Pelvic Organ Prolapse
Pelvic organ prolapse is when one or more of the organs in the pelvis slip down from their normal position and bulge into the vagina. It can be the womb (uterus), bowel, bladder or top of the vagina. A prolapse is not life threatening, but it can cause pain and discomfort.
Cystocele is displacement of the urinary bladder such that it bulges into the front wall of the vagina.
Under normal conditions in women, the bladder is held in place by a “hammock” of supportive pelvic floor muscles and tissues. When these tissues are stretched and/or become weak, the bladder can drop and bulge through this layer and into the vagina. This results in prolapse or a slackened front wall of the vagina, also called cystocele. In severe cases, the prolapsed vaginal wall can be felt at or just inside the opening of the vagina. The symptoms of bladder prolapse include feeling the lump at the vaginal opening, difficulty in emptying the bladder properly, and when a large prolapse has been present for years, the kidney function may be affected.
Mr Alak Pal will discuss treatment options with you which may include pelvic floor exercises, local hormone treatment, vaginal support pessary to push the bladder up and keep it in position, and surgical repair.
Surgical repair consists of freeing the bladder from the vagina, replacing the bladder to its normal position and reinforcing the tissues. This procedure is called anterior vaginal wall repair or repair of cystocele.
Rectocele is displacement of the rectum such that it bulges into the back wall of the vagina.
A rectocele occurs when the thin wall of tissue separating the lower bowel (rectum) from the vagina weakens so that the lower bowel (rectum) bulges into the back wall of the vagina. It is the commonest type of prolapse that develops after childbirth. Some women with a rectocele have no symptoms. However, many women experience vaginal pressure, or the feeling that something is falling out of the vagina. Women also often report rectal pressure or fullness, or the sensation that something is stuck in the rectum, difficulty having a bowel movement, discomfort during sexual intercourse or a soft bulge of tissue that can be felt in the vagina or may protrude outside of the vaginal opening.
Mr Alak Pal will discuss treatment options with you which may include pelvic floor exercises, local hormone treatment, a vaginal support pessary to keep the rectum in place, and surgical repair.
Surgical repair consists of separating the lower bowel (rectum) from the vagina, replacing the rectum back in place and reinforcing the tissues. This procedure is called posterior vaginal wall repair or repair of rectocele.
Uterine prolapse is when the uterus (womb) slides down from its position and is low in the vagina. This occurs when pelvic floor muscles and ligaments stretch and weaken the support to the uterus which then displaces down. Uterine prolapse can happen to women of any age, but it often affects postmenopausal women who have had one or more vaginal deliveries. In severe cases, individuals can feel the cervix low in the vagina. Uterine prolapse is usually associated with backache and pelvic discomfort.
Mr Alak Pal will discuss treatment options including pelvic floor exercises, vaginal support pessaries to keep the uterus and cervix in place by stretching the upper vagina. Surgical procedure usually requires a vaginal hysterectomy to facilitate good repair of the pelvic floor ligaments.
Mostly, there is some combination of prolapse of the front and back walls of the vagina with or without uterine prolapse, and surgical repair may consist of repairs of more than one of the vaginal walls and a vaginal hysterectomy. As these procedures are done through the vagina, there is no cut on the abdomen and recovery is quicker.
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Patient seen for : Dilation and Curettage
Dr Alak Pal was great. He made me feel comfortable and explained everything clearly, including next steps. Would recommend.
Patient seen for : Hysteroscopy
Very professional and helpful in explaining everything. Helped me make an informed decision with this vast knowledge.
Patient seen for : Total Abdominal Hysterectomy
From the initial appointment, surgery, aftercare and to my final appointment, Mr Pal was extremely professional and understanding to my particular medical circumstances. The entire abdominal hysterectomy procedure was extremely satisfactory. He spent time listening to any concerns that I had and explained clearly and simply the process surrounding the surgery. I would highly recommend him for anyone contemplating such a procedure. Additionally, post-surgical care and appointments were excellent too.
Fantastic doctor, very pleased with consultation. Thanks