Our aging bodies can lead to aches, pains and changes most consider a normal part of life. Many women who deal with pelvic pressure or urinary incontinence are too embarrassed to ask their doctor for help.
“Prolapse is not a normal consequence of aging,” said Jason Cruff, D.O., urogynecologist with Marshfield Clinic Health System. “Based on your associated symptoms, prolapse severity and specific needs, we can tailor a treatment plan for you that may include pelvic floor therapy, pessary or surgery.”
What is pelvic organ prolapse?
Some women may experience a bothersome protrusion of their pelvic organs (including the bladder, bowel or uterus/vagina) through the vagina. This is caused by weakness of the support structures inside the pelvis that help keep organs in proper position.
Other symptoms may include:
- Pressure, discomfort and aching or fullness in the pelvis.
- Leaking urine or problems with a bowel moment.
- Problems inserting tampons or during sexual intercourse.
- Pelvic pressure that gets worse with standing or coughing or as the day goes on.
“It’s important that you talk to your primary care provider or women’s health provider to get these symptoms evaluated immediately,” said Dr. Cruff.
What are the risks?
Dr. Cruff said certain risk factors for developing prolapse include older age, obesity, chronic activities or behaviors that put stress on the pelvic floor like strenuous exercises or chronic coughing from certain lung diseases, vaginal deliveries and family history.
Some preventive actions you can take are maintaining a healthy weight, choosing nutrition with fiber to prevent constipation and straining during bowel movements, along with not smoking, which can lead to a chronic cough.
What treatment is available?
Dr. Cruff explained there are several options available to treat pelvic organ prolapse.
A pessary is a non-surgical option where a small silicone device is inserted comfortably in the vagina to keep the prolapse from coming out of the body.
Surgical options include vaginal reconstructive repairs using your own tissues, or safe and effective biologic graft to reinforce weak tissues. Hysterectomy, or removal of the uterus, may or may not be necessary, and some women prefer to retain her uterus through a procedure called hysteropexy. The Health System offers minimally-invasive robotic surgery, especially in cases of large, post-hysterectomy prolapse.
If you medically cannot undergo a long reconstructive procedure and do not desire sexual intercourse, Dr. Cruff said you may consider colpocleisis, where the vagina is completely closed.
“You will discuss treatment options with your provider to decide what works best based on your health history, symptoms and lifestyle,” Dr. Cruff said.
You do not need to suffer in silence with pelvic organ prolapse. Talk to your provider for a referral for treatments available to you.