header

Pelvic Organ Prolapse

Throughout a woman’s lifetime, her body undergoes tremendous changes and challenges. The strain of pregnancy.  The effort of childbirth.  Even the potential trauma of certain gynecologic surgeries-  hysterectomy.  All of these potential stress factors – accumulated over the years – can weaken the natural support structures of the pelvis, causing problems such as but not limited to  a feeling of vaginal fullness, chronic constipation, urinary incontinence and pelvic organ prolapse, Any combination of these may require pelvic reconstructive surgery to repair.

The symptoms of a weakened pelvic floor can range from mild to debilitating, and can affect your ability to lead an active life – and even maintain sexual intimacy. There are many non-surgical and surgical options which can correct problems associated with pelvic organ prolapse, and help restore a better quality of life.

This site is not intended as a substitute for professional medical advice. Only your physician can diagnose; advise you, and appropriately treat your symptoms. Be sure to speak with your doctor about today’s treatment options and help you choose the one that is right for you.
 
 

Frequently Asked Questions

What is pelvic reconstruction?

Pelvic Reconstruction is a surgical procedure to repair prolapse and relieve its symptoms. It’s often performed vaginally, and it typically involves the use of an implant to reinforce the strength of your weakened tissues. It’s a safe and effective procedure, and is highly successful in correcting the problems associated with prolapse, and in helping restore a better quality of life.

Who performs pelvic reconstruction?

Gynecologists, uro-gynecologists, and urology surgeons are all surgeons who specialize in pelvic reconstruction.

Will I have to stay in the hospital overnight?

Pelvic Reconstruction is often minimally invasive, which means the procedures can be done through the vagina. Sometimes an overnight hospital stay is required, but often you can return home that same day.

Is pelvic reconstruction right for everyone?

Different women experience different types of prolapse. For some, pelvic reconstruction might not be the right treatment—for example, since pregnancy and vaginal childbirth can cause a recurrence of the prolapse after surgical repair, it’s usually best to wait until childbearing is complete before surgically correcting your prolapse. Your doctor can tell you what the best treatment is for your type of pelvic organ prolapse.

What are the benefits of pelvic reconstruction?

Quite simply, pelvic reconstruction can restore the natural anchoring to a certain degree, relieve the bothersome—and often devastating—symptoms of pelvic organ prolapse and can help restore a better quality of life for you. Sexual intimacy may be resumed without pain; continence may be restored; and regular bowel habits may return.

Is there anything I can do to prevent pelvic organ prolapse?

  • Maintain a weight that is appropriate for your body size and eat a balanced diet
  • Don't smoke
  • Correct constipation
  • Avoid repetitive heavy lifting and jumping
  • Do Kegel exercises every day

How is pelvic organ prolapse diagnosed?

Your doctor can diagnose pelvic organ prolapse through a simple pelvic exam.

What are some of the symptoms of pelvic organ prolapse?

The symptoms of pelvic organ prolapse can range from mild to debilitating. They include:

  • A feeling of pelvic pressure, or feeling as if something is actually falling out of the vagina
  • A low backache
  • Painful intercourse
  • Urinary incontinence
  • Difficulty with bowel movements
  • Feeling of fullness in the vagina
  • Prolapse of one or several organs

What causes pelvic organ prolapse?

There are many factors that can cause pelvic organ prolapse—chief among them are pregnancy, hysterectomy and vaginal childbirth. Other factors that increase the risk of developing pelvic organ prolapse include:

  • Age
  • Smoking
  • Obesity
  • Chronic constipation
  • Heavy lifting
  • Pelvic surgery
  • Pelvic organ cancers
  • Diseases of the nervous system

 
 

Questions to Ask Your Doctor

  • What type of prolapse do I have?
  • What will happen if my prolapse is not treated?
  • What treatment choices do I have?
  • What is the likelihood that prolapse will return after pelvic reconstruction?
  • What type of anesthesia, if any, will I need for this procedure?
  • How much will my treatment cost?
  • What is the risk for complications and what types of complications are possible for this particular surgery?
  • Will I need to stay overnight in the hospital?
  • How much time will I need to fully recover?
  • Is there anything I won't be able to do after treatment, like sports?
  • How many of these types of procedures have you completed? What's your success rate?

UNDERSTANDING THE DISEASE

What is Pelvic Organ Prolapse?
What Causes Pelvic Organ Prolapse?
What are the different types of pelvic organ prolapse?
Cystocele
Rectocele
Enterocele
Vaginal Vault Prolapse
Uterine Prolapse
How is Pelvic Organ Prolapse Treated?
Surgical Treatments

What is Pelvic Organ Prolapse?


The vagina and pelvic female organs and their surrounding structures (bladder, rectum, etc.) are attached to the pelvis bones by connective tissues such as muscle ligaments, tendons and fascia. These tissues help form walls around the vagina and ensure the functions but also that normal urinary voiding and bowel movements can occur. As the pelvic muscles and other supporting structures become weak  the connective tissues can fail, allowing pelvic structures like the bladder or rectum to bulge into the vaginal wall. Pelvic Organ prolapse can worsen over time, This can cause the following symptoms:
  • A feeling of vaginal fullness, heaviness, or even pain
  • Pain or discomfort during intercourse
  • Loss of bladder control
  • Involuntary urination or inconsistent urinary stream
  • Difficulty with bowel movements
  • Recurrent urinary infections

What Causes Pelvic Organ Prolapse?


Pelvic muscles, ligaments and connective tissues which have been weakened with age are the primary causes, but many other factors may play a role. These may include vaginal childbirth, previous vaginal surgeries, menopause, smoking, diabetes, obesity, a history of heavy lifting, chronic coughing, and chronic constipation. Sometimes pelvic organ prolapse can be caused simply by genetic factors.

What are the different types of pelvic organ prolapse?

When vaginal prolapse occurs, an organ has dropped (prolapsed) out of its normal position and can sometimes even protrude from the vagina. The definition of pelvic organ prolapse is different depending on what anatomic structure in the pelvis is pushing into the vagina, such as the bladder or rectum. When vaginal prolapse occurs, the upper part (apex) of the vagina has dropped to a lower position. It is possible for more than one organ to prolapse into the vagina at the same time.

The different types of pelvic organ prolapse:

  • Cystocele
  • Rectocele
  • Enterocele
  • Vaginal Vault Prolapse
  • Uterine Prolapse

Cystocele

Cystocele (pronounced “sis’to-sel”)

A cystocele occurs when the bladder falls into the vagina. As the connective tissue in the front wall (sometimes referred to as the roof) of the vagina fails, its attachment to the pelvis may be lost, allowing the bladder to drop into the vagina. This is the most common form of pelvic organ prolapse and is often called a “dropped bladder”.

Rectocele

Rectocele (pronounced “rek’to-sel”)

A rectocele occurs when the rectum falls into the vagina. Similar to the cystocele, when the connective tissue in the rear wall (the floor) of the vagina fails, the rectum can then bulge into, or even out of, the vagina. As the rectum bulges upward, this can cause difficulty or pain during bowel movements.

Enterocele

Enterocele (pronounced “en’ter-o-sel”)

An enterocele occurs when the small intestines push the back of the vagina toward the opening. This usually occurs in conjunction with another form of prolapse and is repaired during the same procedure.

Vaginal Vault Prolapse

Vaginal Vault Prolapse

In women who have had a hysterectomy (surgical removal of the uterus), the natural support structures in the vagina provided by the uterus no longer exist. The top portion of the vagina can then push down into the lower vagina, causing vaginal vault prolapse.

Uterine Prolapse

Uterine Prolapse

For women who still have a uterus, the support structures holding the uterus in place can also be compromised, allowing the uterus to fall down into the vagina. This is called uterine prolapse.

 

How is Pelvic Organ Prolapse Treated?

The best treatment for a specific type and severity of pelvic organ prolapse will vary from patient to patient. If your symptoms are mild, the doctor may recommend lifestyle changes, Kegel exercises to strengthen the pelvic muscles, or the use of a pessary to relieve the symptoms. When the symptoms are severe enough to affect your quality of life, your physician may recommend surgery.

Non-Surgical Treatments

Kegel Exercises

  • Your physician may suggest an exercise program of repeated contractions of the muscles of the pelvic floor, called Kegel exercises/. These muscles are identified as those that can be used to halt the flow of urine. Routine exercising of these muscles will help build strength and maintain elasticity in the pelvis.

 

Pessary Devices

  • A pessary is a device that is worn in the upper portion of the vagina similar to a diaphragm, and is designed to support the surrounding tissues. Your physician will determine the appropriate size and design of the pessary that will best support your prolapse.

 

 

Surgical Treatments

Surgical Treatments

Traditionally physicians have used sutures to sew weakened tissues back together. Sometimes, a piece of graft material (man-made or natural tissue) can be used to reinforce these repairs.

Vaginal Vault or Uterine Prolapse repair with graft (Sacrocolposuspension)

Are there risks with a procedure using synthetic mesh materials?

As with any surgical procedure, the prolapse repair procedure itself has the risk of certain complications such as the use of anesthesia, the surgical approach used, and how pre-existing conditions may affect the outcome. Your physician can further explain your specific risks and can provide a list of warnings associated with the procedure.

In addition, there are risks associated with the use of a permanent synthetic mesh. There is a risk that the mesh material will protrude into the vagina causing difficulty and pain with sexual intercourse. Complications can also include localized fluid collection (blood, pus, clear serous fluid), erosion of the graft into surrounding tissues, infection, inflammation, pain, tightening of the repair (resulting in pain), perforation of neighboring tissues or organs, urinary incontinence and recurrence of vaginal wall prolapse. Given the permanency of synthetic mesh, post-procedure removal of the implant may be difficult. Additionally, repair of prolapse using synthetic mesh materials should not be undertaken if you are pregnant or may become pregnant.

If you experience any complications, please notify your physician immediately. Speak with your physician regarding his/her experience with this procedure, and the anticipated probability of any of these complications.

This site is not intended as a substitute for professional medical care. Only your physician can diagnose and appropriately treat your symptoms.

GLOSSARY

The following terms will help you understand what your doctor tells you about your urinary incontinence, and your possible treatment.

View glossary terms

Bard Medical is excited to announce
the acquisition of Rochester Medical

Bard Medical and Rochester Medical are coming together,
combining quality, innovative products and services
to better serve Clinician and Patient needs.


For information about Bard Medical Home Care products. Click here

For information about MAGIC 3® Hydrophilic Catheters. Click here