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15.2: Life Style Intervention

  • Page ID
    15662
  • Several studies have addressed the association of heavy lifting and strenuous physical activity in the causation of pelvic organ prolapse. Jorgensen and colleagues compared the incidence of surgery for prolapse in 28 619 Danish nursing assistance compared to a staggering 1652533 female population controls. The nursing assistants occupation constantly exposed them to repetitive heavy lifting. He found that these nursing assistants where 1.6 times more likely to undergo surgery than their controls. This study did not however adjust for parity and other contributing factors. In another study by Spernol et al they found that 68% of women with prolapse reported heavy to medium work compared to 0% of controls. Again there was no adjustment for parity, mode of delivery, or other contributing factors.

    Body weight was also considered a risk factor in the British Oxford Family Planning Association Study. All of these studies unfortunately were cross -sectional studies and do not control for parity, degree of prolapse or other confounding factors.

    Constipation and a history of irritable bowel syndrome were strong and independent risk factors for symptomatic prolapse in an epidemiological trial done by Guri Rortveit et al. This association between constipation and prolapse has not been observed in other studies that included the condition as a potential risk factor for prolapse. Straining with chronic constipation may damage the pelvic floor; alternatively, constipation may be a symptom of posterior prolapse. This was however, a cross-sectional study and did not allow any inference about causal relationships.

    There is no conclusive evidence that lifestyle changes are going to improve the degree of prolapse or the symptoms associated with the prolapse.

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