Pelvic Prolapse Treatment in Los Angeles

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What Is Pelvic Organ Prolapse?

Pelvic organ prolapse, commonly referred to as pelvic prolapse or vaginal prolapse, is common in women. Although most patients have no symptoms, it can be quite distressing.

Symptomatic patients frequently complain of:

  • A bulge at the opening of the vagina
  • Generalized discomfort or irritation
  • A full sensation in the vagina
  • Trouble evacuating bowels or bladder
    • Urinary urgency & frequency
    • Inability to empty the bladder
    • Incontinence
    • Urinary tract infections

What Causes This Condition?

Common causes of prolapse include:

  • Pregnancy and childbirth
  • Age (postmenopausal)
  • Genetic predisposition
  • Prior hysterectomy or pelvic surgery
  • Obesity

What Are the Signs of Pelvic Organ Prolapse?

Individuals who experience one or more of the following symptoms may be dealing with pelvic organ prolapse:

  • Pressure from the pelvic organs against the vaginal wall
  • “Full” feeling in the lower belly
  • Pulling or stretching
  • sensation in the vagina
  • Lower back pain
  • Pain in the vagina during sex
  • Constipation or other bowel problems

Risk Factors

  • Obesity
  • Constipation
  • Smoking
  • Past Pelvic Surgeries
  • Nervous System Diseases
  • Inherited Genetic Factors
  • Pregnancy & Childbirth
  • Hysterectomy

Should I Consider Surgery?

If you do not have symptoms, you may be able to continue without surgery. However, below are some common symptoms that may point to surgery being your ideal option.

  • Bulge of tissue inside or outside the vagina
  • Pulling sensation or increased pressure when you lift or strain
  • Sensation that something is falling out of the vagina
  • Significant lower back pain or pelvic pain
  • Sex becomes difficult or painful
  • Irregular spotting or bleeding from the vagina occurs
  • Bowel movements become exceedingly difficult
  • Incontinence, frequent urination, or constant urge to urinate
  • Post-pregnancy incontinence

Pelvic organ prolapse is a serious problem, and failure to address this issue may cause symptoms to worsen over time. By scheduling a consultation with Comprehensive Urology, you can meet with an expert urologist and take the first step to getting back on track.

Types of Pelvic Prolapse and Treatment Options

Cystocele

Also known as anterior prolapse or prolapsed bladder. This condition occurs when the wall between a woman’s bladder and her vagina is weakened. This then results in the bladder dropping into the vagina. Due to the compromise, the bladder may bulge through the vaginal opening and cause women discomfort and problems emptying the bladder.

Symptoms of Cystocele

  • Vaginal bulging
  • Heaviness, fullness, or pressure in the pelvis
  • Difficulty and incomplete urination
  • Frequent or urgent urination
  • Tissue protruding from the vagina
  • Stress incontinence
  • Frequent bladder infections
  • Painful intercourse
  • Low back pain

Cystocele Treatment

If symptoms are not too bothersome, we may advise you to avoid heavy lifting or straining activity. The reason is that these can cause a cystocele to worsen. If symptoms are noticeably bothersome, a vaginal pessary may hold the bladder in place.

For more advanced cystocele symptoms, surgery may be the best option. Using modern methods, we can move and keep the bladder in a better position. After surgery, patients normally stay in the hospital for several days. The full recovery period can last about four to six weeks.

Rectocele Prolapse

We fully understand how embarrassing and troubling rectocele can feel. As such, we strongly believe in providing only the most advanced and effective care possible. We focus on preserving quality of life and sexual function just as much as we strive the achieve the best possible outcomes.

Also known as a posterior prolapse, a rectocele occurs when the rectum presses against the front wall of the vaginal canal. In severe cases, the tissue bulges into the vagina as a hernia.

Fortunately, most women who have developed this may not even notice the condition or suffer any uncomfortable symptoms. Unless a patient feels pain or discomfort, many women do not need to undergo treatment.

However, it is important to have the condition examined by an experienced urologist. An expert can determine the severity of the prolapse and whether treatment is recommended.

Rectocele Prolapse Symptoms

In most cases, women are unaware that they have developed a rectocele. They simply do not experience any symptoms. However, particularly in severe cases of posterior prolapse, the following symptoms may occur:

  • Feeling pressure within the vagina
  • Pain or discomfort during evacuation
  • Pain or discomfort during intercourse
  • Feeling that something is falling out within the pelvis
  • Constipation
  • Incomplete defecation
  • Vaginal bleeding
  • Tissue bulging out of the vagina

Rectal prolapse can be diagnosed through a pelvic exam. The strength of the vaginal and rectum walls may be evaluated with a digital exam. And the patient may be asked to provide a stool sample.

Repairing Rectocele

Each treatment entirely depends on the severity of the condition and the patient’s health and symptoms. Treatment may be as minimal as increasing water intake and eating a high-fiber diet. A rectocele does not necessarily need to be treated if the patient does not experience negative symptoms. The most common non-surgical treatments include:

  • Pelvic floor strengthening exercises
  • Stool softeners
  • Pessary (a silicone rubber device worn inside the vagina to support tissues)

When non-surgical treatments fail, surgery may be necessary.

  • Rectocele Surgery 
  • Laparoscopic Rectocele Repair

Recovering from Repair of a Rectocele

The recovery process typically requires only pain management and anti-over-the-counter inflammatory medication. Following the procedure, most women can return home on the same day as the operation. However, abdominal procedures will require hospitalization of 2-3 days.

Vaginal Vault Prolapse

Vaginal vault prolapse is a common condition that affects women typically after a hysterectomy. After this procedure, the pelvic and vaginal tissues and muscles are weakened. This can cause the upper portion of the vagina to lose its normal structure. The upper portion of the vagina then drops into the vaginal canal or outside the vagina.

Symptoms of Vaginal Vault Prolapse

  • Backaches
  • Heaviness or pressure in the pelvis
  • Recurrent bladder infections
  • Enlarged vaginal opening
  • Protrusion of tissue from the vaginal opening
  • Abnormal or excessive discharge from the vagina
  • Urinary incontinence (involuntary release of urine)
  • Frequent and urgent urination
  • Difficulty emptying the bladder
  • Constipation
  • Vaginal bleeding

Treatment Options

Vaginal vault prolapse can be treated non-surgically or surgically. It is best to consult with your medical health professional to understand all your options and decide which method is best for you.

Non-surgical treatment options:

  • Pelvic floor exercises
  • Vaginal Pessary
  • Estrogen Replacement Therapy

Surgical Treatment

During a surgical treatment for vault prolapse, the top portion of the vagina is attached to an anchor point. This could be the:

  • Lower abdominal wall
  • Lower back spine
  • Or the ligaments of the pelvis

General anesthesia is administered for this type of procedure. Most women are required to stay in the hospital from one to two days after surgery. After six weeks, most women can return to normal activities, including sexual intercourse.

Robotic Vault Suspension

Vaginal vault prolapse can cause a variety of uncomfortable and even painful symptoms. The condition occurs when the muscles and ligaments that support the upper portion of the vagina are weakened. This causes the apex of the vagina to drop. It can potentially fall as far as the vaginal canal or even outside the body through the vaginal opening.

In most cases, this is so mild that women do not experience symptoms. However, mild to severe cases may need robotic surgery to repair and secure the vaginal vault. Our skilled urologists are proud to offer the most minimally-invasive surgical treatment using the state-of-the-art da Vinci Surgical System.

Types of Robotic Vaginal Vault Suspension Procedures

Robotic Sacrocolpopexy: This procedure involves surgically securing the vagina with mesh.

Robotic Uterosacral Ligament Suspension: Secures the vagina with the patient’s own ligament tissue, rather than a synthetic mesh.

What Are the Benefits of Robotic Vaginal Vault Suspension?

The da Vinci robot offers the following benefits compared to traditional open surgery:

  • Reduced blood loss and less need for transfusions
  • Less pain
  • Less risk of infections
  • Reduced scarring
  • Shorter hospital stay
  • Quicker recovery

The da Vinci surgical robot offers surgeons a 3D view of the surgical site. At the same time, it allows greater freedom of instrumentation movement and improved surgical ergonomics.

Enterocele Small Bowel Prolapse

Enterocele is a type of rectal prolapse. It occurs when the supporting tissue between the rectum and the uterus causes the small bowel to protrude through the rectum wall. The small bowel descends into the lower pelvic cavity. There it presses on the top part of the vaginal canal and creates a bulge. In mild cases, patients may not even be aware of the condition. However, more significant cases may include vaginal pain and discomfort.`

What are the symptoms?

  • Pulling sensation in the pelvis that relaxes when sitting or lying down
  • Lower back pain that is alleviated by lying down
  • Vaginal or pelvic discomfort
  • Pain during intercourse (dyspareunia)
  • A soft bulge in the vaginal wall
  • Sensation of pressure, pain, or fullness in the pelvis

What are the treatments?

Numerous treatment options are available for small bowel prolapse. The ideal treatment takes into consideration factors such as:

  • The stage of the prolapse
  • The severity of the symptoms
  • Age and overall health of the patient
  • Whether the patient is planning on having children in the future

Medical or conservative treatment options include:

  • Pelvic floor strengthening exercises
  • Pessary (A silicone rubber device that is worn inside the vagina to help support the uterus, rectum, or bladder)
  • Hormone Replacement Therapy
  • Enterocele Repair
  • Laparoscopic Prolapse Repair

Schedule Your Consultation

The sooner you take care of pelvic prolapse, the better. Our team of expert urologists is here to provide your ideal treatment for an optimal outcome. Schedule your consultation today to get started on your personalized treatment plan at Comprehensive Urology.