About Pelvic Organ Prolapse

Many women suffer from conditions of the pelvic floor grouped under the heading of "Pelvic Organ Prolapse." The women who experience pelvic organ prolapse endure symptoms that include chronic pain, bladder leakage, fecal seepage, and others that dramatically impact their lifestyle and enjoyment of life.

Our goal is to restore confidence, dignity, freedom and enjoyment of life to women suffering from conditions of the pelvic floor. Our innovative and comprehensive treatment programs start with an accurate diagnosis. We use rehabilitative and curative care plans that are attentive to our patients' emotional, educational and physical needs. Where surgery is required, your care plan may include both pre- and post- operative physical therapy to rehabilitate your pelvic function.

Common types of Pelvic Organ Prolapse

Cystocele (bladder prolapse)

Cystocele is when the bladder pushes into the vagina. Because of the way it impacts the angle of the bladder and the urethra, stress incontinence often occurs.

Enterocele (small bowel prolapse)

Enterocele is when the small bowel presses against or herniates into the vagina.

Rectocele (rectum prolapse)

Rectocele is when the vaginal wall weakens and the rectum presses against or prolapses into the vagina. This condition may create a bulge that is more noticeable during a bowel movement.

Uterine Prolapse (prolapse of the uterus)

There are 3 degrees of uterine prolapse:

  • When the bottom portion of the uterus enters the vaginal canal, it is a first-degree prolapse
  • A second-degree uterine prolapse occurs when the entire uterus enters the vaginal canal
  • When the prolapsed uterus protrudes through the vaginal opening, it is a third-degree prolapse.

Vaginal Vault Prolapse

The top of the vagina is supported in part by the uterus. Following a hysterectomy, when the uterus is removed, the top of the vagina may drop down toward the vaginal opening. This is called a vaginal vault prolapse.

Female Pelvic Organs - Click for larger view

Our approach to Pelvic Organ Prolapse Repair

Dr. Ashford is board-certified in both OBGYN and Female Pelvic Medicine & Reconstructive Surgery (FPMRS) - a field more commonly known as Urogynecology. This unique training and experience qualifies him to repair even the most advanced cases of pelvic organ prolapse.

How will you correct my prolapse?

Your procedure will be based upon your concerns, desires, anatomic defects, and symptoms. Dr. Ashford is able to correct prolapse with or without the use of mesh.

Do you use mesh?

Sometimes. Many women are good candidates for surgical mesh. Dr. Ashford has been using mesh in pelvic reconstructive procedures to repair pelvic organ prolapse (prolapse of bladder, rectum, uterus and vaginal cuff) since 2001 and has achieved very favorable results. He will discuss the pros and cons of mesh for your repair so you can make the best decision for you.

Are there any non-surgical options?

Non surgical options would include aggressive physical therapy to improve the pelvic floor musculature. This is not expected to cure your prolapse but may improve your symptoms.

What about the use of a pessary?

The use of a synthetic device called a pessary can be utilized. This device is placed in the vagina in the office and does not involve surgery. The pessary does not cure the prolapse but rather holds it up for you. We clean the pessary at regular intervals.

What results have other patients had mesh?

Dr. Ashford has been using implanted transvaginal mesh in various forms for more than 10 years. The most common risks of mesh placement include exposure of mesh material called erosion (about 3% of the time to date), and/or pain with intercourse (in about 2 - 3% of patients). Although complications can occur with any surgery, the overwhelming majority of Dr. Ashford's patients have reported that they are very satisfied with the results.

For additional questions and answers about the repair of pelvic organ prolapse, click to view a Q & A with Dr. Ashford.

Surgical Treatment for Pelvic Organ Prolapse

Many women have found relief from the pain and symptoms of pelvic organ prolapse through advanced surgical treatments. Dr. Ashford has extensive experience with all different types of prolapse.

WARNING: We have provided photos of surgeries where disorders were corrected. Since the photos are taken immediately following surgery, some people may find them to be graphic. With this in mind, if you would like to see photos of pelvic prolapse repairs please visit this page.