Not all women with pelvic organ prolapse can be treated with pessaries. Successful fitting of a pessary depends on the amount of prolapse, the length of the vagina and the width of the vagina. If the prolapse is too severe, it will push the pessary out. Prior vaginal surgery decreases the chance of somebody being well fitted for a pessary while the use of vaginal estrogen usually improves the chance of somebody tolerating a pessary well.
Female Reproductive System Disorders
According to the Centers for Disease Control and Prevention, the female reproductive system is highly fragile and vulnerable to a number of infections, injuries, and diseases. For this reason, it is crucial to visit your doctor annually and take good care of your reproductive health. Health practices like having an annual pap smear and practicing safe sex can reduce your risk of many reproductive health problems. If you experience uncomfortable symptoms in your pelvic region including pain, itching, or unusual discharge, call your doctor. While some itching or discharge can be normal, these symptoms can sometimes be indicative of problems that need medical treatment.
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UCLA Health answeredPessaries can be used in the treatment of pelvic organ prolapse. A pessary is a device that you can put in the vagina. It looks like a diaphragm that is used for contraception. They are made of silicone and come in many different shapes and forms depending on the prolapse and the anatomy of the particular woman. They need to be fitted to work correctly.
In women that are well fit with a pessary, there’s some data to show that at one to two years, about 60% of them will describe being very satisfied with this therapy, and about 40% will want to continue this therapy in the long-term. -
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Dr. B B. Clary, MD , OBGYN (Obstetrics & Gynecology), answered on behalf of Henrico Doctors' Hospital - HCA VirginiaRobotic surgery and traditional surgery can both be used for pelvic organ prolapse. Traditional surgery typically is either done vaginally without a mesh or through a larger incision with mesh.
With traditional vaginal surgery, while minimally invasive and successful, recurrence rates may be higher and initially there may be more discomfort. This is because with traditional surgery surgeons are tightening/repairing the woman’s tissue with her own tissue.
With the traditional open procedure, a sacrocolpopexy, an incision like a caesarean section is made and a piece of mesh is attached to the front and back wall of the vagina and then to a ligament on the spine. While this is arguably the most successful treatment it can have more pain, a slower recovery and perhaps bigger complications when they do occur.
Robotic surgery has many of the advantages of the traditional open sacrocolpopexy, without the long recovery, larger incision, and with much less pain. -
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UCLA Health answeredSee All 2 AnswersThe best candidates for pelvic organ prolapse surgery are women who want definite treatment, are very active, cannot tolerate a pessary or feel the condition really affects their quality of life. There are also other options to manage symptoms.
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UCLA Health answeredObliterative techniques for pelvic organ prolapse are only indicated for some women. They are suitable for women who will never have sex in the future, or elderly women who are not great surgical candidates. For women who are well selected, there’s good satisfaction with this procedure.
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UCLA Health answeredSee All 3 AnswersPelvic organ prolapse is kind of a herniation of the organs that are supported by the vagina; prolapse occurs when these organs protrude into the vaginal canal. The protruding organ could be the bladder; in that case it’s called a cystocele. It could be the top of the vagina, which is called a uterine prolapse, or an enterocele if somebody has had a vaginal hysterectomy or an abdominal hysterectomy. If the rectum has prolapsed, it is called a rectocele.
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Asherman’s syndrome affects women of all races and ages equally, but tends to occur with increased frequency in women who have had repeated Dilation and Curettage (D&C) performed for elective medical abortion or for retained products of conception following a miscarriage, vaginal delivery or cesarean section. The prevalence of Asherman’s syndrome is thought to be approximately 20% in the general population and between 5-40% of women with recurrent miscarriage, medical termination, surgical abortion or retained products of conception. -
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UCLA Health answeredDoctors can determine the stage, or degree, of pelvic organ prolapse on a scale of 0 to 3. Stage 0 means no prolapse at all; stage 1 usually means an organ is protruding into the vaginal canal. Many women may not be aware they have this until a doctor notes it during a gynecological exam -- and it’s usually not symptomatic. Stage 2 starts giving people symptoms because it’s close to the opening or to the hymenal ring, or outside the opening of the vagina. Stage 3 is usually total eversion and is very symptomatic.
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UCLA Health answeredPessaries are an appropriate treatment for women who don't want surgery for pelvic organ prolapse but are bothered by the bulge. They're also appropriate for women who are not surgical candidates because of other medical co-morbidities, and for women who want to postpone surgery and obtain relief from their symptoms in the meantime.
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Dr. Lauren Streicher, MD , Gynecology, answeredIt's always disconcerting to have unexpected vaginal bleeding, but it's particularly unsettling when it occurs years after your uterus and ovaries have closed for business and you no longer possess a pad or a tampon. It's not just about making the midnight run for sanitary products, it's that stomach-dropping fear that "blood equals cancer" that causes women to spend hours searching the Internet for reassurance. In spite of the fact that most women imagine the worst, in the majority of cases, postmenopausal bleeding is not an indication of anything serious.
So, if you see red and you're not supposed to... what next?
The first step is to determine where the blood is coming from. Blood on the toilet paper can be coming from the vagina, rectum or bladder, and while it seems as if the source should be obvious, it's not always easy to know. When in doubt, put a tampon in (you may have to borrow one from your daughter). If the tampon stays white but there is blood in the toilet bowl, it's most likely coming from the rectum or bladder and a visit to your primary care doctor is in order.
The best time to see your gynecologist about abnormal vaginal bleeding is while you are bleeding so we can determine not only where it's coming from, but also how heavy it is. Your description helps, but I have learned over the years that one woman's spotting is another woman's hemorrhage. Many women are hesitant to be examined while bleeding, but as I overheard my nurse once say to one of my patients who was reluctant, "Don't worry. Here, everyone either arrives bleeding or leaves bleeding." Not exactly how I would have phrased it, but somewhat accurate nonetheless.