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Pelvic Organ Prolapse

Pelvic Organ Prolapse

Types of Prolapse

  • Anterior vaginal wall or cystocele,  

  • Posterior vaginal wall or rectocele, 

  • Apical prolapse either uterine prolapse or post-hysterectomy,

  • Bowel prolapse or enterocele.

  • It leads to a sensation of a bulge, pressure, heaviness, feeling of a balloon or sitting on a ball, difficulty and incomplete bowel or bladder emptying, urinary frequency, urgency, incontinence,  and lower back and abdominal discomfort.  POP is linked to childbirth, obesity, genetic factor, advancing age/ menopause, the lifestyle of repetitive heavy lifting, chronic cough, or constipation

Treatment options

Depends on the degree of bother and the degree/severity of the prolapse, including: 

Observation, lifestyle/behavioral modification, and physical therapy

  • Vaginal device (Pessary)

  • Surgery: 

    • Apical suspension like sacrocolpopexy that can be done robotically, or via vaginal route like uterosacral and sacrospinous fixation,    

    • Colporraphy or repair of the cystocele/anterior wall, rectocele/posterior wall, enterocele, perineorraphy

    • Obliterative procedure: colpocleisis  for women who do not desire to maintain sexual function

  • These surgeries are outpatient, meaning the patient will go home the same day with oral pain medications for 3-5 days. Return to work varies from 1-4 weeks depend on the type of the physical activity and baseline health of the patient.

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