Discover the truth about vaginal collapse and what you should do if ever this will happen! Watch as a renowned urologist, Dr.

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Is Vaginal Collapse Dangerous?! What to do next?! Urologist Reveals the Truth!

very recently Jennifer Garner described her OB doctor telling her that her vagina might collapse now what exactly does that mean I'm Dr Reena Malik urologist and pelvic surgeon and today we're going to talk all about vaginal collapse or pelvic organ prolapse so you might be wondering like what it can collapse what does that even mean and will mind collapse what causes it how do you figure this out and what can you do about it well it's not exactly collapsing but it can prolapse so the way to think about pelvic organ prolapse is the vagina is in a u-shape the top part is the anterior vaginal wall behind that typically the bladder sit the apex of the vagina is usually where the uterus or small bowel sits and at the posterior part of the vagina is where the rectum sits so you may hear terms like cystocele rectocele my bladder is falling out but really it's all the vagina that is coming down and out of the vagina now this doesn't happen to everybody but it does happen in about 40 percent of women however not everyone is bothered by prolapse and what does that mean so not everyone gets symptoms that cause them to feel worried about it so you might have a little bit of prolapse but it's not causing any problems and that's okay only about 12 percent of people actually notice discomfort or problems from their prolapse that's still a large number of people but it's certainly not as scary as 40 the good news is that this is not life-threatening dangerous this is a quality of life issue the majority of the time and you may notice you have it because when you see something coming out down there two you might feel like something's falling out like a tampon you may feel some pelvic pressure or pelvic pain or even lower back pain sometimes you might notice some symptoms with urination like you gotta go more frequently or urgently or you're having difficulty emptying your bladder you also make those difficulties with your bowel movements having constipation or leakage of stool and lastly you might notice some discomfort with with sex now what causes prolapse well age certainly contributes to it so as you age your muscles of the pelvic floor get weaker which can make pelvic organ prolapse more likely also doing certain activities over a course of a lifetime so if you're standing for long periods of time during your life if you're doing a lot of high intensity exercise or you've had multiple deliveries vaginal deliveries or even multiple pregnancies that's always putting pressure on the pelvic floor which can cause it to weaken some people also with a chronic cough can cause weakness because they're coughing all the time which is increasing pressure on the pelvic floor muscles causing weakness and lastly certain genetic conditions or connective tissue disorders can put you at higher risk as well so if you think you might have prolapse what should you do about it well first of all you want to know is this bothering you or not if it's not bothering you you should still get checked out just to make sure that it is prolapse and nothing else but rest assured that there's probably nothing you have to do about it if it is bothering you then absolutely see a doctor who specializes in prolapse either a female pelvic medicine reconstructive surgeon who's trained in urology or a urogynecologist who's trained in Gynecology during your visit you can expect that you'll talk about your symptoms what's bothering you and it's really important for you even if your doctor doesn't ask to tell them what's bothering you the most are you just wanting to know that you're okay or are you worried about it and you want to have a treatment because then they can really tailor the discussion to what's important to you and they'll also do a physical examination now what this includes is usually you'll use a speculum but usually you'll just use half the speculum just to look at the walls of the vagina we're not doing a pap smear like you get at the gynecologist during the examination you'll also get what's called a digital exam where the doctor will place a finger in the vagina to feel the muscles of the vagina to assess for how weak they are and assess for any other abnormalities like CIS or things of that nature they may also ask you to squeeze and do a Kegel exercise so they can assess how strong those muscles actually are after this is done they may ask for other testing depending on what you decide to do so if you decide to have surgery they may do what's called a urodynamics test and what this test is is a test to assess what the function of your bladder is and they'll do it normally and then they'll put what's called a pessary or a silicone dish in the vagina to hold things up to assess how lifting the prolapse up will affect bladder function particularly to assess if you're going to leak and this is because when you lift things up with prolapse it can actually take away that buzz that was supporting the urethra that was preventing leakage so you can then have leakage after you take the Bulge away and so you want to know that before you go through with any sort of surgery rather than finding out after the fact now what are the treatment options number one is pelvic floor physical therapy or doing things like Kegel exercises now doing them by yourself at home is like going to the gym by yourself the best thing to do is actually to go to to a pelvic floor physical therapist who can guide you like your personal trainer at the gym in doing the right exercises they'll work with you on things like making sure your pelvis is aligned and also making sure that you're squeezing the right muscles and you're improving week to week another option is a pestry so I briefly talked about this before but the pastery comes in all sorts of different shapes and sizes usually silicone and it's inserted in the vagina to hold up the prolapse and it can be removed either daily by you or every few months usually around every three months by your gynecologist or urologist and lastly there's surgeries now prolapse surgeries there are multiple different kinds of surgeries depending on the type of prolapse you had but generally speaking you can do vaginal surgery meaning that you typically make an incision and the area of the prolapse and rebuild the pelvic floor and this usually will include whatever compartment meaning anterior apical or posterior are involved in the prolapse another alternative is to do a robotic or abdominal surgery where you go in and you actually suspend either the vagina or the uterus or remove the uterus and suspend the vagina so that it's now holding everything up in its normal position using mesh or using suture to hold up the very top of the vagina now there are many risks and benefits of all these options but it's absolutely very important to talk to your doctor about the risks and benefits know what to expect after surgery how long recovery is going to be usually what I tell patients is at least four weeks no heavy lifting and that could be up to six weeks so it's really important to talk to your doctor about the risks benefits any questions you may have about surgery before proceeding with them I always tell my patients you need to be super comfortable with your surgeon if you're not please seek a second opinion talk to somebody else because even we as doctors want our patients to like us and want to work with us so it makes our jobs easier that we know that we are all on the same page and lastly it's important to remember that it's okay to do nothing if you're not having symptoms and you're feeling fine it's really okay to do nothing people often ask me like what is it going to get worse but unfortunately we don't have the answer to that when you look at studies of people who are followed over time who choose not to have surgery on their first visit then usually about 20 percent of them will go on to have surgery later but we don't know exactly who that's going to be ultimately there's no way to tell for sure that you're going to get worse or need surgery later down the line so you should really do what you feel is best for you at that moment in time the last thing I want to leave you with is I see so many people who wait for their care for so so long they take care of their children they take care of their spouse and by the time they're finally at the urologist they are you know they've been waiting and dealing with this for years don't let that be you it's okay to prioritize yourself and get help if you enjoyed this video and you want to learn more about issues that can affect women with weak pelvic floors check out my video on stress urinary incontinence where I talk all about that and what you can do about that as well as always remember to take care of yourself because you're worth it

Dr.

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