According to the National Association for Continence, approximately 200,000 women in the United States undergo surgeries for pelvic organ prolapse (POP).
POP is a herniation (protrusion) of the pelvic organs to or through the vaginal opening. A woman’s pelvic organs, which include the bladder, uterus, and rectum, are supported by a complex “hammock” of muscles and ligaments that attach to the bony anatomy of the pelvis. When these are weakened, those organs can drop. The history of POP dates back to 2000 BC, and was commonly associated with the physical trauma of vaginal childbirth. In addition to childbirth, risk factors also include a family history of POP, obesity, advancing age, menopause, prior hysterectomy, and conditions that result in ongoing elevation of intra-abdominal pressure, such as chronic coughing due to smoking or asthma, or constipation.
Some women have symptoms associated with pelvic organ prolapse, and some do not. Usually, a woman starts having symptoms if the protrusion extends to or beyond the vaginal opening.
POP is not life-threatening, but it can be life-altering, significantly affecting a women’s life quality. Women who experience symptoms of POP describe a feeling of heaviness or pressure in the vagina, painful intercourse, problems with urination, constipation, and urinary or stool incontinence. Frequently, women feel an increase in pressure after a long day of standing or following physical exercise. In severe cases, women describe constantly feeling a “ball” or “bulging” from the vagina.There are different forms of POP. Weakness at the front of the vaginal wall near the bladder can cause a cystocele (dropped bladder). A weak spot in the vaginal ceiling causes uterine prolapse. A defect at the backside vaginal wall, near the rectum results in a rectocele. Very often, several areas are involved. Determining the exact location of the problem is important in identifying the best course of treatment.
The good news is that we have several options for caring for patients with pelvic organ prolapse. Conservative management include pelvic floor strengthening through exercise and pessaries. A pessary is special device placed vaginally to provide organ support. It should be comfortable, but requires upkeep, removal, and cleaning on a regular basis. A local vaginal estrogen is often prescribed along with using a pessary.
Pelvic reconstructive surgery is another option for correcting the anatomy and restoring bowel, bladder, and vaginal functions. Using a minimally invasive approach, the surgery typically achieves positive long-term results. It can be performed vaginally, laparoscopically, or robotically as a same day or overnight stay procedure. Hysterectomy (removal of the uterus) may be performed as a part of pelvic reconstructive surgery, but is not always required.
Dr. Armen Kirakosyan, a board-certified urogynecologist with General Physician PC, cares for patients using the most advanced surgical procedures and technologies. This includes minimally invasive gynecology, advanced laparoscopy, single port laparoscopic surgery and robotic surgery. To make an appointment to see Dr. Kirakosyan, call 716-656-4077. Learn more at https://www.gppconline.com/armen-kirakosyan-md.