Pelvic organ prolapse is a fact of life for 1 in 3 women who have gone through childbirth, menopause or a hysterectomy.

It occurs when pelvic muscles become too weak to hold up a woman’s bladder, uterus or rectum, causing the organ to drop. Unfortunately, countless women suffer silently with its symptoms.

“Pelvic organ prolapse can severely impact physical activities and enjoyment of life. Sadly, many women do not seek medical help because they’re too embarrassed to talk about it,” said gynecologist Dr. Brian Nelson during a free health lecture held on Jan. 25 at the Boulder Jewish Community Center. “If you’re suffering, it’s important to get help.”

Symptoms of Pelvic Organ Prolapse

Dr. Nelson said symptoms of pelvic organ prolapse can include the following:

• The feeling of sitting on a small ball
• Frequent urination or inability to empty your bladder
• Difficulty emptying stool
• Difficult and painful sex
• Repeated bladder infections
• Protruding tissue
• Sensation of heaviness or pulling in the pelvis
• Lower backache
• Stress urinary incontinence (unintentional loss of urine during sudden movement or physical activity such as laughing, sneezing or running)

"Sometimes symptoms develop slowly. Other times it is abrupt, and women feel a sudden pop or tear," Dr. Nelson said. “Also, exercise tends to worsen the symptoms, especially running or jumping.”

What Causes the Organs to Prolapse?

According to Dr. Nelson, the number one risk factor for pelvic organ prolapse is vaginal delivery, which can cause damage to supporting pelvic tissues.

Other causes include:
• Loss of estrogen when aging
• Chronic coughing
• Frequent straining during bowel movements
• Obesity

How Is Pelvic Organ Prolapse Treated?

There are a variety of treatments for reducing the symptoms. They include physical therapy that focuses on proper pelvic floor muscle strengthening; biofeedback and electrical stimulation; adaptive measures such as aggressively treating constipation; or a vaginal pessary, which is an internal support device that holds the uterus in place.

Dr. Nelson added, "Estrogen cream can also sometimes help. It makes the skin become more elastic, moist and thick and can potentially make a woman more comfortable.”

Surgical Treatment Options

About 11 percent of women with pelvic organ prolapse end up in surgery. Called sacrocolpopexy, the surgery involves using the patient’s own tissue or a mesh to lift and repair the dropped organ. The surgery can be performed through one large incision or minimally invasively using traditional laparoscopy or da Vinci® robotic surgery.

“The da Vinci is a robotic-assisted surgical device. The surgeon is 100 percent in control of it at all times,” Dr. Nelson said. “With the da Vinci, I can operate through a few small incisions using miniature instruments that translate my hand movements into smaller, precise movements. It also has a tiny, high-definition, 3D camera that allows for depth perception, which is a capability a surgeon doesn’t have with traditional laparoscopic surgery.”

Compared to open surgery, da Vinci sacrocolpopexy offers important benefits, including significantly less pain, less blood loss, less scarring, shorter surgery recovery time and a faster return to normal daily activities.

If you suffer from symptoms of pelvic organ prolapse, schedule a consultation with Dr. Brian Nelson by calling 303-776-1234.

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