These types of POP are not normal but there are treatment options for patients to improve POP. - Pelvic floor exercises. These commonly known as Kegal exercises and are used to strengthen the muscles that surround the oppenings of the urethra, vagina and rectum. Doing these exercises regularly, and after child-birth, may improve day-to-day living, improve incontinence and slow the overall progression of POP. - Pessary. A pessary is a removable device inserted into the vagina to support the pelvic organs. Pessaries come in many different shapes and sizes. Pessaries are often the first treatment your doctor will try. - Surgery to support the uterus or vagina. During surgery, the doctor may use your own body tissue or synthetic mesh to help repair the prolapse and build pelvic floor support. This type of surgery is recommended for sexually active women with serious prolapse of the vagina or uterus. - Surgery to close the vagina. This surgery, called colpocleisis, treats prolapse by closing the vaginal opening. This can be a good option for women who do not plan to have or who no longer have vaginal intercourse.

PELVIC FLOOR HEALTH

Dr. Meredith Martin-Johnston
May 10
3 min read

Many women assume pelvic floor health issues are simply their fate—part of having vaginal deliveries, getting older, gaining weight or entering menopause. Perhaps they have watched their mothers and grandmothers live with symptoms, such as urinary incontinence and pain. Though pelvic floor disorders involving the bladder, bowel and uterus seem like a routine part of getting older they are not a normal part of aging.

Dr. Meredith Martin-Johnston is answering the call and helping patients change this fate with end-to-end pelvic floor treatment.

WHAT IS THE PELVIC FLOOR?

The pelvic organs include the vagina, uterus, bladder, urethra and rectrum. These organs are held in place by muscles of the pelvic floor and layers of connective tissue that also give support. When those muscles and connective tissues are weakened that can cause pelvic organ prolapse or “POP”. POP results in certain pelvic organs starting to move, change place or even drop down in and outside the vagina.

CAUSES AND PAIN SYMPTOMS OF POP

The main causes of POP are pregnancy and childbirth which often weaken the pelvic floor muscles. Other risks factors are menopause/estrogen loss, smoking, weight, age, individuals with pre-existing connective tissue diseases and family history. Around 3% to 11% of all women experience POP. About 37% of women with pelvic floor disorders, including POP, are between ages 60 and 79. Over half are 80 or older. However, because many patients do not seek treatment for POP, many studies have determined POP is thus widely unreported.

Pain symptoms depend on where the POP is occurring, however, they generally are:

Seeing or feeling something “bulge” out of the vagina.
Fullness or pressure in your vagina.
Fullness, pressure or aching in your pelvis- especially while standing or couching
Pain/discomfort during intercourse
Changes in frequency and duration of when you go to the bathroom

There are several types of prolapse that occur depending on the part of the body that has changed/dropped:

Anterior vaginal wall prolapse- Bladder
Posterior vaginal wall prolapse- Rectum
Uterine prolapse- Uterus
Vaginal vault prolapse- Top of the Vagina

TREATMENT OPTIONS

These types of POP are not normal but there are treatment options for patients to improve POP.

Pelvic floor exercises. These commonly known as Kegal exercises and are used to strengthen the muscles that surround the oppenings of the urethra, vagina and rectum. Doing these exercises regularly, and after child-birth, may improve day-to-day living, improve incontinence and slow the overall progression of POP.
Pessary. A pessary is a removable device inserted into the vagina to support the pelvic organs. Pessaries come in many different shapes and sizes. Pessaries are often the first treatment your doctor will try.
Surgery to support the uterus or vagina. During surgery, the doctor may use your own body tissue or synthetic mesh to help repair the prolapse and build pelvic floor support. This type of surgery is recommended for sexually active women with serious prolapse of the vagina or uterus.
Surgery to close the vagina. This surgery, called colpocleisis, treats prolapse by closing the vaginal opening. This can be a good option for women who do not plan to have or who no longer have vaginal intercourse.

At Midwest Gynecology, we focus on end-to-end pelvic floor health. We work with several top pelvic floor physical therapists who help patients with pelvic floor strengthening and wellness. We focus on addressing nutrition and wellness options address POP symptoms. If pelvic floor physical therapy and wellness changes do not alleviate pain symptoms, Dr. Johnston specializes in all POP related surgeries and especially anterior and posterior vaginal wall repairs.

Dr. Meredith Martin-Johnston is a certified minimally invasive gynecology surgeon (“MIGS”) and has the advanced specialized training to perform these POP surgeries efficiently, with fewer large incisions and better overall patient recovery times. Over the course of her surgical career, she has performed over a thousand POP surgeries and consistently does them every month.

Dr. Johnston’s and Midwest Gynecology’s main goal is help patients understand their treatment options and know they can change their fate if they just ask.