What to expect at your first Pelvic Organ Prolapse doctor visit
16 July 2021 by - Dr Demetri Panayi
The pelvic floor muscles can weaken with age, because of a genetic disposition, or risk factors such as obesity and frequent constipation. The resulting symptoms can include pain, pressure, or discomfort around the pelvic area, a bulge of tissue or organs that can sometimes protrude out of the vaginal opening, incontinence or difficulty passing urine, lower backache, and pain or difficulty becoming aroused during sexual activities.
It’s important to know that you are not alone since as many as 1 in 4 women are affected by Pelvic Organ Prolapse at some point during their lives, although not all women suffer the same symptoms, and some experience none at all. Those who do, say that it can greatly affect their quality of life and ability to carry out everyday tasks. It can be uncomfortable or embarrassing to think of discussing any of these symptoms with anybody, even with a close friend or family member, but it is crucial that you consult with a medical professional if you think you may be suffering from POP, so that a proper diagnosis can be obtained, and appropriate treatment can be administered as soon as possible.
Who can you visit about Pelvic Organ Prolapse?
As with many medical conditions, a proper diagnosis will depend on the experience of treating Pelvic Organ Prolapse that your chosen medical practitioner has. An appointment with your GP is the first step, and they’ll likely be able to provide a diagnosis and offer some initial treatment after a consultation. The most common treatment providers to visit besides your GP include gynaecologists, licensed midwives, and nurse practitioners. A specially trained urogynaecologist will have extra experience surrounding women’s health and urology and will be able to offer more specific insights regarding prognosis and treatments.
Your first visit to the doctor and what to expect
Your doctor will begin by asking you some routine questions about your medical history, and any symptoms or experiences that have led you to believe you may be suffering from POP. You should be prepared to answer questions considered sensitive, personal, difficult, or embarrassing to talk about.
After this, your doctor will ask if they can perform an internal pelvic examination. This is a quick examination similar to having a smear test. The doctor may use an instrument called a speculum, which when gently inserted into the vagina, holds the walls of the vagina open and allows them to see if there is evidence of prolapse and how severe it may be. They may also check the strength of the pelvic floor muscles using one or two fingers to feel inside the vagina.
Some women may put off going for an appointment with their doctor if they feel embarrassed or uncomfortable about what a doctor will do or what they may find. But it is important to take this first step. For additional support during the consultation, you can ask if there is a female doctor available to carry out these examinations or request to have a chaperone with you.
A diagnosis will be formed after discussing your symptoms, an internal pelvic examination, and the results of possible additional testing (this isn’t always necessary, but can include a CT scan, a test involving a camera that checks for abnormalities in the bladder called a Cystoscopy, and a Pelvic Ultrasound that uses radiology to look at the pelvic floor muscles, bladder, and reproductive organs).
Treatment Options for Pelvic Organ Prolapse
After a diagnosis, your doctor will discuss the possible treatment that is available for POP. A minor prolapse, or one that displays no negative symptoms and does not affect your day-to-day life, may not need further treatment and can possibly go away on its own. If the symptoms are affecting your daily life, or if the prolapse is considered to be more severe, your doctor may recommend non-surgical treatment options such as:
- Pelvic Floor Exercises – commonly known as Kegels, these exercises aim to strengthen the pelvic floor by relaxing and contracting the muscles surrounding the opening of the vagina, the urethra, and the rectum.
- Lifestyle changes – making positive changes such as stopping smoking or losing weight can help nullify the symptoms of POP. It is likely your doctor would recommend this in tandem with Pelvic Floor Exercises.
- A Vaginal Pessary – this is a small, soft, removable device that is inserted into the vagina to support any prolapsed organs. They can be left in during sexual intercourse, and the same pessary can be used for up to three months with regular cleaning.
Surgery may be recommended when Pelvic Organ Prolapse causes significant pain, discomfort, or loss of quality of life. It is not always necessary, and you do not need to go into your first visit expecting that surgery is the only treatment option available. Your gynaecologist will consider which organs have prolapsed and the severity, your age, the severity of your symptoms, and whether you have any future desire to have children, before making a recommendation to undergo surgery.
The London Women’s Centre is a leading private gynaecological and urogynaecological practice with various clinics in London. Our dedicated team of Consultant Gynaecologists, Urogynaecologists, and Women’s Health Physiotherapists are highly experienced in dealing with female health concerns, including prolapse and pelvic floor problems. If you think you might be suffering from Pelvic Organ Prolapse, click here to book a face-to-face consultation today.