Hope & Healing: The UF Health Blog

Pelvic Organ Prolapse: One Woman’s Journey to Improved Quality of Life

Linda Butcher loves traveling, gardening, attending Florida Gators sporting events and shamelessly spoiling her four grandchildren and one great-grandchild. After retiring seven years ago, Linda has been enjoying newfound time with family and focusing on her favorite activities.

However, these activities quickly came to a halt when she began having uncomfortable symptoms such as pelvic pain, recurring urinary tract infections, or UTIs, and an increased frequency in urination.

“The symptoms were mounting,” Linda said, “so I knew there had to be something wrong.”

doctor holding a model of a pelvic organ

Gardening became painful, and traveling became nearly impossible because of her constant urge to use the restroom.

“When you have to scope out where the bathrooms are when traveling, it is not conducive to being able to go anywhere and enjoy yourself,” Linda said.

At her annual well-woman appointment, Linda described her symptoms to her provider, which led to a referral to Emily Weber LeBrun, MD, chief of female pelvic medicine and reconstructive surgery at the University of Florida College of Medicine.

Diagnosis and Treatment

During her appointment with Dr. Weber LeBrun, Linda was diagnosed with pelvic organ prolapse, a pelvic floor disorder in which the pelvic muscle and tissue are unable to support the surrounding organs.

Pelvic floor disorders, an all-encompassing term for incontinence and prolapse, is extremely common. Approximately 75% of women will experience urinary incontinence and 40% of women will experience pelvic organ prolapse. Still, pelvic floor disorders tend to be widely ignored and seldomly discussed.

“The data we have from the U.S. Census Bureau and population studies say that over 20% of women will undergo a surgical procedure for a pelvic floor disorder in their lifetime,” Dr. Weber LeBrun said.

Linda was worried when she heard “pelvic organ prolapse” as she thought it was a serious condition with few treatment options that could dramatically impact her quality of life. However, Dr. Weber LeBrun told Linda that her pelvic floor condition was not life-threatening and there were multiple treatment options available.

“One of my favorite parts of my job is informing patients that they have choices,” Dr. Weber LeBrun said. “The fear they may have associated with a big surgery can be ameliorated by this concept that they have a choice of a ‘smaller’ surgery or ‘bigger’ surgery and different techniques that provide different amounts of risk and durability.”

Linda was presented with options for treatment: observation, physical therapy to train and strengthen the pelvic floor muscle, use of a pessary device or surgery. Based on her symptoms and lifestyle, Linda chose to move forward with surgical intervention.

“Dr. Weber LeBrun gave me the facts and explained the outcomes and reliability of each option,” Linda said. “It gave me great confidence, and we came to the conclusion that a surgical approach would be the best solution for me.”

Surgery for Pelvic Organ Prolapse: The First Step in Healing

Linda opted for a procedure called a colpocleisis. This is a procedure specifically for pelvic organ prolapse during which the vaginal canal is surgically shortened.

On the day of the surgery, Linda arrived and was taken back to a preop area. Her medical team provided her with information about how the procedure would unfold and the outcome it was expected to have on her quality of life, making her feel more secure in her decision.

“It was amazing,” Linda said. “Dr. Weber LeBrun introduced me to everybody in the room so I knew who was in there, and it was an all-female staff.”

The surgery was successful, and Linda went home the same day. One week later, Linda saw Dr. Weber LeBrun for a follow-up appointment to make sure she was healing well. Despite some discomfort at the site of surgery, Linda noted that she had started to feel normal again. So much so that she had to remind herself to limit her physical activities to align with her doctor’s guidance.

“It was much easier than I anticipated,” Linda said. “The pain only lasted two or three days. It was no worse than an episiotomy after birth. The hardest part was itching afterwards.”

Because the surgery was internal, no additional rehabilitation or physical therapy was required. At her six-week postsurgical appointment, Dr. Weber LeBrun cleared her for all activities.

“Every day she began feeling better,” Dr. Weber LeBrun said. “By the time I saw her at six weeks, her bowel function had normalized, she no longer had pain and she could basically do anything that she wanted to do.”

Finally, Linda was starting to get her life back.

Better Than Ever: Improved Quality of Life and Optimal Outcomes

Prior to her surgery, Linda’s life was limited by her pelvic organ prolapse symptoms. Constantly needing to use the bathroom, skipping out on adventures because of pelvic pain and recurring UTIs. After her surgery, Linda was ready to get back to enjoying her life. She celebrated by cheering on the Florida Gators at their first home game of the football season.

“I managed to go the whole four hours without leaving the stands once!” Linda said.

For those experiencing similar life-limiting symptoms, Linda has one message to relay: Talk to your physician.

“Dr. Weber LeBrun, in particular, is very knowledgeable and good at making me feel comfortable with my decisions,” Linda said “She’s very forthcoming, very straightforward, and that’s something that I find very appealing. I will recommend any women who are having incontinence issues to visit UF Health.”

Linda is once again enjoying life. She gardens with no pelvic pain, travels without having to scout for bathrooms and enjoys sporting events with her family.

Her message to her medical team is straightforward.

“Thank you for giving me my life back,” Linda said. “I am able to enjoy myself again.”

Frequently Asked Questions About Pelvic Organ Prolapse

What type of doctor should I see for pelvic organ prolapse? Do I need a referral?

The best place to start your journey toward better pelvic health would be with your general OB-GYN to get an initial evaluation. Depending on your symptoms, you may be referred to a urogynecologist for further treatment options. A urogynecologist is an OB-GYN or urologist who has advanced surgical training on reconstructive surgery of the pelvic floor.

What are the risk factors of developing a pelvic floor disorder?

The most common risk factors for developing a pelvic floor disorder include heavy lifting, chronic coughing and childbirth. Women who experience a vaginal delivery with a large baby or have a tear are at higher risk for having muscular or nerve damage that translates to a less stable pelvic floor muscle system. Additionally, women who have pelvic organ prolapse in their family history are at risk because connective tissue disorders pass through genetic lines.

What are common symptoms of pelvic floor disorders?

The most common symptoms of pelvic floor disorders are urinary or fecal incontinence, urinary urgency, recurrent urinary tract infections, bladder or pelvic pain, and discomfort at the vaginal opening. Symptoms may vary depending on where the prolapse occurs. For example, bowel movement issues can manifest as a symptom if the prolapsed organ bulges into the rectal area.

Can pelvic organ prolapse resolve on its own? What happens if it is left untreated?

Pelvic organ prolapse cannot resolve on its own. However, it is very unlikely that an organ will become detached and be expelled from the body. If left untreated, your symptoms, such as incontinence and discomfort, will likely continue. Waiting to seek treatment doesn’t make it more difficult to repair. Treatment options for pelvic floor dysfunction can be as simple as doing pelvic floor exercises and pelvic floor muscle training or require surgical intervention.

Is pelvic organ prolapse serious?

In most cases, pelvic organ prolapse is not serious but rather a quality-of-life inconvenience. However, seeking medical treatment should not be overlooked. Fecal or urinary incontinence are normal symptoms of pelvic prolapse. However, someone with a large prolapse could experience urinary retention or the inability to completely empty the bladder. This can translate to recurrent infections of the bladder or kidney damage. These uncommon circumstances require intervention.

What is the success rate of prolapse surgery?

The success rate of prolapse surgery varies depending on the technique, choice of procedure and specific patient factors. For patients who have a simple tear or minor prolapse, a traditional repair may be recommended. If a patient presents with a more complex case, for example, a patient who has poor quality connective tissue, then using something more durable like surgical mesh to strengthen the repair may be recommended. Generally, patients are fully recovered within 4-6 weeks.

Can prolapse happen suddenly?

A prolapse is typically a gradual process that begins with apparent symptoms such as bladder or pelvic pain, increased urination or chronic urinary tract infections. There are few cases where a prolapse can happen suddenly, but these are typically triggered by actions like moving a heavy object, falling or being in a motor vehicle accident.

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