Pelvic Organ Prolapse - FAQ

Why does coughing and lifting cause bulging of the bladder or rectum?

The vagina, bladder and rectum are supported by a series of ligaments and muscles that prevent sagging when a person coughs or lifts something heavy. Child birth, smoking, loss of collagen with aging, and previous pelvic surgery, especially a hysterectomy, undermines the support system. Sagging of this muscle-ligament support structure doesn’t necessarily mean a woman needs surgical repair, but if her condition worsens, affecting her ability to urinate, for example, or to have normal bowel movements, it’s a condition that requires expert evaluation and may require surgical intervention. In the worst case scenario, some women experience the unpleasant event when the sagging gives way and everything drops and bulges out of the vagina.

What should I do if I develop recurrent urinary incontinence after surgery?

You should make an appointment to discuss the situation with your urologist. Sometimes, simple lifestyle changes and muscle training exercises can make a difference. Injection of a permanent implant called Macroplastique® (see image to the left) may restore urinary incontinence. This simple procedure is done in the hospital under sedation. It only takes 15 minutes to perform. Women are discharged the same day and they can return to normal activity the following day.

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What should I do if I develop recurrent pelvic organ prolapse after surgery?

You should make an appointment to discuss the situation with your urologist. If the surgery was performed many years ago, new surgical techniques and graft material can restore normal vaginal anatomy. When one type of prolapsed is corrected, increases in abdominal pressure can unmask weakness in another area of the vagina. If this occurs, it can be corrected with graft material.

What should I do if I develop urinary incontinence after pelvic organ prolapse surgery?

If urinary incontinence is detected during the pelvic organ prolapse evaluation, it can be surgically corrected at the time of the prolapsed surgery. About 30% of women with pelvic organ prolapse have urinary incontinence. If urinary incontinence develops after POP surgery, it can be corrected with a simple outpatient procedure.

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