236. Prolapse - Surgical and Non Surgical Options

Nov 5, 2023

Dr. Sonya Ephraim, a urogynecologist and founder of Allure Pelvic Wellness, shares her insights on pelvic organ prolapse. She discusses the stigma surrounding this condition and emphasizes the importance of open conversations about women’s health. Topics include the risk factors for prolapse, especially post-menopause, effective treatments like pessaries, and the role of pelvic floor therapy. Dr. Ephraim also addresses common misconceptions about bladder prolapse and explores options for managing intimacy and body image during treatment.

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ANECDOTE

Career Shift to Pelvic Medicine

Dr. Sonya Ephraim switched from obstetrics to focus on female pelvic medicine due to her passion for improving pelvic floor disorders.
She found great satisfaction in performing surgeries that significantly improved women's quality of life.

INSIGHT

Pelvic Organ Prolapse Explained

Pelvic organ prolapse is like a hernia where organs bulge due to weakened connective tissue.
This leads to protrusion usually felt through the vagina when symptomatic.

INSIGHT

De-stigmatizing Prolapse

Vaginal prolapse carries unjust shame which needs rebranding like male hernias.
Prolapse is a natural outcome of life events like childbirth, not a fault or something to feel shame about.

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236 – Prolapse – Surgical and Non-Surgical Options

This podcast is sponsored by Femselect

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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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