PELVIC ORGAN PROLAPSE REPAIR INFORMATION

Overview

Sometimes, does it feel like you have a mass bulging out of your vagina? Is walking or standing difficult? Is sexual intercourse painful? Do you have difficulty emptying your bladder or bowel?

You may be experiencing pelvic organ prolapse. Prolapse occurs when pelvic structures, like the bladder or rectum, bulge or protrude into the vaginal wall. Bladder prolapse is sometimes referred to as cystocele. Rectal prolapse is referred to as rectocele. Sometimes, pelvic organ prolapse is described as a hernia into the vaginal wall.

While the signs and symptoms of pelvic organ prolapse can be disturbing, it is important to know that you are not alone. As many as 14 million women in the USA suffer from prolapse.

Read on to learn about the possible causes and treatment options available to help restore your pelvic health.

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Physiology

To learn more about vaginal prolapse, it is important to understand how vaginal support normally works. The vagina is a muscular tube—elevated and attached to muscles and ligaments in the pelvis—and is the support system for the uterus, urethra, bladder and to some degree the rectum.

Vaginal prolapse is more common in women who have had a hysterectomy. Prolapse occurs when the uppermost part of the vagina—called the apex—descends because it does not have the same support that was there when the uterus was present. As a result, the vaginal apex pulls the rest of the vagina down into the vaginal canal or even outside the vagina.

Vaginal prolapse may occur alone or along with a:

Cystocele (bladder prolapse)—Occurs when the wall between the bladder and the vagina weakens, causing the bladder to drop or sag into the vagina.

Urethrocele (urethra prolapse)—Occurs when there is loss of support for the tube (urethra) that carries urine from the bladder to outside the body. It results in the tube sagging or bulging into the vagina.

Rectocele (rectal prolapse)—Occurs when there is a bulge in the lower back vaginal wall caused by the front wall of the rectum sagging and pushing against it.

Enterocele (intestinal prolapse)—Occurs when the small intestine bulges into the upper back vaginal wall.

Sometimes, these different types of pelvic organ prolapse occur simultaneously. 

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Causes

Weakened or damaged pelvic muscles and ligaments can cause pelvic organ prolapse. These structures can be weakened by:

Pregnancy
Childbirth
Menopause
Previous surgery
Obesity
Chronic heavy lifting
Coughing
Sometimes, prolapse can simply be caused by aging or genetics. Pelvic organ prolapse is experienced almost entirely by adult women.

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Signs

While many women do not have symptoms that accompany pelvic organ prolapse, some may notice a bulge or lump in the vagina or even notice the vagina protruding outside the body. Other symptoms may include:

A pulling or stretching feeling in the groin area
Painful sexual intercourse
Vaginal pain, pressure, irritation, bleeding or spotting
Urinary and fecal incontinence
Difficulty with bowel movements
Delayed or slow urinary stream

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Effects

Despite its prevalence, pelvic organ prolapse is not often discussed. As a result, many women are unaware of the condition. Pelvic organ prolapse, however, can seriously limit lifestyles, activities and relationships because of the discomfort associated with the prolapse. That might mean refraining from sexual intercourse, limiting physical activity, and coping with the unpredictability of urinary or fecal incontinence.

If you are suffering in silence from pelvic organ prolapse, it is important to understand that it doesn't have to be that way. Products designed to be effective and provide a long-term solution are available.

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Treatment

Depending on the type of pelvic prolapse you are experiencing and its severity, there are a number of treatments available. Talk to your doctor about the treatment that is right for you.

Non-surgical treatments
Depending on the severity of the prolapse, your doctor will prescribe different therapies. They might include the following.

Kegel exercises help strengthen pelvic floor muscles and may help relieve some symptoms of minor prolapse. These exercises involve identifying the pelvic floor muscles that purposely interrupt the flow of urine in midstream, and then tightening these muscles for three seconds and relaxing them for three seconds. Kegel exercises are commonly repeated 10 to 15 times per session, at least three times per day.

A vaginal pessary is a device that is placed into the vagina to support surrounding structures and is similar to the outer ring of a diaphragm. Like a diaphragm, a pessary usually is made of silicone and is fitted by your doctor.

Surgical treatments

Sometimes, surgery is needed to repair prolapse. These usually are performed under regional or general anesthesia. Surgical options include:

Sacral Colpopexy—A surgical procedure that attaches one end of mesh to the top of the vagina and the other end to the upper part of the tailbone or lower part of the spine.

Straight-In™ from AMS is a repair system designed to treat vaginal vault prolapse in an open or laparoscopic procedure.

Graft Augmented Repairs—Some surgeons will utilize a synthetic or biologic graft to augment their prolapse repairs because the tissue has been weakened and needs to be reinforced.

InteXen™ is a biologic graft made from porcine dermis that is used in prolapse repairs.

IntePro™ is a soft, large pore synthetic mesh that is used in prolapse repairs.

Prolapse Repair Systems

AMS has developed two revolutionary prolapse repair systems that take graft augmented vaginal surgery to a new level by standardizing minimally invasive approaches to restore function.

Apogee™ is a vaginal vault suspension procedure. When combined with IntePro or InteXen apical and posterior wall repairs can be made.

Perigee™ is a surgical solution for bladder prolapse (cystocele) that is performed vaginally using InteXen or IntePro.

Information from  www.AmericanMedicalSystem.com

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