Put Your Prolapsed Organs Back Where They Belong

Women’s bodies undergo significant changes throughout life, from pregnancy and childbirth to menopause and aging. While the spirit remains resilient, the tissues that hold the pelvic organs in place can weaken under these demands. Over time, these tissues may stretch, allowing the bladder, small bowel, rectum, or uterus to slip down toward the vagina—a condition known as pelvic organ prolapse (POP).

When Things Feel Off

It can be alarming to discover that your organs are not in their proper place! “Most women notice a bulge of tissue protruding from their vagina when they’re showering or using the toilet,” explains Dr. Tracy Cannon-Smith, A experienced pelvic organ prolapse Specialists. In some cases, women may need to push the bulge back in vaginally to urinate or have a bowel movement. Others may describe the sensation as feeling like they’re sitting on a ball.

Other signs of POP include vaginal pain, bleeding, spotting, or a sensation similar to pulling a groin muscle. Nearly 50 percent of women will experience pelvic organ prolapse at some point in their lives. “For women who are still sexually active, prolapse can be embarrassing and can hinder intimacy with their partners,” Dr. Cannon-Smith adds. Fortunately, there are several ways to address prolapse, both vaginally and robotically.

Diagnosing the Problem

Pelvic organ prolapse often masks underlying incontinence issues. “Bladder prolapse can hide leakage problems,” Dr. Cannon-Smith explains. “Typically, the more the bladder drops, the more it blocks urine from leaking.”

To identify any hidden incontinence, urodynamics testing is performed before surgical repair. This testing helps prevent unexpected urine leakage after the bladder is returned to its normal position. “Urodynamics testing uses a catheter to fill the bladder, capturing video and still images while the bladder is filled and emptied,” Dr. Cannon-Smith says. “This allows us to determine the best surgical approach for the patient.”

<h4>Surgical Solutions: Putting Everything Back Where It Belongs</h4>

Depending on the severity of the prolapse and the organs involved, surgical repair may be necessary. There are two main methods for addressing prolapse: vaginal prolapse repair and robotic prolapse repair.

Vaginal Prolapse Repair

This minimally invasive approach is generally used for less severe cases of prolapse, such as cystocele (where the bladder bulges into the vagina) or rectocele (where the rectum bulges into the vagina). The repair is made through the vagina, lifting the bladder to its natural position using either the patient’s own tissue or other biological materials. “With the vaginal repair, we can secure the bladder in place,” says Dr. Cannon-Smith. “However, if the prolapse becomes too severe, this option may no longer be viable.”

Robotic Prolapse Repair

For more severe prolapse cases, a robot-assisted procedure known as robotic sacrocolpopexy is often required. “This is especially necessary for women who have had a hysterectomy or are experiencing a vaginal vault prolapse,” Dr. Cannon-Smith explains. “Robotic sacrocolpopexy is also recommended for women undergoing a hysterectomy due to uterine prolapse, allowing us to address everything at once.”

During the procedure, small incisions are made in the belly, similar to laparoscopic surgery, to lift and secure the prolapsed organ with graph material. Studies show that five years after surgery, women who undergo sacrocolpopexy have a success rate of 95 to 98 percent.

Both vaginal and robotic procedures typically require an overnight hospital stay. Dr. Cannon-Smith advises taking one to two weeks off work for recovery, depending on the nature of the job, and abstaining from sex and strenuous activities for six weeks.

Post-Surgery Precautions

After prolapse repair, it’s essential to avoid certain activities that can strain the pelvic floor. “You don’t want to deal with chronic constipation where you’re bearing down with hard stools,” Dr. Cannon-Smith warns. “It’s also important to be cautious with weightlifting. While staying in shape is crucial, using heavy weights during exercises like squats that expose the pelvis is not advisable.”

Women facing pelvic organ prolapse can benefit from consulting with Pelvic Organ Prolapse Specialists to explore their options and find the best treatment plan tailored to their needs.