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What Do You Mean My Pelvic Wall Can Collapse?

Caus­es and treat­ments for vagi­nal prolapse

A com­mon con­di­tion that many women face is called vagi­nal pro­lapse, or pelvic organ pro­lapse (POP), which occurs when one of the pelvic organs stretch­es or expands to pro­trude through the vagi­nal open­ing. Vagi­nal pro­lapse is very com­mon; affect­ing near­ly one in three women who have had a child dur­ing their life­time. And POP won’t just go away on its own.

What is Vagi­nal (Pelvic Organ) Prolapse?

Pelvic organ pro­lapse is a con­di­tion that occurs when mus­cles and lig­a­ments that sup­port your pelvic organs weak­en. Your pelvic organs include your blad­der, uterus (womb) and rec­tum. A Pro­lapse is when the lig­a­ments weak­en and cause your pelvic organs to slip from their nat­ur­al position.

Caus­es of Vagi­nal Prolapse

Gen­er­al­ly vagi­nal child­birth, espe­cial­ly those who have had mul­ti­ple preg­nan­cies, obe­si­ty, chron­ic con­sti­pa­tion, chron­ic heavy lift­ing or a pri­or hys­terec­to­my are the pri­ma­ry caus­es of vagi­nal pro­lapse. Pro­longed child labor and large babies can weak­en pelvic floor mus­cles which weak­en sup­port for the vagi­na. This is not true for all women but does occur for many who may not com­plete­ly recov­er from child­bear­ing. Menopause can also affect the mus­cle tone of the pelvic region.

Signs & Symp­toms of Vagi­nal Prolapse

Many women do not expe­ri­ence any signs or symp­toms of vagi­nal pro­lapse. Most com­mon symp­toms include:

  • Feel­ing of full­ness or dis­com­fort in their vagina
  • Vis­i­ble vagi­nal bulge or protrusion
  • Feel­ing of some­thing falling out of the vagina”
  • Dif­fi­cul­ty uri­nat­ing or defecating

Treat­ments for Vagi­nal Prolapse

As with many med­ical con­di­tions, most physi­cians start with con­ser­v­a­tive approach­es, like pelvic exer­cis­es. If the con­di­tion does not improve, or con­ser­v­a­tive meth­ods fail, there are sur­gi­cal treat­ment options available.

NON-SUR­GI­CAL OPTIONS

  • Pelvic floor exer­cis­es - these exer­cis­es help to strength­en the pelvic floor mus­cles and decrease the symp­toms of pelvic organ pro­lapse. While these may strength­en the pelvic floor, they will not fix any actu­al anatom­ic abnormality.
  • Pes­sary - a plas­tic device insert­ed vagi­nal­ly like a diaphragm to help sup­port your pelvic organs. This device can be removed at any time by you or your physician. 

SUR­GI­CAL OPTIONS

The goal of surgery would be to recre­ate the nat­ur­al anatom­ic sup­port for the vagi­na and reduce the pro­lapse through the vagina.

  • Vagi­nal approach — Vagi­nal inci­sions are made to help treat the pro­lapse, includ­ing hys­terec­to­my if applicable.
  • Abdom­i­nal approach — Typ­i­cal­ly done as a min­i­mal­ly-inva­sive surgery using the da Vin­ci robot­ic sur­gi­cal sys­tem (sim­i­lar to laparo­scop­ic surgery). Small abdom­i­nal inci­sions are made to help treat the pro­lapse, includ­ing hys­terec­to­my if applic­a­ble. Robot­ic surgery has many advan­tages over tra­di­tion­al sur­gi­cal meth­ods includ­ing less pain, less blood loss, short­er hos­pi­tal stay, short­er recov­ery time and less vis­i­ble scars.

Don’t be afraid to dis­cuss your pelvic issues with your physi­cian. There are many treat­ments avail­able to cor­rect pro­lapse issues and help you improve your qual­i­ty of life.

Health Topics:

  • Medicine is a partnership. In counseling and caring for patients, I want them to feel valued as an individual and confident in the treatment plan.