What is pelvic prolapse?
Pelvic prolapse is a condition that affects women and is often the result of childbirth, but also can be related to aging, straining from chronic constipation, or prior pelvic surgery. Basically, prolapse is when the pelvic organs drop down from their normal anatomic locations due to weakening of the supporting structures.
This often affects the bladder (cystocele), rectum (rectocele), small intestine (enterocele), or uterus (uterine prolapse). patients with significant pelvic prolapse often complain of a bulging sensation in the vagina and prolapse may also lead to urinary symptoms such as incontinence or in some cases, difficulty urinating or having bowel movements.
How is pelvic prolapse diagnosed?
Pelvic prolapse can be diagnosed with a physical examination including a pelvic exam and urinary issues related to prolapse can be better evaluated with urodynamics. During urodynamic studies in patients with prolapse, the test is often performed with and without a pessary which is a small ring that reduces the prolapse temporarily. This helps to mimic how the patient's bladder will function after corrective surgery.
How is pelvic prolapse treated?
The treatment of significant pelvic prolapse typically requires surgery and the procedure depends on the type of prolapse. For many women, prolapse surgery will often include a hysterectomy. The majority of prolapse surgery is performed trans-vaginally so there are no external scars, but occasionally, a lower abdominal incision is necessary for more severe cases. For a prolapsed bladder (cystocele), a synthetic mesh is often placed to help restore support to the bladder and prevent a recurrence.