PELVIC ORGAN PROLAPSE AND FEMALE UROLOGY

 

Using state-of-the are techniques and equipment, our doctors at Cleveland Urology Associates offer hope to those suffering from urinary incontinence and pelvic organ prolapse, from the simplest problem to the most complex. Our doctors are recognized leaders in developing new treatments for female urology conditions for over 30 years. They have pioneered many of the innovations that today are the standards of care worldwide for such conditions as urinary incontinence, pelvic floor disorders, vaginal and uterine prolapse and voiding dysfunction.
 
Our goal is to provide compassionate, individualized care to women suffering from these conditions and restoring their quality of life as optimally as possible. We work closely with our referring physcians to help patients conquer incontinence. To ensure high quality care, we follow the clinical practice quidelines for urinary incontinence developed by the Agency of Health Care and Research.
 

What is pelvic organ prolapse?

Do you have an uncomfortable feeling of bulging, dropping, or pressure in your vagina?

This condition is called pelvic organ prolapse – common, but rarely talked about female health problem.

Normally the vagina and uterus are supported by and also secured to the pelvis by network of muscles, ligaments and connective tissues. As pelvic floor muscles weaken, this support system weakensor collapses causing the pelvic organs to fall out of normal position into the vagina.

What causes pelvic organ prolapse?

 

How common is pelvic organ prolapse?

 

Different types of pelvic organ prolapse?

There are several different types of prolapse, which are defined by what area of the vagina is weakened. Often a woman can have more than one type of prolapse.

  • Cystocele
  • Rectocele
  • Uterine Prolapse
  • Vaginal vault Prolapse
  • Enterocele

 

Prolapse of the bladder (Cystocele)

When the front wall of the vagina weakens, the bladder and urethra which rest on this area of the vagina, can sag through the layers of muscles and ligaments into the vagina. This defect is called a cystocele or cystourethrocele or the bladder drop. The sagging bladder will appear at the vagina’s opening and can even protrude through it and can come outside the vagina.

 
Rectocele

When back wall of the vagina loses its support, the rectum can sag into the vagina, called rectocele. Sometimes it may come outside the vaginal opening.

Uterine prolapse

When the top of the vagina weaken, uterus may fall into the vagina – called uterine prolapse

Vaginal vault prolapse

This occurs in women who have had hysterectomy and have no uterus. Because of lack of support at the top of the vagina. The top or the dome of the vagina pushes into the lower vagina.

Enterocele

Where top or dome of the vagina sags into the lower vagina, parts of intestines may sag also into the vagina, called enterocele

All these prolapses have several stages:
1st degree – mild
2nd degree – moderate
3rd degree – severe

What are the symptoms?

 

How is it diagnosed?

Complete medical, gynecological and obstetrical history
Physical examination, including a thorough pelvic exam
Q-tip test
Cystoscopy
Urodynamic evaluation
Ultrasound

Treatment options

Pelvic organ prolapse is rarely a life threatening condition
Not all women with pelvic organ prolapse have symptoms that require treatment
Patients with mild symptoms may be managed conservatively:

 

Surgical treatment

Treatment varies depending on the type of prolapse
If a woman develops symptoms of one type of vaginal prolapse, she is likely to have other types as well. The typical strategy is to correct all defects
The traditional pelvic reconstructive surgery is performed through the vagina or abdominally, either using an open incision or through laparoscopy. During the procedure, prolapsed organs are secured to the surrounding tissues and ligaments by placation, and many times the uterus is removed. However, this type of treatment is associated with very high risk of recurrence (up to 40 to 60% of recurrence are at the same site.
At Cleveland Urology Associates, our urologists have pioneered a new revolutionary surgical procedure in which a specially designed supportive soft mesh is placed in the pelvis to restore pelvic support.
They have performed hundreds of these procedures with excellent outcomes and minimal complications. They also teach other urologists and gynecologist the techniques of this unique minimally invasive surgical procedure.

How is this procedure different from traditional surgical procedures?

 

PATIENT INSTRUCTIONS

Before the operation

We will schedule the operation at the hospital of your choice
Hospital will call you to arrange for pre operative testing and evaluation (EKG, chest x-ray, and blood tests)
Please do not eat or drink any thing after midnight the night before your surgery
You may take your regular medications with a sip of water
Please do not take aspirin or any blood thinning medications for 7 days

On the day of your procedure

 

After the procedure when you are home

 

Are there any risks or complications?

All medical procedures present risks
Complications are rare, they include: