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What is Pelvic Organ Prolapse?

Pelvic Organ Prolapse or Pelvic Prolapse, is a very common condition, particularly among older women. It's estimated that half of women who have children will experience some form of Pelvic Organ Prolapsee in later life. Many women, particularly because they may no longer be sexually active, and fail to continue receiving their annual pelvic exams, don't seek help from their doctor. Therefore, the actual number of women affected by Pelvic Organ Prolapse is unknown. 

Pelvic Organ Prolapse may also be called; genital prolapse, pelvic relaxation, pelvic prolapse, uterine prolapse, uterovaginal prolapse, pelvic floor disorder, urogenital prolapse or vaginal wall prolapse.

What is Pelvic Prolapse?

Pelvic Prolapse is another term used for "Pelvic Organ Prolapse."  Pelvic Prolapse is a very common condition, particularly among older women. It's estimated that half of women who have children will experience some form of Pelvic Organ Prolapse in later life. Many women, particularly because they may no longer be sexually active, and fail to continue receiving their annual pelvic exams, don't seek help from their doctor. Therefore, the actual number of women affected by Pelvic Organ Prolapse is unknown. 

Pelvic Prolapse may also be called; genital prolapse, pelvic relaxation, uterine prolapse, uterovaginal prolapse, pelvic floor disorder, urogenital prolapse or vaginal wall prolapse.

What are the symptoms that indicate a woman is suffering from  Pelvic Organ Prolapse?

• Loss of bladder control.

• Loss of bowel control.

• Increasing need and frequency to urinate - and then difficulty in completely emptying your bladder.

• The feelings that your of pelvic or vaginal heaviness, bulging, fullness and/or pain, or a feeling that something is "dropping."

• Recurrent bladder infections.

• Excessive vaginal discharge.

• Pain or lack of sensation during sex

But Pelvic Organ Prolapse is a real, common and treatable problem. Consider this:

About half of all women over age 50 suffer from some degree of Pelvic Organ Prolapse.

One in 10 women undergo surgery for Pelvic Organ Prolapse by age 80.

What is a Prolapsed Uterus?

A Prolapsed Uterus refers to a collapsed uterus, or descended uterus, or other change in the position of the uterus in relation to the surrounding structures within the pelvis. The pelvis contains many soft tissue structures vital to normal body functions, supported primarily by the diaphragms, layers of muscles, fibrous coverings called fasciae, and various ligaments and tendons. These soft tissues of the pelvis derive their ultimate support from the bony pelvis. 

A Prolapsed Uterus may be one of three types, depending on the severity:

• First-degree prolapse occurs when the uterus sags downward into the upper
vagina.

• Second-degree prolapse occurs when the cervix is at or near the outside of the
vagina.

• Third-degree prolapse (sometimes referred to as total prolapse) occurs when the entire uterus extends outside the vagina.

What is a Vaginal Vault Prolapse?

The vaginal vault is the area at the top of the vagina, next to and adjacent to the cervix. It can only “fall” or descend downwards toward the introitus, or the entrance of the vagina, after a woman's womb has been removed (hysterectomy). Vaginal Vault Prolapse occurs in about 15% of women who have had a hysterectomy for uterine prolapse, and in about 1% of women who have had a hysterectomy for other reasons.

What Everyone Needs to Know About Reconstructive Pelvic Surgery.

Reconstructive pelvic surgery is an area of surgery dealing with a woman's pelvis, and includes gynecology and uro-gynecology.  Pelvic reconstructive surgery is many times very complex surgery that may require not just the removal of certain organs or tissues in a woman's pelvis, but may also include the resection of areas and putting her organs and tissues back together in a way that makes her more functional, with less/no pain and feels better. 

What is Pelvic Inflammatory Disease?

Pelvic inflammatory disease, or "PID" is an infection of a woman's pelvic organs which include the uterus, fallopian tubes, and ovaries. 

Bacteria causes pelvic inflammatory disease. Bacteria can move upward, from a woman's vagina or cervix - which is the opening to the uterus, or womb - into her fallopian tubes, ovaries and uterus, which then cause an infection. Many types of bacteria can cause pelvic inflammatory disease. But bacteria found in two common sexually transmitted diseases - chlamydia and gonorrhea - are the most frequent causes of pelvic inflammatory disease. 

After a woman becomes infected, it can take from a few days to a few months to develop pelvic inflammatory disease. 

The major symptoms of pelvic inflammatory disease are lower abdominal pain and abnormal vaginal discharge. 

Other symptoms of pelvic inflammatory disease may include one or more of the following; fever, pain in the right upper abdomen, pain during vaginal intercourse, and irregular menstrual bleeding.  

Pelvic inflammatory disease, particularly when caused by chlamydia, may produce only minor symptoms or no symptoms at all, even though it can seriously damage the reproductive organs. 

Untreated, pelvic inflammatory disease causes scarring and can lead to infertility, tubal pregnancy, chronic pelvic pain, and other serious problems. 

Pelvic inflammatory disease is more common and more aggressive in HIV+ women than in uninfected women. Pelvic inflammatory disease may become a chronic and relapsing condition as a woman's immune system deteriorates. 

Women can play an active role in protecting themselves from pelvic inflammatory disease disease by following these steps and precautions: 

*  Call your doctor if you have discharge with odor or bleeding between cycles. 

*  Use either male or female condoms during sex. 


What is Pelvic Floor Dysfunction?

Pelvic floor dysfunction, which is also referred to as outlet obstruction or outlet delay, refers to a condition in which the pelvic floor muscles of a woman's lower pelvis - that surround the rectum, do not function normally. It is not known why these muscles fail to work properly in some women, but they can make the passage of stools difficult even when everything else seemingly is normal.

What Causes Pelvic Floor Dysfunction?

Women with pelvic floor dysfunction find that muscle pain occurs when muscles are tense, strained, traumatized and/or otherwise inflamed. Their pelvic muscles are no exception. Causes of pelvic floor dysfunction can include:

*  Chronic faulty posture with weak core musculature 
*  Trauma (fall on tailbone, old tailbone fracture, auto accident)
*  Inflammation or infection
*  Pelvic organ disease (endometriosis, irritable bowel syndrome, interstitial cystitis) 
*  Repetitive motion injuries such as those from gymnastics, volleyball, soccer, ballet or ice
    skating
*  Abdominal muscle wall weakness or hernias 
*  Chronic constipation
*  Pregnancy or complicated vaginal delivery 
*  Abdominal or pelvic surgery such as a hysterectomy 

Do I have Pelvic Floor Dysfunction?

Women with pelvic floor dysfunction often have changes in their spine and/or pelvis.  Symptoms or conditional might include; scoliosis, short leg, swayback or a "torsioned" sacrum. The most common symptoms of pelvic floor dysfunction include one or more of the following:

*  Vaginal pain 
*  Pain with urination 
*  Urinary urgency and frequency 
*  Rectal pain 
*  Pain during vaginal intercourse 
*  Pain with sitting, standing, walking 
*  Pain and/or difficulty getting up from a seated or lying down position
*  Hip pain often with loss of range of motion in hips 
*  Deep pain in lower back radiating to legs, thighs, groin, hips 
*  Abdominal and lower abdominal/intestinal pain
*  Pelvic pressure or a feeling like your vagina or uterus are "falling out."
*  Involuntary loss of urine or stool 

What are Pelvic Adhesions?

Pelvic adhesions are the cause of many gynecological problems including significant pain, infertility and conception. Pelvic adhesions are irritations of a woman's pelvic organs as a result of a "pelvic inflammatory event" or from trauma to the area such as in the case of pelvic or gynecological surgery.

Examples of a pelvic inflammatory event include; fallopian tube infections that might occur from endometriosis, removal of an ovarian cyst, sexually transmitted diseases such as gonorrhea, post surgery infections, and even appendicitis and appendectomies.

As a woman's body's pelvic area recovers from an inflammation, trauma or surgery, it begins the healing process and starts to repair itself.  The woman's body and its' healing process may cause some tissues and structures in the pelvis to become unintentionally "stuck" to another tissue or structure. In a normal woman's healthy pelvis, this space is lined with a tissue called the peritoneum, which also covers the outside of organs located in the abdomen and pelvis. In the pelvis of a non-injured/non-irritated woman, the peritoneum can be very "slippery" with the the organs and structures lying immediately next to each other that "slip" off each other and do not become bonded together. With a woman who has had a pelvic inflammation, trauma or injury, her body's healing process starts a sequence of events that may result in some of the pelvic tissues becoming "stuck" to or "adhering" to tissues or organs next to the inflamed, or injured tissue, and when this occurs, the outcome may be pelvic adhesions.


Facts About Female Sexual Dysfunction

       *   43% of all women (and therefore, their husbands/partners as well) are
            suffering from various types of Female Sexual Dysfunction, also called
            "Female Sexual Problems."

       *   50% more women than men, are suffering from Erectile Dysfunction, which
            is referred to as "Female Erectile Dysfunction."

       *   Many people fail to recognize that unless a woman's clitoris is fully erect,
            that she is incapable of reaching an orgasm.

Vaginal Relaxation?

Ladies, is your loose vagina causing you embarrassment or have you lost the joy of intimacy?  

If one or more vaginal childbirths have caused your vagina to become loose, and "not tight", he has probably noticed as well. You can once again, have the "tight vagina" of your youth! 

What you, and he are experiencing, is something called "Vaginal Relaxation," the medical jargon for "loose vagina."

Vaginal Relaxation?

Did you know that over 30 million American women and their husbands are suffering loss of joy and intimacy due to "Vaginal Relaxation?" 

Have you or your husband noticed that the thrill of intimacy you and he used to enjoy has been diminished due to the loss of your vagina's tightness?

Stop the Suffering! 
Our Board Certified Physicians have 
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Vaginal Relaxation!

Our doctors can treat and cure your (or your wife's) 
"Vaginal Relaxation" Problems!

Did you know that about 35 million to 40 million American women – and their husbands and partners - are suffering from “Vaginal Relaxation.”?  

“Vaginal Relaxation” is often referred to as a “loose vagina” wherein the vagina is not as tight as it once was, whether due to vaginal childbirth, age, or other vaginal trauma. The vagina has become relaxed, or loose, and now it has become a problem for the woman, as well as her husband/partner.

Some women, as another symptom of Vaginal Relaxation, have problems controlling their urine in certain situations or notice changes in their bowel habits. These symptoms of Vaginal Relaxation are typically related to one or more problems that occur as a result of vaginal childbirth, other vaginal trauma, aging or a combination of the above.  

There is hope!  Women, and their husbands/partners, no longer need to suffer from Vaginal Relaxation.  More and more doctors are treating women and couples suffering from Vaginal Relaxation with treatments – sometimes including surgery – that will help them return to a life without the embarrassment, disappointments and heartache of the symptoms and discomforts associated with Vaginal Relaxation.

What is "Nerve Stimulation" and how does Nerve Stimulation help patients?

There are various types of nerve stimulation, each with its own protocols for treating various ailments and conditions.

One type of nerve stimulation is for treating people with moderate to severe depression.  Depression can be a very serious and life-threatening condition that may require life-long management and treatment.  Treating depression may sometimes have a lower than hoped for success rate and estimates indicate that more than half of all patients with depression have relapses. Anti-depressant drugs and medication may lessen symptoms but may not relieve all of the symptoms in some patients.

Seizures also do not always respond to treatment. Some patients have tried two or more medications and still have seizures, as well as side effects from the drugs, both of which affect their quality of life.

Vagus nerve stimulators are a small medial device that are implanted under the skin of the chest.  A very small wire runs to the patient's vagus nerve, which is then stimulated by the device, in the same manner a pacemaker works.  In general, patients with depression normally experience an improvement in alertness, energy. memory, their depression improves as a result. better mood. These quality-of-life benefits improve over time. 

Vagus nerve stimulators, in general, have proven to be a safe and effective way to control seizures and lessen the severity of depression.   Because Vagus nerve stimulators are used, drugs are usually not required, and there are no side effects that are associated with anti-depressant or seizure-control medications.

See:  www.DepressionHelp.net  for more information about depression.

What is Perineoplasty?

Perineoplasty, also known as "Perineorrhaphy,"is one of the fastest growing elective medical procedures and is the reparative or plastic surgery of the perineum which helps women with problems with vaginal opening laxity or looseness - medically referred to as "Vaginal Relaxation."  Many also incorrectly call this procedure "vaginoplasty" or "vaginaplasty."

Perineorrhaphy is the reconstruction of the muscles and tissues at the opening of the vagina and has successfully decreased the "introitus" or size of the vaginal opening. Perineorrhaphy does NOT reduce sexual sensation, in fact, properly performed, Perineorrhaphy INCREASES sensation for the woman as well as her husband/partner.

What is Colporrhaphy? 

Colporrhaphy is the surgical repair of the vaginal wall. This includes repairing many types of vaginal surgery, including the repairs of the vagina in a "Pelvic Organ Prolapse," "vaginal prolapse," "Vaginal Vault Prolapse," or the repair of a "cystocele" in the vaginal wall(s) or vaginal vault or a rectocele. A cystocele occurs when the bladder protrudes into the vagina, and a rectocele when the rectum protrudes into the vagina.

In the Colporrhaphy procudeure, a uro-gynecologist, or gynecological surgeon, places a vaginal speculum inside the vagina, which spreads/keeps the vagina open, for the doctor to inspect and repair the vagina. The vaginal wall is cut opened to reveal an opening in the supporting structures, or fascia and the defect is closed and then the vagina is repaired by suture and closed, and the speculum removed. 


Who performs the Colporrhaphy and where is it performed?

Colporrhaphy is usually performed in a nearby hospital operating room by a uro-gynecologist, urologist or gynecological surgeon.


What is the Vaginal Vault?

What is Vaginal Vault Suspension?

Vaginal Vault Suspension is a surgical procedure that provides support for the apex/vault of the vagina to various pelvic structures.

What is Vaginal Dryness?

Vaginal dryness is one of the most distressing, and painful problems a woman faces.  Vaginal dryness occurs when the natural vagina secretions decreases within the vagina. The amount of vaginal moisture varies throughout a woman's monthly menstrual cycle. Vaginal dryness is particularly problematical as a woman enters and becomes menopausal.

What is a "Vaginal Moisturizer"?

Vaginal moisturizers, provided by numerous companies, and a variety of brand names, are products designed to relieve the pain and discomfort of vaginal dryness. These products are applied or inserted, into the vagina, one or more times per day, depending on the amount of vaginal dryness she may be experiencing.

A vaginal moisturizer may or may not be a vaginal lubricant.  Vaginal lubricants are normally used as an aid for intercourse and used on a short-term basis to help a woman that is not able to produce enough vaginal moisture to permit her to comfortably (and painlessly) engage in intercourse.  

A menstruating woman's vaginal moisture changes from day to day, and varies depending upon her hormones that control the production of vaginal moisture.  A woman can experience vaginal dryness even during times of menstrual bleeding, especially when using tampons, as tampons can remove the natural moisture her vagina produces which can cause irritation and pain.

What is Female Sexual Arousal Disorder?

Female Sexual Arousal Disorder or simply "FSAD" occurs when a woman is unable to attain and maintain a full and complete erection of her clitoris along with sufficient vaginal lubrication during intercourse to be able to reach an orgasm.  

Female Sexual Arousal Disorder may also be diagnosed when the woman has no desire for sexual intercourse. 

Female Sexual Arousal Disorder affects up to 43 percent of all women, or an estimated 90 million women. Most women (more than 1/2) with FSAD are postmenopausal. Some women with Female Sexual Arousal Disorder describe the condition as being "unable to get turned on," or being continually disinterested in sex. Female Sexual Arousal Disorder has  also been called "frigidity." Other symptoms of Female Sexual Arousal Disorder may include dyspareunia and vaginismus, both of which involve pain during intercourse.

The woman and her husband/partner should both be seen as this is a "couple's problem" that is typically best resolved with both partners in treatment.  Their doctor will also insure that this  is not the result of another psychological disorder which could be a primary problem. 

If the husband/ partner of a patient with suspected Female Sexual Arousal Disorder feels that this is a problem within the relationship, that concern should be sufficient for the individual to seek psychological consultation.

What is Female Erectile Dysfunction?

Female Erectile Dysfunction occurs when a woman is unable to attain, and maintain a complete erection of her clitoris through orgasm.

If the husband/partner of a patient with suspected Female Erectile Dysfunction feels that this is a problem within the relationship, his concern should be sufficient for the individual to seek psychological consultation. 

What Are Female Sexual Problems?

Female Sexual Problems are also referred to as "Female Sexual Dysfunction."  A woman may have one or more Female Sexual Problems that we are just now learning that may be related to a number of factors.  

Typically, Female Sexual Problems are labeled generically as "Female Sexual Dysfunction" until such time as her doctor or therapist may be able to make a proper diagnosis.  

Female Sexual Problems may be a cause of significant distress to both her and her husband. 

If the husband/partner of a patient with suspected Female Sexual Problems feels that this is a problem within the relationship, his concern should be sufficient for the individual to seek psychological consultation. 

What is Female Orgasmic Disorder?

Female Orgasmic Disorder is defined as a sexual dysfunction that is characterized by a persistent or recurrent delay or absence of orgasm following the excitement phase of the female sexual response cycle, causing significant distress or interpersonal problems, and not being attributable to a drug or a general medical condition. 

Female Orgasmic Disorder is directly related with the woman's inability to attain and maintain a fully-erect clitoris.  

Without a full erection of the clitoris, a woman cannot reach an orgasm. 

What is Hypoactive Sexual Desire Disorder?

Hypoactive Sexual Desire Disorder or "HSDD" has been defined as a deficiency or absence of sexual fantasies and desire for sexual activity. Hypoactive Sexual Desire Disorder is considered a disorder if it causes distress for the woman or husband.  The woman and her husband should both be seen as this is a "couple's problem" that is typically best resolved with both partners in treatment.  Their doctor will also insure that this  is not the result of another psychological disorder which could be a primary problem. 

If the husband/partner of a patient with suspected Hypoactive Sexual Desire Disorder feels that this is a problem within the relationship, his concern should be sufficient for the individual to seek psychological consultation.

Psychiatric Medicine
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