Understanding Pelvic Floor Prolapse
The pelvic floor is a group of muscles and tissues supporting your bladder, bowel, and other pelvic organs. With age, childbirth, chronic straining, or other stressors, these muscles weaken. When they weaken enough, organs can descend into the vagina (prolapse). This causes pressure, bulging sensation, pain, and sometimes urinary or fecal symptoms. Dr. Libby evaluates pelvic floor prolapse and offers treatments from conservative to surgical.
Symptoms of Pelvic Floor Prolapse
- Bulging or heaviness in the vagina or perineum
- Pressure or full feeling in pelvis, worse with standing or exertion
- Difficulty with bowel movements or urination
- Lower back or pelvic pain
- Urinary or fecal incontinence
- Sexual dysfunction or pain with intercourse
- Visible bulging mass at the vaginal opening
Types of Pelvic Organ Prolapse
- Cystocele: Bladder descends into vagina
- Rectocele: Rectum descends into vagina
- Enterocele: Small intestine/bowel descends
- Uterine prolapse: Uterus descends (in women with uterus)
Evaluation
Dr. Libby examines you while standing and straining to assess prolapse degree. Imaging (pelvic ultrasound or MRI) can help in complex cases. He evaluates your urinary and bowel function to understand which symptoms relate to prolapse versus other conditions like overactive bladder.
Treatment Options
Conservative Treatment (First-Line):
- Pelvic floor physical therapy—often very effective for mild to moderate symptoms
- Pessary—removable device placed in vagina to support organs; simple and effective for many
- Weight loss if overweight
- Avoiding straining and heavy lifting
- Treatment of chronic cough or constipation
Surgical Treatment (If Conservative Fails or Symptoms Severe):
- Robotic-assisted sacrocolpopexy—anchors prolapsing organs back to sacrum with mesh; excellent long-term support
- Vaginal repair procedures—traditional approach, less durable than sacrocolpopexy
- Hysterectomy with pelvic reconstruction—if uterus involved and hysterectomy appropriate
Recovery & Outcomes
Most women with conservative treatment improve significantly. Those choosing surgery recover well with robotic sacrocolpopexy offering durable results and low recurrence. Sexual function typically improves after successful treatment. Dr. Libby helps you choose the best option for your situation and goals.