Pelvic Organ Prolapse generally occurs when pelvic organs like uterus, bladder & others prolapse or drop from normal place inside lower belly & push against the wall of vagina. Common problem among women the world over, this usually happens when muscles holding the pelvic organ in place get stretched or weakened due to childbirth or from surgery. Many women are found to have some type of pelvic organ prolapse during their lifetime. However, it is not any big health issue as such, since it does not always get worse, but even seems to get better with time in some women.
Pelvic Organs Susceptible to Prolapse
More than one pelvic organ is susceptible to prolapse at the same time. Organs which can be involved in pelvic prolapse in women include the following.
- Small Bowel
Bladder is the most common type of pelvic organ prolapsed noticed among women the world over. Pelvic organ prolapse is mostly linked to straining during childbirth. Pelvic organs are normally kept in place by tissues & muscles in lower belly. These muscles can stretch or get weakened during childbirth. However, in case they cannot recover, they will also not be in a position to support pelvic organs anymore. Many women also get pelvic organ prolapse in case they have undergone hysterectomy surgery so as to remove uterus. Removal of uterus can sometimes leave other organs within the pelvis with lesser support.
Pelvic organ prolapse is also made worse by something which exerts pressure on the belly including conditions listed below.
- Obesity – being excessively overweight
- Long – Lasting Cough
- Pelvic Organ Tumors
- Frequent Constipation
- Older Women – are more likely to have pelvic organ prolapse
- Pelvic organ prolapse also runs in families
Symptoms of Pelvic Organ Prolapse
- Feeling pressure from pelvic organs pressing against the wall of vagina. This is one of the most common symptoms of pelvic organ prolapse.
- Feeling extremely full inside lower belly.
- Feeling like something is falling out of vagina.
- Feeling stretched or pulled inside groin area.
- Feeling of pain in lower back.
- Incontinence – release of urine without intention or frequent need to urinate.
- The pain inside vagina during sexual intercourse.
- Persistent problems like constipation with bowels.
Diagnosing Pelvic Organ Prolapse
Doctors will ask a wide range of questions to patients regarding symptoms, health problems & pregnancies to women. They will also conduct a physical examination which will invariably include a pelvic exam. Decisions about treatment will, however, be based upon which pelvic organs have prolapsed & how severe the symptoms are. In case symptoms are mild, patients may be allowed to work at home so as to help themselves feel better. Many symptoms can also be relieved by adopting newer & healthier habits. Patients can try special exercises called Kegels which can make their pelvic muscles stronger. Obese patients can lose weight & maintain at a healthy level. Pelvic organ prolapsed patients must, however, avoid lifting heavy loads which put stress on their pelvic muscles.
Tests to Determine Pelvic Organ Prolapse
Some additional tests may be necessary for some situations beyond the visit to the hospital. Patients must ask their healthcare providers as to why each test is necessary so that they can understand different decisions which are being made about management options. Some tests which are commonly conducted for pelvic organ prolapse include the following.
- Bladder Function Test – Some tests are so simple like finding out whether bladder leaks while it is put back in place during the physical examination. Other tests may measure as to how well the patient’s bladder is emptying. Observing these tests can help doctors determine as to which is the most appropriate type of management for pelvic organ prolapse.
- Pelvic Floor Strength Test – Doctors commonly test the strength of patient’s pelvic floor & sphincter muscles at the type of physical examination. This involves testing the strength of ligaments & muscles which support the bladder, urethra, rectum, uterus & vaginal walls.
- MRI – Magnetic Resonance Imaging – MRI will basically create a detailed 3-D image of the patient’s pelvis & is therefore only useful in complex cases.
- Ultrasound – This will just help doctors view patient’s bladder, kidneys & muscles around anus & is, therefore, useful only in specifically complex cases of pelvic organ prolapse.
Types of Surgery for Pelvic Organ Prolapse
- Surgery to repair damaged tissue which supports prolapsed organ.
- Surgery to support tissue in & around a vagina.
- Surgery to close the opening of the vagina.
- Hysterectomy – surgery to remove the uterus.
It is also possible that pelvic organ prolapsed can return even after undergoing surgery. Nevertheless, performing Kegel exercises can make pelvic muscles stronger & which will help patients recover faster following surgery. This combination can effectively make patients successfully recover than surgery alone.
Treatment Options for Pelvic Organ Prolapse
Treatment for pelvic organ prolapse will generally depend upon the severity of symptoms. When prolapse does not bother patients, healthcare providers might recommend treatment without surgery. Only when symptoms get worse & significantly affect the quality of life of patients, option for surgery may be required. Weakness in pelvic floor most often affects more than just one area. Like for example, when patients develop symptoms of one type of prolapse, they are most likely to develop other types in case the first is left untreated. Therefore, pelvic floor specialists make sure to correct all prolapse-related issues at the same time.
- Medications – Many women suffering from pelvic organ prolapsed are also in menopause. Since menopause results in producing lower levels of estrogen, it effectively leads to dryness in vagina. When vaginal dryness is a problem with menopausal women they should discuss estrogen replacement therapy with their healthcare providers. Moreover, some women may also be treated with estrogens prior to a surgical intervention. However, as some women should not be using estrogen, therefore it would be sensible for pelvic organ prolapse patients to discuss risks & benefits with doctors.
- Physical Therapy – Physical therapy is most often recommended for women with pelvic organ prolapse. It commonly includes pelvic floor exercises using biofeedback in order to strengthen specific muscles located on the pelvic floor. Biofeedback typically involves using monitoring devices with sensors which are placed inside the vagina of patients or upon the skin. When patients perform an exercise, a computer screen allows doctors to see whether the patient is using the right muscles & strength of each squeeze or contraction so that the patient can eventually learn how to exercise properly. Long-term strengthening of pelvic floor muscles is the most important factor in reducing symptoms of pelvic organ prolapse. Biofeedback effectively teaches women how to use their own muscles so as to keep them strong.
- Pessaries – In case patients still have symptoms, doctors may decide to fit a device called pessary which can help women with pain & pressure caused by pelvic organ prolapse. Pessaries are silicone devices which come in a variety of sizes & shapes. They are removable devices which are placed inside the vagina of pelvic organ prolapse patients in order to hold the pelvic organ in place. Many women prefer nonsurgical options for prolapsed pelvic organs. However, women suffering from severe prolapse may find it troublesome to keep this pessary in place.
Surgical Intervention for Pelvic Organ Prolapse
Surgery in many cases can be an ideal treatment option for women experiencing serious symptoms of pelvic organ prolapse. But women who are planning to have children may want to delay undergoing surgery as the strain of childbirth may cause pelvic organ prolapse to come back. Surgeons associated with IndianMedTrip might either use vaginal approaches or other minimally invasive laparoscopic surgical techniques including robot-assisted surgery to treat many types of pelvic organ prolapse in women. Minimally invasive surgical methods allow surgeons to make small incisions & which can also shorten stay at the hospital for patients. Patients should, therefore, talk to surgeons as to why one procedure may be better for them than another & the type of surgical approach is planned including the type of materials which will be used. Women should also make it a point to ask surgeons about long-term success for the planned procedure.
Women may most likely want to consider surgery for pelvic organ prolapse in the following conditions.
- When they are having unbearable pain due to the prolapsed organ.
- When they are having problems with their bladder & bowels.
- When pelvic organ prolapse is making it hard for them to enjoy sexual intercourse.
Surgical Strategies for Various Types of Pelvic Organ Prolapse
Different surgical strategies for various types of pelvic organ prolapse invariably depend upon the location of prolapse.
- Posterior Prolapse – Posterior pelvic organ prolapse often involves the rectum & is medically termed rectocele. Surgeons will secure connective tissue between vagina & rectum of patients as a treatment in order to reduce a size of the bulge. Surgeons during this procedure will also remove excessive tissue.
- Anterior Prolapse – Anterior pelvic organ prolapse most often involves the bladder & is medically termed cystocele. Surgeons will push the bladder up & secure connective tissue between bladder & vagina of patients so as to keep the bladder in the right position. Surgeons during the procedure will also remove excessive tissue. Moreover, for patients having urinary incontinence, surgeons may also recommend a sling or bladder neck suspension in order to support the urethra.
- Uterine Prolapse – For women who are not planning to have more children, surgeons most often recommend hysterectomy surgery to remove uterus in order to correct uterine prolapsed.
- Vaginal Vault Prolapse – Medically called Apical Prolapse, pelvic organ prolapse is at the apex in women who have undergone hysterectomy surgery in the past. This is also known as Vaginal Vault Prolapse. It is a type of pelvic organ prolapse which might involve the rectum, bladder & more commonly the small bowel where the bulge is known as enterocele. Surgeons in this condition might perform corrective surgery through the abdomen or vagina. For the vaginal approach surgeons will use ligaments supporting the uterus so as to correct the problem. The abdominal approach, which is most often performed laparoscopically, robotically or as open surgery procedure, surgeons will attach vagina to tailbone along with small portions of synthetic mesh which is utilized to help support vaginal tissue. This is a particular type of surgery which is clinically known as Sacrospinous Fixation. Sometimes, other vaginal vault suspensions are also recommended. Patients must, however, talk to surgeons about the use of synthetic mesh materials in case they have concerns.
Pelvic Organ Prolapse Aftercare
Women must remember that pelvic organ prolapse surgery only repairs bulging of tissue. Therefore, surgery is not required in case the bulge is not bothering them. Moreover, recurrent pelvic organ prolapse is also quite common as surgery is unable to repair the underlying weakened tissue. Pelvic organ prolapse generally results from weakened pelvic floor tissues which create a bulge which is looking like hernia. Everything which can be done so as to stop weakening of these tissues is protective against the bulge getting worse, or a possibility of returning after surgical repair.
Precautions to be Taken
- Quit smoking
- Loose excessive weight
- Strengthen core & the pelvic floor
- Treat conditions which strain the pelvic floor – like a constipation & chronic cough
Why Choose IndianMedTrip for Pelvic Organ Prolapse Surgery?
- A wide spectrum of specialists works with IndianMedTrip so as to provide patients the best care for their medical problems. A multidisciplinary team of healthcare experts associated with IndianMedTrip is trained in female pelvic floor medicine & reconstructive surgery which includes both urologists & gynecologists who evaluate & treat different kinds of pelvic organ prolapse. Treatment options with IndianMedTrip include both, nonsurgical & surgical interventions.
- Highly skilled surgeons associated with IndianMedTrip treat thousands of women every year with pelvic organ prolapse, from all around the world. These surgeons have extensive experience with repairing procedures & which includes minimally invasive techniques requiring small incisions. This will eventually result in faster recovery along with shorter stays at the hospital.
- IndianMedTrip mission is to find & share the best medical expertise in the subcontinent. This means that they are in close contact with people who are researching to discover better methods so as to diagnose & treat different forms of pelvic organ prolapse. IndianMedTrip patients are therefore destined to benefit from important research & that every patient’s treatment would eventually contribute to future knowledge.
- IndianMedTrip doctors take time to listen closely so that they get to know the case better & completely alleviate patient’s concerns. They will also explain the options patients have in plain language. Experience has shown that understanding & considering issues raised by patients simply works better in developing an effective treatment plan.
Affordable Treatment for Pelvic Organ Prolapse in India
Over the past two decades, India has emerged as a leading destination for medical tourism by providing high quality of healthcare solutions at reasonable prices. While costs of healthcare around the world have skyrocketed, Indian healthcare services are still comparatively affordable. Featuring a healthcare infrastructure which is at par with the best in the world, there are many doctors & surgeons in the country who have initially trained in western countries like the UK, Canada & United States, but have now returned to settle in their homeland. IndianMedTrip is a globally reputed medical tourism company based in South Asia which is associated with the best hospitals & top doctors in the country providing a variety of low cost healthcare solutions including pelvic organ prolapse surgery to people from all around the world. Providing seamless services to international patients, IndianMedTrip services begin with the first telephonic conversation & go on to identifying the ideal hospital & expert surgeon, assisting in obtaining medical visa, warm welcome reception at airport, convenient travel, comfortable accommodation, scheduled appointments & treatment sessions, exotic recuperative vacations, follow-up evaluation & a successful farewell when patients fly back home.