan tanpa gejala, pada keadaan berat (tingkat III) baru dirasakan adanya keluhan. Yang perlu diperhatikan dan dipahami adalah pada keadaan ini bukan merupakan suatu penyakit tetapi kelainan letak sehingga semua turun peranakan memerlukan pengobatan dan bila memerlukan pengobatan dapat dilakukan secara konservasi atau operasi.
Turun peranakan dapat berupa turunnya kandungan kemih ke dalam liang atau organ kemaluan (uretrokel), turunnya rahim bawah dan kandung kemih kedalam liang atau rongga kemaluan (uretrovesikokel), turunnya kandungan kemih ke dalam liang atau rongga kemaluan (vesikokel), turunnya rahim beserta jaringan penunjangnya kedalam liang atau rongga kemaluan (prolapsus uteri), turunyan usus besar bagian bahwa kedalam liang atau rongga kemaluan (rektokel) dan turunnya tunggul bekas operasi pengakatan rahim kedalam liang atau rongga kemaluan (prolaps puncak vagina).
Amir, mengatakan otot dasar punggung pada dasarnya berfungsi sebagi pembatas rongga perut dan menjaga agar organ panggul berada pada posisi yang benar dan sebagai sandaran organ panggul tersebut, sehingga pada keadaan normal organ pelvis tidak turun, fungsi lainnya adalah menjaga keseimbangan tekanan udara di dalam dan di luar perut. Bila otot dasar panggul rusak, maka pertahanan terakhir dari organ panggul tersebut adalah alat penggantungnya yang menyokong organ tersebut dengn melekatkan diri pada dinding samping rongga panggul.
Keistimewaan dari otot dasar panggul adalah tetap bekerja (kontraksi) meskipun dalam keadaan istirahat sehingga tidak ada celak yang memungkinkan terjadinya penurunan alat organ genetalia. (arsep pajario)
Cara Alamiah Atasi Masalah Kehamilan
Bila saat hamil Anda mengalami berbagai keluhan sebaiknya pergi ke rumah sakit atau ke dokter kandungan dan mintalah penjelasan dokter, apakah tekanan darah Anda normal atau tinggi. Tekanan darah yang terlalu tinggi patut diwaspadai, karena bisa menjadi tAnda peringatan, mungkin Anda mengalami preeklamsia.
Penyebab lain ialah kekurangan zat besi.
Sebaiknya Anda banyak mengandung makanan yang mengadung zat besi seperti, jagung, daging sapi, telur, kacang-kacangan dan buah-buah yang menolong menyerap zat besi secara baik.l Jika tekanan darah tinggi maupun darah rendah keduanya dapat menyebabkan sakit kepala. Karena itu setiap pagi secara teratur semprotkan air dingin dengan selang ke seluruh bagian kaki, di bawah lalu ke paha dan pantat, kemudian kembali dri atas ke bawah.
Selanjutnya pada kedua belah tangan, mulai dari telapak tangan ke bahu dan sebaliknya.l Bila Anda mengalami migren yang mendadak, atau sakit kepala karena tegang, maka dengan minyak lavender ketegangan tersebut dapat diatasi. Minyak tersebut dioleskan pada leher dan kening.l Perubahan hormon tidak dapat dihindari dan dapat dicegah melarnya kulit terutama dibagian perut, dada, dan pantat. Salah satu cara mencegahnya atau menguranginya adalah dengan menyikat kulit Anda terutama di bagian-bagian tersebut dengan sikat sangat lembut, kemudian memijatnya dengan baby oil.
l Makin dekat ke saat melahirkan, Anda akan sering terjaga pada saat malam hari. Perut yang membesar membuat Anda sulit untuk mendapatkan posisi tidur yang tepat. Sebaiknya Anda melatih pernapasan untuk persiapan kelahiran. Minuman yang hangat juga dapat menenangankan ketegangan. Campurlah air jeruk nipis ke dalam teh hangat.
l Beban fisik dan kejiwaan pada saat hamil dapat menimbulkan keputihan. Untuk mengatasi hal tersebut yakni dengan mencuci alat kelamin hanya dengan cairan pencuci bebas sabun, agar asam pelindung kulit tidak rusak. Dan pakailah pakaian yang terbuat dari kantun.
l Untuk memperlancar aliran darah ke seluruh tubuh saat hamil, dapat dilakukan dengan cara memprotkan air dingin dengan selang, mulai dari telapak kaki lalu naik ke lutut.
(arsep p/ayahbunda)
Peranakan Turun, Bagaimana Mengatasinya
Republika, Minggu, 03 Juli 2005
Gangguan ini bisa menurunkan kualitas hidup. Karena itu, sebaiknya segera ditangani. Caranya cukup beragam, mulai dari pijat sampai operasi. Anda sedang hamil?
Nah, ada pesan untuk Anda saat melahirkan si jabang bayi nanti. Usahakan melahirkan si kecil dengan cara yang bagus. ''Jangan didorong-dorong waktu mengejan. Cara seperti itu bisa menyebabkan peranakan turun,'' kata dokter R Muharam SpOG, ahli kebidanan dan kandungan dari Bagian Obstetri dan Ginekologi Fakultas Kedokteran Universitas Indonesia (FKUI)/Rumah Sakit Cipto Mangunkusumo (RSCM) Jakarta.
Dalam ilmu kedokteran, peranakan turun dikenal dengan istilah prolaps genetalia. Keadaan ini disamakan dengan suatu hernia di mana ada bagian organ dalam tubuh yang turun ke rongga kemaluan. Bahkan, ada kalanya, bagian organ dalam tubuh itu sampai keluar dari liang kemaluan. ''Pada penderita peranakan turun, leher rahimnya biasanya melek.
Jadi, rahimnya turun, seperti ada daging keluar,'' jelas Muharam. Lalu, siapa saja yang berisiko mengalami hal ini? Wanita yang baru melahirkan, apalagi yang sudah berulangkali melahirkan, tergolong dalam kelompok wanita yang berisiko tinggi menderita gangguan ini. Selain itu, cara penjahitan pascaoperasi yang kurang baik, juga bisa merangsang turunnya peranakan.
Patut pula dicatat, peranakan turun ternyata tak cuma bisa diderita oleh wanita yang pernah melahirkan. Artinya, wanita yang belum pernah melahirkan pun bisa mengalami gangguan ini. ''Tapi memang, kemungkinannya kecil. Kalaupun ada biasanya didapat dari bayi.'' Umumnya, peranakan turun terjadi karena lemahnya otot besar panggul. Otot yang lemah ini mengakibatkan satu atau lebih organ di dalam panggul menjadi turun.
Ini terjadi secara perlahan-lahan. Bahkan pada awalnya, si penderita tak merasakan keluhan apapun. Namun, seiring dengan bertambahnya usia yang dibarengi dengan turunnya kadar hormon estrogen dalam tubuh seorang wanita, kondisi tersebut mulai terasa mengganggu karena fungsi otot mengalami penurunan. Karena itu, bisa dipahami bila peranakan turun biasanya dikeluhkan oleh wanita yang telah memasuki masa menopause.
Muharam menjelaskan, wanita yang pernah melahirkan, apalagi yang sudah berulang kali bersalin, berisiko tinggi mengalami kelemahan pada otot besar panggul ini. Bila ini terjadi, maka organ dalam bagian panggul bisa saja mengalami penurunan. Pada keadaan ringan dan sedang, kondisi itu umumnya tak memunculkan gejala. Pada keadaan berat, barulah si penderita merasakan beberapa gejala. Sementara berat-ringannya kelainan, sangat tergantung pada posisi organ dalam panggul (yang turun itu) di dalam liang kemaluan.
Menurunkan kualitas hidupPada derajat yang cukup berat, peranakan turun bisa menimbulkan sejumlah gejala. Ada wanita yang mengeluh, vaginanya terasa penuh. Ada pula yang mengeluh sakit pinggang. Ini terjadi karena otot penunjang rahim sudah lemah akibat kehamilan atau batuk yang lama. Hal lain yang kerap dikeluhkan para penderita adalah badan terasa tidak enak, pegal, dan buang air menjadi susah. ''Ini berakibat pada menurunnya kualitas hidup.''
Peranakan turun perlu secepatnya ditangani. Bila tidak, bisa berakibat lebih jauh sehingga organ dalam tubuh yang turun ke liang kemaluan itu harus diangkat. Artinya, penderita harus menjalani operasi. Untungnya, peranakan turun tak selalu diatasi lewat tindakan operasi. Pada stadium rendah, penanganan bisa dilakukan dengan menggunakan semacam cincin karet. ''Tapi kalau sudah keluar yang berarti sudah dalam stadium berat, harus dioperasi.''
Di luar penanganan medis, penderita peranakan turun bisa pula ditolong dengan cara diurut atau dipijat. Ini dilakukan untuk mengembalikan organ dalam tubuh yang sudah turun itu agar bisa kembali ke posisi semula. Cuma sayangnya, organ yang sudah terlanjur turun tersebut terkadang sulit dikembalikan ke posisi semula, apalagi pada penderita yang sudah berusia lanjut.
Agar tak Makin Parah
Peranakan turun berpotensi menurunkan kualitas hidup. Pada stadium yang berat, peranakan turun bisa membuat seorang wanita sulit melakukan aktivitas sehari-hari karena sakit yang dirasakan. Nah, agar keluhan ini tak makin parah, dokter R Muharam SpOG, memberikan sejumlah saran, yaitu:
* Jangan mengejan (ngeden) sembarangan dan tidak terlalu banyak batuk. Terlalu banyak batuk bisa membuat organ dalam tubuh keluar dari liang kemaluan.
* Hindari mengangkat benda atau barang yang berat.
* Jangan terlalu banyak berdiri. (bur )
Gangguan ini bisa menurunkan kualitas hidup. Karena itu, sebaiknya segera ditangani. Caranya cukup beragam, mulai dari pijat sampai operasi. Anda sedang hamil?
Nah, ada pesan untuk Anda saat melahirkan si jabang bayi nanti. Usahakan melahirkan si kecil dengan cara yang bagus. ''Jangan didorong-dorong waktu mengejan. Cara seperti itu bisa menyebabkan peranakan turun,'' kata dokter R Muharam SpOG, ahli kebidanan dan kandungan dari Bagian Obstetri dan Ginekologi Fakultas Kedokteran Universitas Indonesia (FKUI)/Rumah Sakit Cipto Mangunkusumo (RSCM) Jakarta.
Dalam ilmu kedokteran, peranakan turun dikenal dengan istilah prolaps genetalia. Keadaan ini disamakan dengan suatu hernia di mana ada bagian organ dalam tubuh yang turun ke rongga kemaluan. Bahkan, ada kalanya, bagian organ dalam tubuh itu sampai keluar dari liang kemaluan. ''Pada penderita peranakan turun, leher rahimnya biasanya melek.
Jadi, rahimnya turun, seperti ada daging keluar,'' jelas Muharam. Lalu, siapa saja yang berisiko mengalami hal ini? Wanita yang baru melahirkan, apalagi yang sudah berulangkali melahirkan, tergolong dalam kelompok wanita yang berisiko tinggi menderita gangguan ini. Selain itu, cara penjahitan pascaoperasi yang kurang baik, juga bisa merangsang turunnya peranakan.
Patut pula dicatat, peranakan turun ternyata tak cuma bisa diderita oleh wanita yang pernah melahirkan. Artinya, wanita yang belum pernah melahirkan pun bisa mengalami gangguan ini. ''Tapi memang, kemungkinannya kecil. Kalaupun ada biasanya didapat dari bayi.'' Umumnya, peranakan turun terjadi karena lemahnya otot besar panggul. Otot yang lemah ini mengakibatkan satu atau lebih organ di dalam panggul menjadi turun.
Ini terjadi secara perlahan-lahan. Bahkan pada awalnya, si penderita tak merasakan keluhan apapun. Namun, seiring dengan bertambahnya usia yang dibarengi dengan turunnya kadar hormon estrogen dalam tubuh seorang wanita, kondisi tersebut mulai terasa mengganggu karena fungsi otot mengalami penurunan. Karena itu, bisa dipahami bila peranakan turun biasanya dikeluhkan oleh wanita yang telah memasuki masa menopause.
Muharam menjelaskan, wanita yang pernah melahirkan, apalagi yang sudah berulang kali bersalin, berisiko tinggi mengalami kelemahan pada otot besar panggul ini. Bila ini terjadi, maka organ dalam bagian panggul bisa saja mengalami penurunan. Pada keadaan ringan dan sedang, kondisi itu umumnya tak memunculkan gejala. Pada keadaan berat, barulah si penderita merasakan beberapa gejala. Sementara berat-ringannya kelainan, sangat tergantung pada posisi organ dalam panggul (yang turun itu) di dalam liang kemaluan.
Menurunkan kualitas hidupPada derajat yang cukup berat, peranakan turun bisa menimbulkan sejumlah gejala. Ada wanita yang mengeluh, vaginanya terasa penuh. Ada pula yang mengeluh sakit pinggang. Ini terjadi karena otot penunjang rahim sudah lemah akibat kehamilan atau batuk yang lama. Hal lain yang kerap dikeluhkan para penderita adalah badan terasa tidak enak, pegal, dan buang air menjadi susah. ''Ini berakibat pada menurunnya kualitas hidup.''
Peranakan turun perlu secepatnya ditangani. Bila tidak, bisa berakibat lebih jauh sehingga organ dalam tubuh yang turun ke liang kemaluan itu harus diangkat. Artinya, penderita harus menjalani operasi. Untungnya, peranakan turun tak selalu diatasi lewat tindakan operasi. Pada stadium rendah, penanganan bisa dilakukan dengan menggunakan semacam cincin karet. ''Tapi kalau sudah keluar yang berarti sudah dalam stadium berat, harus dioperasi.''
Di luar penanganan medis, penderita peranakan turun bisa pula ditolong dengan cara diurut atau dipijat. Ini dilakukan untuk mengembalikan organ dalam tubuh yang sudah turun itu agar bisa kembali ke posisi semula. Cuma sayangnya, organ yang sudah terlanjur turun tersebut terkadang sulit dikembalikan ke posisi semula, apalagi pada penderita yang sudah berusia lanjut.
Agar tak Makin Parah
Peranakan turun berpotensi menurunkan kualitas hidup. Pada stadium yang berat, peranakan turun bisa membuat seorang wanita sulit melakukan aktivitas sehari-hari karena sakit yang dirasakan. Nah, agar keluhan ini tak makin parah, dokter R Muharam SpOG, memberikan sejumlah saran, yaitu:
* Jangan mengejan (ngeden) sembarangan dan tidak terlalu banyak batuk. Terlalu banyak batuk bisa membuat organ dalam tubuh keluar dari liang kemaluan.
* Hindari mengangkat benda atau barang yang berat.
* Jangan terlalu banyak berdiri. (bur )
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