Garron R Hale, MD

DIPLOMATE, AMERICAN BOARD OF OBSTETRICS & GYNECOLOGY

Overview

Have you experienced some loss of bladder control lately? Have you felt a pressure in your pelvic area that won’t go away? Pain or discomfort during sexual intercourse? Does it constantly feel like you are wearing a tampon, and it’s falling out?

If so, you may be suffering from pelvic organ prolapse (POP), a common but rarely discussed condition in which organs in the seniors3pelvic region shift out of their normal position, or prolapse.

Pelvic organ prolapse, sometimes known as “dropped bladder,” can be uncomfortable both physically and emotionally. Women with pelvic organ prolapse tend to limit their daily activities and avoid sex because of pelvic pain and the need to urinate frequently.

What are common symptoms of pelvic organ prolapse?

  • Loss of bladder or possibly bowel control
  • Difficulty completely emptying your bladder
  • Increased need to urinate
  • Feelings of pelvic or vaginal heaviness, bulging, fullness and/or pain, or a feeling that something is “dropping”
  • Recurrent bladder infections
  • Excessive vaginal discharge
  • Pain or lack of sensation during sex

Causes of Pelvic Organ Prolapse

The organs in your pelvic area — uterus, vagina, bladder and rectum — are held in place by a web of muscles and connective tissues that act like a hammock. When this web becomes weakened or damaged, one or more pelvic organs shift out of normal position and literally “fall,” or prolapse, into the vagina.

As a result, organs may press against the vaginal wall and produce a hernia-like bulge, causing discomfort and limiting physical and sexual activity.

The major risk factor for pelvic organ prolapse is having delivered a baby vaginally. Other risk factors include:

  • Obesity
  • Menopause
  • Loss of muscle tone with aging
  • Hysterectomy
  • Genetics

Types of Pelvic Organ Prolapse

There are several different types of pelvic organ prolapse, defined by which organs are involved. It’s also possible to have more than one type of prolapse.

  • Bladder: The most common type of pelvic organ prolapse is cystocele (pronounced sis-tuh-seel) and is often called “dropped bladder.” As the front wall (or roof) of the vagina stretches or loses its attachment to the pelvis, it drops into the vaginal opening. The bladder, which rests on this area of the vagina, similarly “drops” out of position.
  • Intestines: For women who have had hysterectomies and no longer have a uterus, the intestines and the top of the vagina push into the lower vagina. This is called an enterocele (pronounced en-tro-seel).
  • Rectum: As the back wall (or floor) of the vagina loses its support, the rectum can protrude into the vaginal opening, creating a “pocket” called a rectocele (pronounced rek-tuh-seel).
  • Uterus: Prolapse of the uterus (and cervix) into the vagina is called uterine prolapse.

Stop Coping. Start Living.

Maybe you’ve been too embarrassed or confused by how you feel to seek medical help. You may even have wondered if your symptoms would just go away.

But pelvic organ prolapse is a real, common and treatable problem. Consider this:

  • About half of all women over age 50 suffer from some degree of pelvic organ prolapse.
  • One in 10 women undergo surgery for pelvic organ prolapse by age 80.

You don’t have to accept the limits that pelvic organ prolapse can put on your lifestyle.

Treatments for Pelvic Organ Prolapse

Pelvic organ prolapse (POP) can be treated with a variety of methods, including nonsurgical and surgical procedures, depending on the severity of the prolapse and the associated symptoms.

Nonsurgical treatment options

  • Behavioral/Muscle Therapy: If symptoms are mild, therapy often starts with Kegel exercises to help strengthen the pelvic floor muscles.
  • Pessary: This device can be inserted into the vagina to support the pelvic area and help relieve mild symptoms of pelvic organ prolapse, including incontinence.Dr. Hale  may recommend using vaginal estrogen along with the pessary. In some instances, a pessary may make urinary incontinence worse; if this happens, see Dr. Hale to discuss other treatment options.
  • Biofeedback: In this method, the patient exercises the pelvic floor muscles while connected to an electrical sensing device. The device provides “feedback” to help you learn how to better control these muscles.Over time, biofeedback can help you use your pelvic muscles to decrease sudden urges to urinate and lessen certain types of pelvic pain.

Surgical Options

For women whose symptoms don’t respond to nonsurgical methods, Dr. Hale may recommend pelvic reconstructive surgery. With this technique, the surgeon repositions the prolapsed organs and secures them to the surrounding tissues and ligaments.

  • Synthetic Mesh Repair: Using very small incisions inside the vagina, the surgeon repositions the prolapsed organs and secures them to surrounding tissues and ligaments using a soft mesh – a material similar to that used for abdominal hernia repair. This is an effective treatment with a success rate ranging from 87-91%, depending on the type of prolapse. Learn more.
  • Posterior and Anterior Colporrhaphy (pronounced kol-por’e-fe): These procedures involve folding and then suturing, or stitching, the back (posterior) or front (anterior) wall of the vagina to support prolapsed organs.Colporrhaphy can be effective for patients with pelvic organ prolapse; however, up to 40% of colporrhaphies fail to treat symptoms, and 29% of patients require repeat surgeries to treat their symptoms effectively.
  • Hysterectomy: A hysterectomy may be done in combination with other pelvic floor repair procedures, depending on the type of pelvic organ prolapse.  Ask us about your hysterectomy options to learn about less invasive treatments that offer shorter recovery times.

Stop Coping. Start Living.

If you’ve been told that pelvic organ prolapse is an inevitable part of getting older, you should know that you don’t have to cope with it – treatment may help.

About Us

Scottsdale North Obstetrics, Gynecology & Wellness Center is a full service practice, which includes consultation, screening and referral for a full range of treatments. We will provide care without regard to race, creed, religion, color, gender, national origin or economic status. We treat all patients and their families with compassion and consideration and provide a physical environment and facility which is attractive and conducive to patient care and comfort. Please make an appointment to see Dr. Hale today. You will enjoy his compassionate, experience, and friendly approach.

9070 E Desert Cove Ave
Building A - # 103
Scottsdale, AZ 85260
Phone 480-946-4774
Fax 480-946-4999