Pelvic Health and the Pelvic Floor
What is the pelvic floor?
The pelvic floor is a group of muscles that form a sort of “hammock” across the pelvic opening that keeps the pelvic muscles in place.
What are some common problems with the pelvic floor?
Pelvic organ prolapse – or POP – is common in many women. Fortunately, there are ways to treat it, but first let’s define this condition. POP occurs when the pelvic floor becomes weak, stretched, or torn, causing the pelvic organs to slip out of place and bulge out of the vagina. There are several different types of prolapse: uterine, vaginal vault, bladder, rectal, small bowel, and urethral.
Treatments of Pelvic Organ Prolapse (POP)
Non-surgical Options
If your symptoms are mild, your doctor may suggest that you:
- Watch and wait
- Do daily Kegel exercises, which can help strengthen your pelvic floor muscles
- Make lifestyle changes - if you’re overweight, smoke, or suffer from chronic constipation
- Try a vaginal pessary, a small device inserted into the vagina to support any bulging issues
- Physical therapy (PT) with a trained therapist to help target weakened muscles
Surgical Options
If you’ve tried nonsurgical options without success, your doctor may explore some of these less-invasive surgical procedures:
Uterosacral Ligament Suspension – This is performed through the vagina using your own tissues. If you experience urinary incontinence, a procedure to prevent that may also be done simultaneously.
Sacrospinous Fixation – This procedure is also done through the vagina. Stitches are placed into a strong ligament in the pelvis (the sacrospinour ligament) and then to the cervix and the vaginal vault. Eventually, these stitches are replaced by scar tissue, which then supports the vagina or uterus. This is often combined with a vaginal hysterectomy and/or other prolapses or stress urinary incontinence.
Coporrhaphy – Also performed through the vagina, this procedure repairs bladder or rectal prolapse by reinforcing or repairing your own tissues.
Sacrocolpopexy – This involves attaching the vaginal vault to the sacrum using surgical mesh. This can be done laparoscopically, using a robotic-assisted system, or through open abdominal surgery.
Know that you’re not alone. In fact, about 1/3 of all women will be affected by prolapse or similar conditions in their lifetime. And don’t be afraid to be completely open with your doctor about your symptoms. It’s important that she or he has all the facts to accurately diagnose you and move forward with an effective treatment plan.
