Rockledge, Florida

Marja Sprock, M.D., FACOG, FPMRS Board Certified
Fellowship Trained Urogynecologist

Now Accepting New Patients

info@CFUroGyn.com      Phone:  321-806-3929

Recently Published

new  New Treatments for Vaginal Atrophy

new  The Healthy Weight Lifestyle Formula

new  Small Battery Can Fix Bowel Control Issues

new  Laser and the Vagina

new  Fecal Incontinence  - More Common Than You Think!

new  Overactive Bladder

new  Painful Bladder Syndrome / Interstitial Cystitis

new  Stress Urinary Incontinence

new  The Thrill is Gone

new  Chronic Constipation

Laser Treatment for Vaginal Atrophy

Have You Had Your Pap Smear?

Resources for Pelvic Floor Disorders

The Uterine Fibroid Dilemma

Are You Leaking ?

New Non-Surgical Laser Solution for Stress Urinary Incontinence

New Treatment Option for Stress Urinary Incontinence

Non-hormonal Vaginal Atrophy Treatment -- Non-painful Sex Without Estrogen

In-Office Painless Laser Vaginal Tightening

Central Florida UroGynecology Announces LASER 4D Aesthetics

Accidental Bowel Loss - A Socially Hidden Problem

Nerve Stimulation to Treat Urinary and Fecal Problems

Is UTI a Major Health Problem?

It Appeared to be an Overactive Bladder

Pessary Treatment of Prolapse

Overactive Bladder Evaluation Chart

Accidental Bowel Loss or Fecal Incontinence

Overactive Bladder Guidelines

Vaginoplasty and the “Designer Vagina”

Surgical Treatment of Stress Urinary Incontinence

Recurrent UTI - Urinary Tract Infection

Pads are "Out of Style"

Stool or Bowel Incontinence

Pain with Sex

Nightime Urination

A Tighter Vagina - the Answer to Happiness

Do not Let Urine Loss Color the Golden Years

Office Injection Procedure for Urinary Incontinence

Read a Magazine and Regain Urinary Continence

Position Statement on Mesh Midurethral Slings

Botox Covered by Insurance

Walk to Guard Against Disease!

Estrogen Treatment Possible Side-Effects Often Overstated -- Consider the Benefits!

What the doctor does not tell you…

Tips from Dr. Sprock
September 2013

Health and Feeling Good About Yourself

I have to Go All the Time

Treatments for Fecal Incontinence

Third Generation i-Lipo Xcell now available!  FIRST IN U.S.A.

Central Florida UroGynecology Opens Its New Facility on Eyster in Rockledge

Tips from Dr. Sprock
    
 March 19     March 10

But I don't have to go ...

Pelvic floor muscle training and the In Tone® device

Jessica Alba had i-Lipo, Would you?

Take Action in the New Year !!

InTone Home Device to Treat Urinary Incontinence

Regenlite Skin Tightening and Collagen Stimulation

New Options for Incontinence

Sexy Meshes ???

Control Incontinence.  Enjoy Being a Senior!

A Happy Patient Testimonial - Swimming Again After Bladder Procedure  <external>

Getting Rid of Adult Diapers

Nocturia, Nighttime Voiding

Dr. Sprock Connects with her Patients

Inches Off Where You Want Them Off - I-Lipo® Introduction

Another Incontinence Success Story

Space Coast Daily:  Dr. Sprock Does I-Lipo  <external>


Previously Published by Category

URINARY ISSUES

FECAL STOOL ISSUES

SEXUAL HELP

COSMETIC GYNECOLOGY

I-LIPO

PROLAPSE

OVERVIEW


Technical & Educational Info


All Published Articles

Pessary Treatment of Prolapse
By Marja Sprock, M.D. FACOG, FPMRS Board Certified

A pessary is a support or space filling device which can be placed in the vagina in case of descend or prolapse of the organs. Pelvic organ prolapse (POP) of the bladder, uterus, top of the vagina after hysterectomy (cuff) or small bowel can be supported by a pessary. They are usually not very effective in case of weakness of the vaginal/rectal wall (rectocele).

POP occurs when there is lack of adequate tissue and muscle support of the pelvic floor. The bladder is most commonly involved, but uterus, cervix, vagina, small bowel, urethra or rectum can all be part of POP.

A lot of women may have some POP, however are not bothered by it. Pregnancy, labor and childbirth may result in POP as well as advancing age, genetic predisposition, obesity, constipation and connective tissue disorders.

Repair of vaginal prolapse, has been scrutinized recently and numerous patients are unsure about what to do. Some have chosen to stay away from a healthcare provider, since they feel that there is no good decision to be made.

Surgery is an option when organs start protruding through the vagina, possibly causing back pain, pressure, difficulty urinating, night time urination, sitting on an egg feeling, ulcerations, bleeding, difficulty evacuating bowel movements and difficulty with sexual relations.

Surgery can be performed vaginally or through the abdomen with a laparoscope or robot. When using a laparoscope or robot a mesh is usually used; through the vagina it can be repaired with or without a mesh. A prolapse repair with permanent and/or non-permanent stitches has a higher failure rate than if a mesh is used. The FDA has released several reports and warnings of potential side effects with the use of a mesh. The mesh will possibly be re-qualified as a high-risk device. This as opposed to the sling for stress urinary incontinence (SUI) which will remain a low-to moderate risk device. Several companies are performing after market studies and we already have several studies in the literature showing the superiority of some meshes over others. Usually the lower weight, the lower density, the more chance there is for natural ingrowth of tissue, leading to a stronger repair.

The FDA states that all surgical procedures have risks. Also there are risks with medical implants. A mesh is permanent, a pessary temporary and can be removed. In fact a pessary needs to be cleaned and reinserted on a regular basis. A pessary however can keep organs in place, without having to go through a surgery. A ring pessary which makes people think of a diaphragm, can be removed before intercourse or left in; a space occupying pessary like a Gellhorn can’t be easily removed or left in for sexual encounters. A pessary like a Gellhorn gives great support to a severely prolapsed vagina, however needs professional cleaning and reinsertion at least once every 3 months. If a pessary is left in place for too long, it will create discharge and could produce pressure ulcers.

Pessaries, think of them as support shelves in the vagina, need to be fitted. If the POP is inside the vagina and not protruding like an egg or ball, the ring pessary can usually provide support, unless there are very weak muscles. A Gellhorn or space occupying pessary is usually successful for the more severe prolapse. Some women are very pleased with their pessary and will use this for years, others do not like to have a shelf, which is prone to the formation of discharge, in the vagina.

Non-surgical options for POP are pessary and pelvic floor muscle training. Pelvic floor muscle training is crucial for vaginal health, no matter which solution for prolapse will be chosen. It is difficult to walk without using your leg muscles; there is lack of vaginal support without strengthening you pelvic floor muscles. Remember there is no surgery involved in strengthening your pelvic floor muscles, just some effort and time. It can be done at home after proper instruction or with helpful devices.

Wilma at 66 had enough of feeling it was Easter all year long. There is nothing good about having a bulge coming out of your vagina, providing a constant pressure and egg feeling. Her 89 year old mother Edna had had the same problem and had been very happy with a pessary. Edna did not want to remove, clean and reinsert the pessary herself and had the doctor do it for her. Edna used to get up 4-5 times at night and now gets up once and feels much better. Wilma after reading about all the options and the pro’s and con’s of POP repair, was feeling dazzled. She needed more time, but was done with Easter. Wilma requested a pessary insertion and is sure she eventually desires a surgical repair, however decided to buy some time and still be comfortable. Wilma does not care for the discharge the pessary provokes; her mother barely notices anything with hers. Wilma also likes to be sexually active, which her mother has no interest in anymore.

Remember everybody is different, even the ones with the same genetic predisposition.

Having a pessary fitted is one way of dealing with POP. Make an appointment at Central Florida UroGynecology and we can prevent you from getting dazzled with all the POP options and make sure you and your prolapse get taken care of.

Call 321-806-3929 and schedule an appointment with Katrina Davis, MD or Marja Sprock, MD. or check us out at www.CFUroGyn.com

"Central Florida UroGynecology where high tech and common sense meet"


Central Florida Urogynecology

101 Eyster Boulevard, Rockledge, FL 32955

Phone 321-806-3929

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updated:  January 11, 2016