236. Prolapse - Surgical and Non Surgical Options

You Are Not Broken

Kelly Casperson, MD

Medicine, Health & Fitness

5 • 743 Ratings

🗓️ 5 November 2023

⏱️ 55 minutes

🔗️ Recording | iTunes | RSS

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Summary

236 – Prolapse – Surgical and Non-Surgical Options This podcast is sponsored by Femselect Thanks to our sponsor Sprout Pharmaceuticals addyi.com/notbroken Go to Addyi.com and use code NOTBROKEN for a $10 telemedicine appointment. Thanks to our sponsor Uber Lube 10% off, Code NOTBROKEN uberlube.com Dr. Sonya Ephraim, MD, FACOG, FPMRS, is a urogynecologist and the founder of Allure Pelvic Wellness and Aesthetic Gynecology in Deer Park, Illinois, outside of Chicago. She talks about how she decided to go back to do a fellowship in female pelvic medicine. In this episode, we talk a lot about prolapse and touch on- · What is pelvic organ prolapse? · Why prolapse needs a rebranding – so much shame · Risk factors for prolapse · What are the signs and symptoms? · Our tips for treating constipation · Prolapse risk goes up after menopause – we discuss the likely role of hormones and decreased muscle strength. · The impact of prolapse on those suffering · Why we hate calling it “bladder prolapse” · How the bladder can be affected by vaginal prolapse and what may and may not improve · How do we know if we have prolapse · How do we know if we should treat prolapse · Risk of de novo stress urinary incontinence when prolapse is fixed, either with pessary or surgery · What is a pessary and what are the risks of a pessary. · Can you be sexually active with prolapse? · The role of pelvic floor physical therapy and prolapse. · Surgical treatment options: o One size does not fit all. o Obliterative surgery – colpocliesis o Hysteropexy vs. hysterectomy o Minimally invasive options – suture or mesh based (sacrocolpopexy) procedures o New treatment options (EnPlace) benefits and data o The cervix as a sexual organ for some people and the consideration of cervix/uterine preservation in prolapse surgery. · Modern prolapse repair is safe, effective and recovery is not too stressful for most women. · Post surgery instructions and rehab – vaginal estrogen and pelvic floor physical therapy · The risk of recurrent prolapse · When to consider adding a sling to your prolapse procedure · Just because someone or something said you have prolapse, doesn’t mean you need surgery Instagram.com/allurebydrsonya https://allurepelvicwellness.com/ #EnPlace, #PelvicOrganProlapse, #WomensHealth #PelvicHealth My previous Prolapse episodes 21 – pelvic organ prolapse master class 138 – February Live – Hormones, prolapse, pelvic floor PT and more 161 – “I Just need to put something in my vagina”, Prolapse, and how PT helps Did you get my “You Are Not Broken” Book Yet? https://amzn.to/3p18DfK Listen to my Tedx Talk: Why we need adult sex ed Join my NEW Adult Sex Ed Master Class: https://www.kellycaspersonmd.com/adult-sex-ed Join my membership to get these episodes ASAP when they are created and without advertisement and even listen live to the interviews and episodes. www.kellycaspersonmd.com/membership --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit megaphone.fm/adchoices

Transcript

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0:00.0	You are listening to You Are Not Broken, the only podcast that combines science, medicine, and psychology to re-educate your brain and help you live your best love life. And I'm your host, board certified female urologist, Dr. Kelly Casperson. All right, friends, welcome. I'm so excited to do this podcast about prolapse because it's been a long while and I don't expect my super fans like go back and listen to the podcast from episode one, but there's like over 200 episodes at this point. There is a very remote prolapse episode, but it's time to revisit. So I am here with my new friend, Dr. Sonia E. Friam, who is a urologist based in the Midwest out of Chicago,
0:40.0	and she does a ton of prolapse. And I do a ton of prolapse, and we're so excited to talk about
0:44.6	prolapse today. You did your OB-Gyne residency, and then you went back and did a fellowship
0:49.4	specifically in female pelvic medicine and reconstructive surgery. And now that's what you do.
0:55.9	Yep.
0:56.3	No more catching babies.
0:57.8	No more catching babies.
0:58.9	I would have done the same thing.
1:00.4	Yep.
1:01.0	If babies came between the hours of 9 a.m. and 2 p.m.
1:04.6	It wouldn't be so bad, would it?
1:05.9	I would be all about the babies.
1:08.1	The first time I delivered the baby, I was like, the miracle of life. Like by
1:12.5	baby number four, I'm like, oh, they come at 2 a.m. frequently. The miracle of life likes
1:18.6	nighttime. Yeah, they like to come really quickly, too. Yeah, totally. So, and there's such an
1:24.0	unmet need for female pelvic health, female pelvic surgeons.
1:28.5	Like, I always say this to be funny, but it's like, women are 50% of the population.
1:33.3	It's a lot of people.
1:35.5	And we do not have enough, you know, the untreated prolapse, the untreated incontinence.
1:39.7	All of that is, I think part of it's just, and then we don't have enough people to help that
1:44.8	out. How did you decide to do a fellowship in female pelvic medicine and reconstruction after,
1:51.5	you know, catching all the babies for five years after residency? It was a tough decision, you know,
	...

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