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Women’s bodies endure significant changes throughout life—pregnancy, childbirth, menopause, hysterectomy, and aging. Despite the spirit's resilience, the tissues supporting the pelvic organs can weaken under these demands. Over time, these tissues stretch and lose strength, causing the bladder, small bowel, rectum, or uterus to descend toward the vagina, a condition known as pelvic organ prolapse (POP).
Recognizing the Symptoms
Discovering that your organs are misaligned can be alarming. “Most women notice a bulge of tissue protruding from their vagina while showering or using the toilet,” says Tracy Cannon-Smith, M.D., a pelvic organ prolapse specialists in female pelvic medicine and reconstructive surgery. Some women may need to push the bulge back in to urinate or have a bowel movement, and others describe a sensation of sitting on a ball.
Additional symptoms include vaginal pain, bleeding, spotting, or a feeling similar to pulling a groin muscle. Nearly 50 percent of women will experience pelvic organ prolapse at some point. “For sexually active women, prolapse can be embarrassing and inhibit intimacy,” Dr. Cannon-Smith notes. “Fortunately, there are several ways to correct prolapse, both vaginally and robotically.”
Diagnosing Pelvic Organ Prolapse
Women with pelvic prolapse often have hidden incontinence issues. “Bladder prolapse can mask leakage,” Dr. Cannon-Smith explains. “The more the bladder drops, the more it blocks urine from leaking.”
Urodynamics testing helps identify any leakage before surgical repair. “We want to avoid restoring the bladder's position only to find it leaks with every cough or sneeze,” she says. This testing involves using a catheter to fill the bladder while capturing video and still images during filling and emptying, allowing physicians to examine the sphincter muscles and detect leakage.
Surgical Solutions
The severity of the prolapse and the organs involved determine the surgical approach—vaginal prolapse repair or robotic prolapse repair.
Vaginal Prolapse Repair
This minimally invasive method is used for less severe cases, such as cystocele (bladder bulging into the vagina) and rectocele (rectum bulging into the vagina). The repair, known as vaginal colporrhaphy with apical suspension, is done through the vagina. “I lift the bladder to its natural position and secure it using either native tissue or other biological materials,” Dr. Cannon-Smith explains. Severe prolapse can eliminate this option as the repair may not hold.
Robotic Prolapse Repair
For severe cases, robotic sacrocolpopexy is often required. This procedure involves four to six small incisions in the abdomen to lift the prolapsed organ and secure it with graft material. “Women who have had a hysterectomy or are experiencing vaginal vault prolapse benefit from sacrocolpopexy,” says Dr. Cannon-Smith. “We also perform this procedure during hysterectomies for uterine prolapse in collaboration with the patient’s gynecologist.”
Studies show a 95 to 98 percent success rate five years post-surgery for sacrocolpopexy. Both vaginal and robotic procedures typically require a one-night hospital stay. Dr. Cannon-Smith advises a one to two-week recovery period for desk jobs and abstaining from sex and strenuous activities for six weeks post-surgery. She also cautions against chronic constipation and heavy weightlifting post-repair.
Seeking Help for POP
If you are experiencing symptoms of pelvic organ prolapse, don’t endure them in silence. The experienced and compassionate specialists at Urology Partners are here to help you regain your quality of life. Call 866-367-8768 for assistance.
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