The Most Basic Advice

If any doctor or specialist diagnoses you with any one prolapse (bladder, rectal, vaginal), it is critical that you not allow a single prolapse repair. First find an ob/gyn who is experienced in evaluating and treating pelvic prolapse (which views the entire condition of the pelvic organs).

If the single prolapse is due to a weakened pelvic floor condition or another pelvic issue, other organs may be impacted and the surgery may lead to the next prolapse. A trained ob/gyn will decide in which order the prolapse(s) needs to be repaired. Having a single repair and then learning of the pelvic prolapse can cause complications.

It's your body. Take charge and get a second opinion from a board certified ob/gyn who has adopted viewing any organ prolapse as potentially pelvic prolapse.


Not so fast...

Of course when the rectal prolapse suddenly appeared again, I panicked. These are body parts falling to the outside. Very disturbing. Because of the holiday, Brian placed an emergency call to Dr. DeLeo. That's when we learned the doctor does not do emergency call backs. I spoke to her office the next day and secured an appointment for July 6.

Dr. DeLeo confirmed the presence of a "slight" rectal prolapse. She asked me to have a "second opinion" with a colo-rectal specialist. I left her office wondering why she asked me to have a second opinion. Isn't that something the patient requests? She didn't say, "I'd like you to see a specialist because I'm not sure what is going on." Seeing a male colo-rectal person was not an option for me.

I returned home and hit the internet searching bladder and rectal prolapse. That was the first time I ran into the term "pelvic prolapse" or "pelvic floor disorder". They were articles about the big picture. The bladder, vagina, and rectum are all connected in terms of issues. When the bladder prolapses, it bulges into the vagina. The vagina can also prolapse causing pressure on the other two organs. A rectal prolapse can cause pressure on the vaginal wall. One of the main causes of pelvic prolapse is weakening of the pelvic floor muscles which can be due to age, childbirth, frequent lifting, and (while not specifically stated) I would imagine long-term sexual abuse.

I extensively researched the best way to evaluate pelvic prolapse. The NIH highly recommended a specific type of MRI. I printed out their recommendations and requested an appointment with Dr. DeLeo right away. I cancelled the appointment with the colo-rectal surgeon because I wanted the "big picture" approach. If that surgeon confirmed the rectal prolapse, he would have recommended a rectocele without taking the condition of my entire pelvic region into consideration.

My thinking at that point was Dr. DeLeo had performed the cystocele well. The explanation given for the immediate rectal prolapse was that one prolapse usually leads to another. "Nothing to worry about. I can fix that." While she was board certified, I realized she was certified in General Surgery but held herself out to be experienced with ob/gyn issues. Because she had been recommended for the colonoscopy my assumption was she knew that area of the body well. I didn't mind working with her.

In the meantime, I was concerned about additional time away from my clients. I didn't have an ob/gyn because my PCP since 2004, Dr. Bogdan, had been doing my annual Pap smear and checkups. I called her office to find out if she could get me in to see a female ob/gyn because I was in a mid-pelvic crisis and wasn't positive I was with the right doctor. Each ob/gyn I called either wasn't accepting new patients or had a wait until January. It was July. The prolapse was too uncomfortable for me to wait that long. I also assumed Dr. DeLeo was sending reports to Dr. Bogdan so she could monitor what was happening with me.

Returning to Dr. DeLeo's office with research in hand, she ordered an MRI for me. During my next meeting with her, she reviewed the MRI results with me. I had a rather large cyst on my left ovary, likely a "chocolate cyst" also called an endometrioma. She indicated she would have to remove the cyst before she performed the rectocele. Both procedures were scheduled.

Lesson: Even if your PCP performs your annual ob/gyn checkup, make sure you are on record with an ob/gyn in case of an emergency.

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