Pelvic Organ Prolapse
Ask the average woman about female pelvic health concerns like urinary incontinence or fibroids and she ’ s likely to have at least a basic knowledge of these conditions . But ask her about pelvic organ prolapsed , and she may be stumped .
Pelvic organ prolapsed occurs when pelvic structures , like the bladder or rectum , bulge or protrude into the vaginal wall . Often women describe it as a feeling that something has “ fallen .” In addition to the sensation of feeling an uncomfortable bulge in the vagina , you can experience symptoms such as :
• Pain or pressure in the pelvis , the lower back , or both
• Urinary problems , like urine leaking or the feeling that you need to constantly urinate
• Constipation
• Painful sex
In the case of vaginal vault prolapsed , it is more common in women who have experienced vaginally delivered childbirth or have had a hysterectomy . It occurs when the uppermost part of the vagina , called the apex , descends because it doesn ’ t have the same support that was there when the uterus was present . As a result , the apex pulls the rest of the vagina down into the vagina canal or even outside the vagina .
The pain and discomfort with prolapsed can be considerable . Often , women will refrain from sexual intercourse because of discomfort , limit physical activity and even encounter difficulty when urinating . However , it isn ’ t usually a big health problem and it doesn ’ t always get worse . And in some women , it can get better with time .
More than one pelvic organ can prolapsed at the same time . Organs that can be involved when you have pelvic prolapsed include the :
• Bladder
• Urethra
• Uterus
• Vagina
• Small blowel
• Rectum
How prolapse is named depends on which organ is affected :
• Cystocele Prolapse - is when the bladder protrudes into the vagina , creating a bulge . It ’ s the most common form of prolapse .
• Rectocele Prolapse - is when the rectum bulges into the back wall of the vagina .
• Uterine Prolapse - involves the uterus dropping into the vagina .
Treatments available for prolapse depend on the type of prolapsed that is presenting and its severity . Pelvic floor exercises called Kegel exercises or a vaginal pessary device placed in the vagina to support surrounding structures are two traditional , non-surgical treatments .
Surgery is an option for women who aren ’ t comfortable with the idea of using a pessary or who have tried it and found it didn ’ t relieve their symptoms . Surgery for prolapsed has made considerable strides in recent years and physicians can now offer a number of longterm surgical solutions . Many use a mesh , either synthetic or biologic or both , to provide support for the organs necessary to restore the vagina to its normal anatomical position .
Mesh is soft and has large pores designed to allow your body tissue to grow into it , providing a framework of support . The use of surgical mesh is not new . It has been used in surgery for many years .
For those women who have more than one type of prolapsed , all can often be repaired during one surgical procedure .
The best news about pelvic organ prolapsed is that women do not have to live with it or its associated pain and discomfort . New surgical options are available that are safe and highly effective . Your gynecologist can assess your case and decide with you a great treatment option .
DALLAS COUNTY Living Well Magazine | MARCH / APRIL 2017
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