What Do You Mean My Pelvic Wall Can Collapse?
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.
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.
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.
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
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.