Childbirth is a beautiful thing, but it also can lead to a condition in which muscles supporting the pelvic region weaken, causing organs to slip from their normal position.
Over time, women could develop what’s known as pelvic relaxation syndrome, which can include a range of troublesome and painful symptoms.
Dr. Jeffrey Palen, an obstetrician and gynecologist, said women shouldn’t let embarrassment keep them from exploring options to restore function.
Pelvic relaxation can manifest itself in a number of different ways:
- The bladder can descend into the vaginal area, which can lead to incontinence, including leakage that coincides with a sneeze, cough or laugh.
- In some cases, the rectum can bulge up into the vagina, leading to severe constipation.
- In other cases, the upper part of the vagina itself can sag into the vaginal canal, and in severe cases, can lead to protrusion of tissue mass from the vagina.
Women often don’t know there’s an effective and minimally-invasive surgery that can help put things back where they’re supposed to be, said Dr. Palen.
Traditionally, surgeons used to make a large incision in the abdomen to re-suspend the vagina to sacral tissue. It was an invasive procedure that required multiple days in the hospital.
Using a da Vinci “robot” that is able to translate the hand movements from a surgeon into smaller, more precise movements, surgeons can now correct the problems with just a few tiny incisions, even for women with complex cases.
The surgery takes about two hours. Women often stay overnight and go home the next day. While they’ll still have limitations on heavy lifting and strenuous exercise for six weeks, they’re usually feeling quite well within a matter of days, Dr. Palen said.
Recently, he saw a 68-year-old patient who came to see him who had been treating her symptoms through the use of a pessary, a donut-shaped piece of plastic which can non-surgically manage symptoms. Dr. Palen said it isn’t an ideal choice for many women, because of increased risk of pressure sores in the vagina and because it requires follow-up visits with a doctor every few months. The woman was relieved to find out there was an alternative, he said.
“I don’t think a lot of women know about the treatments that are available now and I don’t think enough physicians know about it either,” he said.
Dr. Palen chalked up the lack of information in part because many women are reluctant to tell their physician about their condition, because they find it embarrassing.
But leaving the conditions unchecked can impact their quality of life, he said. Fear of episodes of incontinence can lead to increased social isolation, he said. And for women with protrusions, it can make standing, walking and exercise difficult. Intercourse also can be painful.
“I hope women out there understand that doctors have heard it all and we’ve seen it all,” Dr. Palen said. “They just need to share what their problems are. These are things that often can be easily fixed, and once they’ve been functionally restored, they don’t have to live with these limitations on their lifestyle.”
Cindy Creed, the manager of patient care services in women’s surgery at TMC, said the new procedure allows women another alternative to one in which a large vaginal mesh is used for pelvic support. Some significant health problems have been reported with the procedure as the mesh eroded, causing pain and infection.
Dr. Palen agreed, noting this mesh is not only more refined and softer, but more importantly, there are no vaginal incisions, which could interrupt the blood supply to the vagina and weaken it.
“The da Vinci has really helped us address the problem in a different way and that’s been a great benefit,” Creed said.
Read more about urinary incontinence in women here
