Pelvic floor disorders, including pelvic organ prolapse (or vaginal prolapse) and urinary incontinence, are very common problems suffered by millions of women worldwide. In the United States, one out of every nine women has surgery to correct pelvic organ prolapse or urinary incontinence by age 80. These conditions are often associated with significant health issues and cause impairment in a person’s quality of life.
Vaginal prolapse is commonly referred to as “falling” or “dropping” of the bladder, uterus, or rectum, into or outside the vagina. In reality, what happens is that the pelvic organs (bladder, uterus or rectum) “push” against the vagina, resulting in a “herniation” of the vagina. At its most severe, the entire vagina may be everted (turned inside-out), protruding outside of the body. Although this sounds scary, the condition is generally not dangerous, but can create very bothersome symptoms.
Symptoms associated with this condition include an uncomfortable sensation of a vaginal bulge (or “bolita” in Spanish), pressure, or “sitting on a ball”. Symptoms may progressively get worse over the course of the day and/or with activity. Other associated signs and symptoms may include bladder irritation, urinary urgency or frequency and difficulty emptying the bladder and/or rectum.
Bladder control issues are commonly seen in U.S. women of all ages, but particularly in the elderly. After age 60, it is estimated that one in three women experience bladder control problems. Urinary incontinence, which is the involuntary leaking or loss of urine, may occur through different mechanisms. The most common types of urinary incontinence seen in women are stress urinary incontinence (associated with cough, sneeze, exercise, lifting) and urgency urinary incontinence (associated with a sudden, unexpected urge to urinate). Urinary incontinence episodes may be associated with loss of a few drops or large amounts of urine at a time, causing significant distress, embarrassment, and impairment in daily activities—women with bladder control problems often avoid leaving the house for prolonged periods of time, underscoring again the significant quality of life detriment that these patients experience.
Fortunately, in most situations, these conditions are treatable. The Texas Tech University Health Sciences Center at El Paso clinic has a dedicated team of urogynecologists–experts in the evaluation, diagnosis and treatment of these types of problems exclusively. They are able to offer an extensive array of non-surgical and surgical treatment options for patients, including the use of minimally invasive approaches through transvaginal (natural orifice), laparoscopic and robot-assisted surgery.
BIO – T. Ignacio Montoya, M.D., is an assistant professor in the Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center at El Paso. He is board certified through the American Board of Obstetrics and Gynecology. Dr. Montoya specializes in female pelvic medicine and reconstructive surgery at the University of Texas Southwestern Medical Center in Dallas.