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Women’s Pelvic Health is a Priority

Get Back to Doing the Things You Love

As we head into the winter season, when coughs and colds abound, some women will dread catching the common cold more than others. For women who suffer from pelvic organ prolapse, the coughing that comes with a cold can make them feel like everything down there is going to fall out. Winter or summer, coughing or not, that’s what pelvic organ prolapse can feel like. It can affect a woman’s day-to-day life, causing her to retreat from activities and relationships she used to enjoy. Let’s take a closer look at pelvic organ prolapse, as well as some available treatment options that can help women get back to doing the things they love.

Made up of muscles, ligaments, and connective tissue, the pelvic floor supports several organs including the bladder, rectum, uterus, small intestine, and vagina. Over time, the muscles in the pelvic floor can weaken, allowing one or more organs in the pelvis to drop down and sometimes protrude into the vagina. This condition is called pelvic organ prolapse, which can be further classified depending on what organ has dropped. For example, cystocele is when the bladder protrudes, rectocele is when the rectum protrudes, uterine prolapse is when the uterus protrudes, enterocele is when the small intestine protrudes, and vaginal vault prolapse is when the vagina protrudes.

Symptoms of pelvic organ prolapse can range from mild to severe, and from slightly irritating to life-altering. Some of the symptoms include: a sense of pressure or heaviness in the vagina; feeling or seeing a bulge or protrusion in the vagina; urinary incontinence; pain, pressure or constipation; the inability to completely empty the bladder; and pain during sexual intercourse.

While many women do not discuss these sensitive, but treatable symptoms with their doctors or loved ones, pelvic organ prolapse affects approximately half of all women who have had children by vaginal delivery. Other factors that can contribute to prolapse include advancing age, obesity, hysterectomy, chronic straining, and abnormalities of the connective tissue.

Treatment options for women suffering from pelvic organ prolapse run the gamut and include non-invasive and surgical procedures. There are a number of non-invasive treatment options, such as diet modifications, pelvic exercises, and physical therapy that women experiencing pelvic organ prolapse should try first. Another option is a pessary, which is a rubber or plastic device that is inserted vaginally and designed to support the pelvic area when it is in place.

For some women, non-invasive therapies may not be enough. These individuals may be good candidates for minimally invasive surgeries. During surgery, the prolapsed organ is put back in place, the connective tissue is tightened, and sometimes, small pieces of synthetic mesh are used to help strengthen the weakened tissue. These surgical procedures can be performed with or without the da Vinci®, the minimally invasive surgical system that uses robotics technology.

With all treatments, the goal is to help a woman of any age regain an improved quality of life. Just like any medical condition, it’s important to make an appointment with your healthcare provider so that together, you can determine the best course of treatment based on your individual health and medical history.

Tovia Martirosian Smith, MD, is a urogynecologist at Virginia Women’s Center. She specializes in treating symptoms of urinary and fecal incontinence and difficulties from relaxation of the pelvic floor. Born and raised in Richmond, she is happy to be able to practice medicine in her hometown. Dr. Smith and her husband have two young children.
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