There are a number of problems associated with the pelvic floor that a woman may experience during her lifetime. Some of these problems are the direct result of carrying and bearing children. Others may be due to aging. Regardless of the cause, treatment by a urogynecologist may be necessary in order to find relief.

Pelvic prolapse is the relaxing or dropping of the pelvic organs. Women may experience prolapse of the uterus, urethra, vagina, bladder or rectum. Also called genital prolapse, some common symptoms include pain during intercourse, a low backache, a feeling of pelvic pressure or of something falling out of your vagina, spotting or bleeding of the vagina, urinary incontinence and difficult bowel movements.

There are a variety of ways to treat pelvic prolapse and its symptoms.

• Pelvic floor (Kegel) exercises – These exercises are used to strengthen the pelvic muscles. Weak pelvic muscles can contribute to problems associated with pelvic prolapse.
• Lifestyle changes – Smokers should try to quit. Smoking causes chronic coughing, which can lead to loss of control of the bladder in cases of acute urinary incontinence. It also helps to maintain a healthy weight, as excess weight can put undo strain on the pelvic muscles.
• Absorbent pads or undergarments – While not a cure, these products provide a way to manage urinary incontinence that is satisfactory to some women.
• Pessaries – This is a plastic device similar to a diaphragm that fits into the vagina and helps prop up the uterus.
• Medication – Certain medications may be helpful in treating some types of urinary incontinence. Medication is often combined with behavioral methods, such as bladder training and timed voiding, in order to increase effectiveness.
• Surgery – In severe cases of pelvic prolapse when other treatment options fail to provide relief, surgery may be recommended. Surgical options may include strengthening or repairing stretched ligaments, reconstructive surgery of the entire pelvic floor or hysterectomy.

In some cases, surgery to treat pelvic prolapse can be performed laparoscopically. Laparoscopic surgery is minimally invasive since it requires much smaller incisions than traditional surgery. Often this means shorter recovery times with less pain and fewer complications.

David Jaspan, DO, has special expertise in performing minimally invasive gynecologic surgery.

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Glossary Terms:

Laparoscopic surgery– A laparoscope is a thin, hollow tube with a light and magnifying lens on one end. During laparoscopic surgery, the surgeon makes a small incision (cut) and inserts the laparoscope into the body so he or she can view the internal organs. The surgeon then uses surgical instruments to perform the necessary procedure through the same or other small incisions.

Bladder training– In this behavioral method, a schedule for urinating is established with the goal of increasing the length of time between urinating.

Timed voiding– This is a behavioral method that sets a schedule for voiding (urinating) based on a person’s habits.

Urethra– The tube through which urine leaves the body.

 

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