It is a tradition for Vermont Gynecology to have one or more relay teams running in the VCM, so we were sorry that the race had to be postponed this year due to Covid-19. When Memorial Day came around recently, we remembered fondly the lovely race day from last year and dusted off some pictures from that day. We look forward to seeing VCM runners and supporters on the course again some time in the future. But in the meantime, let’s all find other ways to stay active and healthy!
Pelvic Organ Prolapse – Frequently Asked Questions
What is prolapse?
Pelvic prolapse can occur when pelvic connective tissue and muscle tear or weaken. This can cause the pelvic organs to fall into the vagina, much like a hernia. This is referred to sometimes as a “dropped bladder”, “dropped uterus,” or “dropped rectum.” Your provider may have also called this a cystocele, rectocele, or enterocele. You may see or feel a bulge coming out of your vagina.
What causes pelvic prolapse?
Prolapse is caused by a weakening of the vaginal tissue. It is associated with pregnancy and childbirth although can happen in women who have never had children. Prolapse is also associated with aging and menopause, repetitive heavy lifting and conditions that result in chronic cough, chronic constipation, poor tissue, and genetics.
What are the symptoms of prolapse?
Common symptoms of prolapse include pressure from a protrusion or bulge in the vagina which may become more bothersome after walking or standing for long periods of time. It can also cause vaginal dryness, irritation, or spotting from rubbing against clothing. It’s also common to experience urinary incontinence, trouble urinating or with bowel movements, and sexual dysfunction.
How severe is my prolapse?
Many women can have minor prolapse with minimal to no symptoms. For some, their prolapse worsens over time. Your provider will take a complete history and perform a physical examination to determine the severity of your prolapse. For most, the option to treat depends on how much they are bothered by their symptoms. Treatment options range from pelvic floor exercises or physical therapy or exercises, pessary devices, and surgery.
How is pelvic prolapse treated?
Treatment can be categorized into non-surgical and surgical options.
Non-surgical treatment includes pelvic floor exercises which can strengthen the pelvic muscles and improve mild symptoms. Patients can see a specialized therapist who will use a variety of techniques to improve symptoms. A pessary can also be offered as a non-surgical option. This is a device that can be inserted into the vagina in order to lift and prevent the bulge from coming down. Pessaries come in different shapes and sizes and can help with different degrees and types of prolapse. They are fitted by a provider, typically a gynecologist or a urogynecologist.
Regarding surgical options, there is no single best approach for all patients. Your particular surgical approach will depend on many factors. Your surgeon will discuss the various options with you and will recommend the type best suited to your condition and needs.
– Jeanette Rivera, MD, FACOG, FPMRS
VTGyn is Weathering the Covid-19 Storm
We couldn’t be more proud of how our team has functioned during the current pandemic. As soon as it became clear for public health reasons that we should scale back in-person patient care to urgent office visits only in Mid-March, we did. And we quickly pivoted to telehealth to care for our patients remotely. Everyone gamely and capably worked from home, and we enjoyed touching base via Zoom. Our patients remained gracious as always, embracing the many changes as they came.
Now, three months later, our team is intact and continuing to work hard and with a great sense of purpose, having followed the State’s and CDC’s guidance about slowly opening up again. We have moved to a hybrid and nimble form of patient care in the office, in the operating rooms, and by telehealth. We have invested a lot of time and resources equipping the office and our staff to take care of our patients effectively without risking safety. While we and you will be wearing masks when we see each other again, know that there are big smiles on our faces. It is wonderful to be seeing patients in person again!