236 – Prolapse – Surgical and Non-Surgical Options

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Dr. Sonya Ephraim, MD, FACOG, FPMRS, is a urogynecologist and the founder of Allure Pelvic Wellness and Aesthetic Gynecology in Deer Park, Illinois, outside of Chicago. She talks about how she decided to go back to do a fellowship in female pelvic medicine.

In this episode, we talk a lot about prolapse and touch on-

· What is pelvic organ prolapse?

· Why prolapse needs a rebranding – so much shame

· Risk factors for prolapse

· What are the signs and symptoms?

· Our tips for treating constipation

· Prolapse risk goes up after menopause – we discuss the likely role of hormones and decreased muscle strength.

· The impact of prolapse on those suffering

· Why we hate calling it “bladder prolapse”

· How the bladder can be affected by vaginal prolapse and what may and may not improve

· How do we know if we have prolapse

· How do we know if we should treat prolapse

· Risk of de novo stress urinary incontinence when prolapse is fixed, either with pessary or surgery

· What is a pessary and what are the risks of a pessary.

· Can you be sexually active with prolapse?

· The role of pelvic floor physical therapy and prolapse.

· Surgical treatment options:

o One size does not fit all.

o Obliterative surgery – colpocliesis

o Hysteropexy vs. hysterectomy

o Minimally invasive options – suture or mesh based (sacrocolpopexy) procedures

o New treatment options (EnPlace) benefits and data

o The cervix as a sexual organ for some people and the consideration of cervix/uterine preservation in prolapse surgery.

· Modern prolapse repair is safe, effective and recovery is not too stressful for most women.

· Post surgery instructions and rehab – vaginal estrogen and pelvic floor physical therapy

· The risk of recurrent prolapse

· When to consider adding a sling to your prolapse procedure

· Just because someone or something said you have prolapse, doesn’t mean you need surgery

Instagram.com/allurebydrsonya

https://allurepelvicwellness.com/

#EnPlace, #PelvicOrganProlapse, #WomensHealth #PelvicHealth

My previous Prolapse episodes

21 – pelvic organ prolapse master class

138 – February Live – Hormones, prolapse, pelvic floor PT and more

161 – “I Just need to put something in my vagina”, Prolapse, and how PT helps

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20 Questions with Dr. George Heffernan