What is Prolapse? What are surgical and non surgical options for Pelvic Organ Prolapse?

Dr. Sonya Ephraim, a urogynecologist, joins Dr. Kelly Casperson on her "you are not broken" podcast to discuss pelvic organ prolapse. They talk about the unmet need for female pelvic health, the decision to specialize in female pelvic medicine and reconstructive surgery, and the impact of prolapse on quality of life.
They define pelvic organ prolapse as the displacement of pelvic organs from their normal position and discuss the need for rebranding and destigmatizing the condition.
They also explore the risk factors for prolapse, including childbirth, constipation, obesity, and smoking. The conversation covers the importance of fiber intake, the role of hormones in prolapse, and the use of vaginal estrogen and pelvic floor physical therapy for treatment and prevention.
They emphasize the need for appropriate expectations and individualized treatment plans for patients with prolapse. In this conversation, Dr. Sonya Ephraim and Dr. Kelly Casperson discuss various treatment options for pelvic organ prolapse.
They cover the use of pessaries, the potential risks and benefits of surgery, the importance of pelvic floor physical therapy, and the decision between uterine-sparing and hysterectomy procedures.
They emphasize the need for individualized treatment plans and the importance of finding a surgeon who is experienced and knowledgeable in the different surgical options. They also address common misconceptions about surgery and the importance of managing patient expectations.
Podcast Takeaways:
There is an unmet need for female pelvic health and female pelvic surgeons.
Pelvic organ prolapse is the displacement of pelvic organs from their normal position.
Prolapse needs to be rebranded and destigmatized.
Risk factors for prolapse include childbirth, constipation, obesity, and smoking.
Fiber intake, hormones, vaginal estrogen, and pelvic floor physical therapy can be used for treatment and prevention.
Individualized treatment plans and appropriate expectations are important for patients with prolapse. Pessaries can be an effective non-surgical option for managing pelvic organ prolapse, but they should be fitted by a professional to ensure proper use and minimize complications.
Surgery for pelvic organ prolapse should be tailored to the individual's specific needs and goals, taking into account factors such as health status, physical activity level, and sexual activity.
Pelvic floor physical therapy can be beneficial for mild cases of pelvic organ prolapse and can help prevent further progression of the condition.
The decision between uterine-sparing and hysterectomy procedures depends on factors such as the size and condition of the uterus, as well as the individual's sexual preferences.
It is important to find a surgeon who is experienced and knowledgeable in the different surgical options for pelvic organ prolapse, and who is willing to refer to other specialists if necessary.
Surgery for pelvic organ prolapse is generally safe and minimally invasive, with outpatient procedures and short recovery times. However, it is important to manage patient expectations and ensure appropriate post-operative care.
Not all cases of prolapse require surgery, and it is important to differentiate between clinically significant prolapse that causes symptoms and incidental findings that do not require intervention.
Keywords: pelvic organ prolapse, female pelvic health, urogynecology, quality of life, rebranding, destigmatizing, risk factors, childbirth, constipation, obesity, smoking, fiber intake, hormones, vaginal estrogen, pelvic floor physical therapy, treatment, prevention, pelvic organ prolapse, treatment options, pessaries, surgery, uterine-sparing, hysterectomy, pelvic floor physical therapy, individualized treatment, surgeon selection, misconceptions, patient expectations

[@luz5558]

My prolapse was caused when the doctor had me push out my breach baby and the placenta didn’t come out so I was put to sleep with the gas and he yanked the placenta out causing my uterus to prolapse….I was 33 at the time, I’m now 42 and you can’t imagine what I’ve gone through with that prolapse…I think I’m being punished by Gad for not being such a good person in the past…no one should have to live like this…the shame, the discomfort, the inability to empty completely…then these doctors are quick to suggest taking your uterus…well, I learned a lot from your videos, thank you…might travel to Washington just see you. Oh, and my bandy didn’t survive.

[@ladonnavietti2784]

Oh my, you ladies are amazing! I so wish I could come to you! THANK YOU for going deep in conversation about ME! I have so many questions!

[@woolridge2498]

So I just had a uterus prolapse January 23rd or 2024 with a stereo and posterior repair I opt out of getting the bladder sling so I do have the bladder leakage right now I'm in PT trying to build those pelvic walls I don't know much about the bladder Botox the doctor suggested it I really do not want mesh do you think that if I continue to do the kegels this will stop the bladder leakage?

[@deborahsimpson2732]

Sorry for the length of this comment. I see another woman had a very similar concern/question. I had a high utero sacral ligament and rectocele surgery in Oct. At first it felt great not to have "that bulge" but I feel "something" in my rectum that is making it a challenge to have a bowel movement. I asked my surgeon about this - three times now - and he just says that sometimes the rectocele surgery creates a bulge in the rectum and the stool just needs to go around it to pass. Uhh; not pleased. OK, fine. I just need to contort on the toilet to eliminate waste. Ugh. But now I have an anterior prolapse. It seems my "front" wants to fall as well. My surgeon says that the first surgery looks great and that I can wait on a second surgery without any concern. As long as I "can deal" with the prolapse (no pain and urinating fine) there is no rush. However, my defecation situation is causing my front prolapse to feel worse. In other words, when I try to go to the bathroom the pushing is not good for the prolapse. To alleviate the "straining" I take a laxative. That just brings about diarrhea, no formed stool. I've tried different types of things to help my elimination situation and getting more frustrated. I do not want to have another surgery and make my GI tract go to sleep again. Nor do I want to have a mesh (which is what my surgeon told me he would do with this second surgery) because I am fearfully afraid of any negative impact on my bladder. In fact, my surgeon for full disclosure told me that there may be some mesh visible after a few years since it may come through the muscle tissue. Huh?!! Are there any cystocele type surgeries/anterior vaginal prolapse procedures that do not involve a mesh? Any help out there besides surgical? I do Kegels and try not to sit a lot. That seems to help. Trying not to be discouraged.

[@JEANMAMMA]

I am in the UK & awaiting a Hysterectomy. & Pelvic floor repair , I have a Pessary in place at present my 3rd one since 5th April 2024 ( 1st one 5th April , 2nd one 3rd May then a few days ago 6th June 2024 ) I can only seem to hold on to them on average 3/4 weeks . My last one is a bigger one from my first ( first. 72 latest I think 89) under normal circumstances I think they should last for 4/6 months each fitting , hope I can hold it in longer. My Prolapse is severe though & it's very hard to put back by the Doctor each time & I dread the procedure every time. The Doctor who will be performing my operation ( I've been told 1 year plus waiting time ) she explained the operation , which will be a Vaginal Hysterectomy & Repair & that she will put some kind of Stitch during the Op which will be for life , she said I will be in Hospital for about a day . Maybe some of the terms & words you both use during your video sound different but may mean the same thing here , anyway I love your video & comments you both are very good in your explanations , I only wish either one of you were doing my Operation , thank you ❤❤

[@woolridge2498]

Typo surgery

[@kossysmirror348]

Se😂2, to,4