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Doctor insights on:
Pessaries For Bladder Prolapse
1
What is cystocele (bladder prolapse mild)?
A bladder prolapse: Whether mild, moderate or severe a cystocele is a bladder prolapse. ...Read more
Bladder (Definition)
The bladder is a muscular organ in the pelvis that accepts urine from the kidneys, stores the urine at low pressure, & expels the urine during voluntary voiding. Though seemingly a simple reservoir, the bladder is a complex organ intricately connected with the brain and spinal cord with sensory, motor, and autonomic circuits. The muscular layer that contracts during voids ...Read more
2
What is the difference between bladder sling for incontinince and sling for bladder prolapse?
See below: A bladder sling is used to treat stress urinary incontinence in women and is usually made of a strip of surgical mesh, or less often autologous fascia, usually inserted through one vaginal incision and two small abdominal incisions. Bladder suspension refers to surgery that helps place a sagging bladder back into its normal position using adjacent autologous fascia, or less often transvaginal mesh ...Read more
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3
Does pelvic prolapse cause incontinence?
Yes and No: Pelvic prolapse and urinary incontinence are two distinct entities that often occur together. In some circumstances pelvic prolapse reduces urinary incontinence due to increased urethral pressures. Surgeons often discuss issues of future incontinence when treating prolapse. A complete pelvic floor evaluation is important when planning surgery to avoid these issues. ...Read more
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4
Anyone have cure without mesh for pelvic organ prolapse?
Yes: Pessaries can help but most women won't use them long term. Mesh seems to be the only permanent solution since you treat the vaginal prolapse as the hernia that it is. The colporrhaphy operations are over 100 years old and treat a lateral defect with a central repair & usually don't hold. Despite the lawyer's commercials, most mesh repairs do very well. ...Read more
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5
Compare rectocele and rectal prolapse?
Vaginal vs. Anal: A rectocele is bulging of the rectum towards the vagina (thus creating a "bulge" in the vagina, and possibly difficulties having a bowel movement). It is due to a weakening of the connective tissue between the rectum and vagina. Rectal prolapse is a condition in which the rectum loses its normal attachments inside the body, allowing it to telescope out through the anus, thereby turning it “inside out”. ...Read more
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6
Is postmenopausal bladder prolapse progress slowly? Only using estrace cream for HRT.
Bladder prolapse: Although Estrace cream can assist in keeping the epithelium of the vagina distensible, post menopausal bladder prolapse is more function of the lack of bladder ligament support or prior vaginal childbirth trauma. Patient's who have had multiple vaginal deliveries are more likely to see a more rapid bladder prolapse then not. ...Read more
7
Does the bladder sling surgery stop urinary incontinence caused by Prostate surgery?
See remark: There are bladder slings that help in male incontinence following prostate surgery...but the results are not as good as when placing slings in female incontinence ...Read more
8
Can mild bladder or vaginal prolapse be corrected with kegals?
Pelvic muscles: Although prolapse might not be reduced by increasing vaginal/pelvic muscle strength, you may be able to limit its progression. The most important time to "squeeze" is before you cough or sneeze as the force will be distributed across the muscles and not directly to your weak spots where things are prolapsing. ...Read more
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9
How does vag estrogen help with bladder prolapse?
Here are some...: Vaginal estrogen may improve the texture of vaginal & urethral lining leading to decrease the degree of mild stress urinary incontinence in some but will not help the degree of bladder prolapse since it results from general weakness of periurethral and pelvic floor supporting muscles which is related to aging and childbirth. More? Ask your attending doctor. ...Read more
10
Grade 2 cystocele and rectocele grade 1-2 uterine prolapse. No sensation of heaviness etc would you repair while doing sling for stress incontenence?
Probable not: If you are currently asymptomatic, i would probably not recommend repairing the cystocele or rectocele providing they are not causing any issues. That said, a number of factors go into determining whether to have surgery or not. I would suggest you discuss your options with your physician and follow their recommendation. ...Read more
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11
How successful is surgery for pelvic prolapse?
Very: Surgery for pelvic prolapse done by a well trained specialist has a high degree of success and a somewhat predictable rate of long term failure or recurrence. The key is good training and ongoing volume and surgery chosen that is applicable to the patient's specific prolapse problem(s). ...Read more
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12
How to decide the urgency for booking hysterectomy, bladder and bowel repair?
totally depends: On your symptoms and what condition everything is in, your doc should be giving you strong guidance for that please call the gyn , or gen surgeon or whomever suggested the surgery. ...Read more
13
Is pelvic floor rehabilitation therapy effective for interstitial cystitis (aka: painful bladder syndrome)?
For symptoms yes: But it probably doesn't actually treat the condition ie heal the bladder wall. Painful bladder syndrome includes manythings that aren't ic such as pelvic floor dysfunction that will respond well to rehab. ...Read more
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14
How common are bladder mesh problems after cystocele repair?
Bladder mesh problem: The incidence of bladder mesh complications (infection/pain/erosion/retention/....) is actually very "low" if properly applied/implanted. One should be careful and ascertain the physician's expertise in these specific surgical procedures: obviously, i would trust a reputable individual that is experienced and can demonstrate his/her expertise...... ...Read more
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15
Will surgery for incontinence also tighten vagina?
No: But u can have that surgery done at the same time, if gyn is doing the incontinence surg then the gyn can do the other but the incon. Will be covered by insurance the other one may not be, so u would have to check that out before surgery, if a urologist is doing the incon. Surgery, then u would need a gyn also. ...Read more
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16
Does prostate surgery always cause urinary incontinence?
No: There are of course different type of prostate surgery. Postate removal for cancer has a severe incontinence rate of 3-5% and a mild to moderate incontinence rate of 10-15%. Both are very treatable in hands of surgeons who treat this often. Prostate scraping and laser treatments for benign disease rarely lead to incontinenece buts is also very treatable. Bottom line:it happens and is treatable. ...Read more
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17
Is oxybutynin the best choice for neurologic bladder and occasional bladder leakage? or detrol? or vesicare (solifenacin)?
It's the cheapest: oxybutynin happens to be the original (and che"anticholinergic" on the market, originally developed in the 1970's. It is effective but has side effects (dry mouth, eyes, and constipation). The newer drugs have slightly better side effect profiles. Check out the new beta agonist myrbetriq too. See a specialist in neurogenic bladder, urologists often have additional training in this area. ...Read more
18
Bladder sling for stress incontinence, what to do?
Effective for many: Performed by urologists ; uro-gynecologists after suitable urodynamic studies have been performed. Presume you developed after childbirth ; sling has been advised. This is s a very satisfactory treatment option, however might be good to delay until after a future pregnancy if you intend to have any more children. ...Read more
19
What is your experience with patients using a vaginal prolapse pessary?
Good: Pesseries for prolapse (cystocele, rectocele, vaginal prolapse) are very useful for someone who wants to avoid surgery, desires more vaginal deliveries (children), or can't have surgery. Properly sized & placed, pts feel no pressure, most don't notice a difference. The best candidates are pts who are able to remove & replace it as needed. I have many pts satisfied with only their pessary. ...Read more
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20
Rectal prolapse treatable without surgery?
Unlikely: See colorectal not general surgeon for 2 nd opinion. ...Read more
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