Pelvic and Vaginal Prolapse
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Pelvic Prolapse
The uterus is held in position by pelvic muscles, ligaments and other tissues. If the uterus muscles and connective tissues weaken, the uterus can drop out of its normal position, this is called prolapse. The uterus can slip to the extent that it drops partially into the vagina and creates a noticeable lump or bulge, or an incomplete prolapse. A complete prolapse occurs when the uterus slips to such a degree that some uterine tissue is outside the vagina.
Vaginal Prolapse
Pelvic prolapse is usually accompanied by some degree of vaginal vault prolapse. Vaginal vault prolapse occurs when the upper part of the vagina loses its shape and sags into the vaginal canal or outside the vagina. Pelvic prolapse may also involve sagging or slipping of other pelvic organs, including the bladder, the urethra and rectum.
Symptoms may include:
- Sensation of sitting on a small ball
- Heaviness or pulling in the pelvis
- Pelvic or abdominal pain
- Pain during intercourse
- Protrusion of tissue from the opening of the vagina
- Repeated bladder infections
- Vaginal bleeding or an unusual or excessive discharge
- Constipation
- Frequent urination or an urgent need to empty your bladder
Symptoms may worsen with prolonged standing or walking due to added pressure placed on the pelvic muscles by gravity. This condition may be caused from childbirth, previous surgeries, and obesity.
Non-Surgical Treatment Options
There are a number of non surgical options that are available for you to discuss with your physician.
- Kegel Exercises - Special exercises, called Kegel exercises, can help strengthen the pelvic floor muscles.
- Vaginal Pessary - A pessary is a rubber or plastic doughnut-shaped device that fits around or under the lower part of the uterus (cervix), helping to prop up the uterus and hold it in place. A health care provider will fit and insert the pessary, which must be cleaned frequently and removed before sex.
- Estrogen Replacement Therapy - Taking supplements of hormones such as estrogen alone or estrogen with another hormone called progesterone. Taking estrogen may help to limit further weakness of the muscles and other connective tissues that support the uterus. However, there are some drawbacks to taking estrogen, such as an increased risk of blood clots, gallbladder disease and breast cancer. The decision to use ERT must be made with your doctor after carefully weighing all of the risks and benefits.
Surgical Treatment Options
A sacrocolpopexy is a procedure in which the vagina is lifted back into its proper position using a synthetic mesh.
Prolapse surgery has traditionally been performed as open surgery. A long horizontal incision is made in the lower abdomen to access the pelvic organs. Prolapse surgery can also be performed minimally invasively – through small incisions - with laparoscopic surgery.
da Vinci® Surgery/Less Invasive Surgery
If your doctor recommends surgery to treat pelvic prolapse, you may be a candidate for da Vinci Sacrocolpopexy. Using state-of-the-art technology, da Vinci Surgery requires only a few tiny incisions, so you can get back to your life faster. The da Vinci System enables your doctor to operate with enhanced vision, precision, dexterity and control.
da Vinci Sacrocolpopexy offers several potential benefits over traditional open surgery, including:
- Significantly less pain
- Smaller incisions
- Less blood loss
- Less risk of infection
- Shorter hospital stay
- Quicker recovery and return to normal activities
- Small incisions for minimal scarring
- Better outcomes and patient satisfaction
As with any surgery, it is important to talk to your doctor about all treatment options, including the risks and benefits. This information can help you to make the best decision for your situation