By Ana Theresa Williams,BSN,RN
Not everyone knows or is aware of the organ pelvis. Pelvis is either the lower part of the trunk of the human body between the abdomen and the thighs (sometimes also called pelvic region of the trunk) or the skeleton embedded in it (sometimes also called bony pelvis, or pelvic skeleton).
The primary function of the pelvis is to allow movement of the body, especially walking, running, sitting and kneeling. The pelvis contains and protects the reproductive organs as well as the bladder and rectum.
However, problems commonly take place like this so-called pelvic organ prolapse, wherein your bladder-drops or prolapses from its normal place in your lower belly and pushes against the walls of your vagina. This can happen when the muscles that hold your pelvic organs in place get weak or stretched from childbirth or surgery.
Davao Doctors Hospital urogynecologist and pelvic reconstructive surgeon Geoffrey M. Que,MD said pelvic organ prolapse is very common with several factors leading to it. Among them includes having many kids, vaginal birth, menopause or aging and hypoestrogenism or estrogen deficiency that refers to a lower than normal level of estrogen, the primary sex hormone in women.
Other causes are chronic coughing, constipation, obesity, trauma to the pelvic floor and genetic factors or hereditary, he added.
But the medical expert said this can be treated either through conservative or surgical. Conservative treatment includes kegel’s exercise or pelvic floor muscle training, pessary use or a special device made of pvc, latex and silicone that is inserted inside the vagina to support the pelvic organs, behavioral modifications and lifestyle changes. (Please see how the ring pessary is inserted and where it is situated through an illustration provided by Dr. Que.)
Meanwhile, Dr. Que said surgery is only indicated for symptomatic patients.
He said the chief complaint of the patient is like there’s a palpable introital mass that is aggravated on prolonged standing or during effort or exertion. This means “murag naay makapa na itlog sa manok” or “kung gamay pa, murag itlog sa pugo,” or “murag naay niloslos.”
For the patients, they can feel and palpate it. Then in advanced stages, some patients will have a difficulty in urinating or defecating due to obstruction of the prolapse, the urogynecologist and pelvic reconstructive surgeon said.
Pelvic organ prolapse is very common to women above 40 years of age and those in the perimenopausal and menopausal stages, he said.
This condition cannot be treated through herbal. They should see a professional instead of herbalist, he said.
“Instead of saving money for herbal meds, they’ll end up paying more due to complications with herbal therapy in general,” Dr. Que explained.
Since pessary is quite expensive for those who are in financial difficulties, they can visit the OBGyne Department of Southern Philippines Medical Center along Bajada Road, particularly at the OPD section of the hospital where they can get FREE urogynecology and reconstructive pelvic surgery from the hospital’s clinic every Wednesdays from 1 to 5 in the afternoon, the medical expert said.
“Pessary is quite tedious initially, but it gets easier eventually,” he added.
“Pessary is usually removed and washed at night time then inserted once again during daytime. Patients can do it by themselves. But for active patients (not bedridden), they’ll use pessary for a month or a couple of months then they will have their operation already.”
If left untreated, Dr. Que said it will worsen and progress to a more advanced stage. It will also end up with more lower urinary tract symptoms like difficulty in urination, recurrent UTI or urinary tract infection, bleeding, and more prominent defecatory dysfunction like constipation and feeling of incomplete rectal vault emptying.
Take note that pelvic organ prolapse is NOT a cancer. The staging is just used to connote the degree of the prolapse like the more advanced the prolapse has become, the signs and symptoms also worsened, he said.