Pelvic Prolapse: Common But Treatable
By Melissa Edwards, MD
Some of life’s most pleasurable activities—laughing, exercising, dancing—can cause embarrassment to women with pelvic prolapse disorders. These conditions can result in urinary incontinence or leakage, as well as frequent urination and difficulty emptying the bladder or bowels. The good news is that women don’t need to live with the discomfort and embarrassment of these symptoms. Many treatments are available for pelvic prolapse, including lifestyle changes, physical therapy and surgery.
The pelvic floor, made up of ligaments and muscles, supports the pelvic organs, including the bladder, vagina, uterus, rectum and small intestines. The ligaments can be damaged during vaginal childbirth or during heavy lifting. Often, the damage doesn’t become apparent until a woman is in her late 40s or early 50s, when the breaks in ligaments become bigger and the pelvic muscles can no longer compensate. In such cases, the pelvic floor prolapses—or relaxes—resulting in descent of the organs. The onset of symptoms of pelvic prolapse may be sudden or gradual. While pelvic prolapse is more common in women with vaginal deliveries, it affects about 15 percent of all women, including those who had C-sections and those who never had children.
Some of the early symptoms of pelvic prolapse include urinary incontinence, a feeling of pressure or fullness in the vagina, a bulge from the vagina (which could be the bladder, uterus or rectum) or difficulty emptying the bladder or bowels. Women may experience one, several, or all of these symptoms.
If you experience any of these symptoms, see your gynecologist. We’ll start with a detailed medical history and a physical exam. We’ll do specialized testing tailored to your particular symptoms. Based on the results of our testing, we can discuss possible courses of treatment. Here’s a brief outline of some of those options:
If you experience the embarrassment or inconvenience of pelvic prolapse, don’t suffer in silence. Be sure to talk with your Women’s Care physician about treatment options that will get you dancing and laughing confidently again!
Melissa Edwards, MD, is a Women’s Care gynecologist with a special interest in urogynecology.
Some of life’s most pleasurable activities—laughing, exercising, dancing—can cause embarrassment to women with pelvic prolapse disorders. These conditions can result in urinary incontinence or leakage, as well as frequent urination and difficulty emptying the bladder or bowels. The good news is that women don’t need to live with the discomfort and embarrassment of these symptoms. Many treatments are available for pelvic prolapse, including lifestyle changes, physical therapy and surgery.
The pelvic floor, made up of ligaments and muscles, supports the pelvic organs, including the bladder, vagina, uterus, rectum and small intestines. The ligaments can be damaged during vaginal childbirth or during heavy lifting. Often, the damage doesn’t become apparent until a woman is in her late 40s or early 50s, when the breaks in ligaments become bigger and the pelvic muscles can no longer compensate. In such cases, the pelvic floor prolapses—or relaxes—resulting in descent of the organs. The onset of symptoms of pelvic prolapse may be sudden or gradual. While pelvic prolapse is more common in women with vaginal deliveries, it affects about 15 percent of all women, including those who had C-sections and those who never had children.
Some of the early symptoms of pelvic prolapse include urinary incontinence, a feeling of pressure or fullness in the vagina, a bulge from the vagina (which could be the bladder, uterus or rectum) or difficulty emptying the bladder or bowels. Women may experience one, several, or all of these symptoms.
If you experience any of these symptoms, see your gynecologist. We’ll start with a detailed medical history and a physical exam. We’ll do specialized testing tailored to your particular symptoms. Based on the results of our testing, we can discuss possible courses of treatment. Here’s a brief outline of some of those options:
- Lifestyle changes—We can often get positive results simply by altering things patients do on a daily basis. For instance, chronic constipation can be treated with medication to reduce strain on the pelvic floor. We can change voiding patterns, and discuss what kinds and types of fluids to drink. We can train the bladder through Kegel exercises to reduce incontinence. And we can help patients avoid heavy lifting, which weakens the pelvic ligaments.
- Physical therapy—Several physical therapists in our community specialize in rehabilitation of the pelvic floor.
- Use of a pessary—A soft, flexible device similar to a diaphragm, a pessary is inserted in the vagina and holds things in place. Typically, it’s inserted in the morning and removed and cleaned at night.
- Surgery— Only 5 to 8 percent of all women in the U.S. have surgery to treat incontinence. The vast majority of women with urinary incontinence are able to deal with their symptoms nonsurgically. Often my patients ask, “How will I know if I need surgery?” I tell them that the answer is completely personal. Pelvic prolapse isn’t life threatening; instead it’s life altering. It’s up to each patient to decide when her symptoms interfere with her life enough to warrant surgery. That said, there are a wide variety of surgical techniques available to treat pelvic prolapse, ranging from simple outpatient vaginal procedures to more complex abdominal surgeries. In general, our goal for surgery is to restore the patient to her normal lifestyle.
If you experience the embarrassment or inconvenience of pelvic prolapse, don’t suffer in silence. Be sure to talk with your Women’s Care physician about treatment options that will get you dancing and laughing confidently again!
Melissa Edwards, MD, is a Women’s Care gynecologist with a special interest in urogynecology.
