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Risk Factors and Causes

  • Pregnancy & Childbirth: This is the most significant contributing factor in most cases of female pelvic prolapse.  Childbirth places significant stress on the supportive muscles and ligaments of the pelvic floor and can cause them to weaken and stretch.  Women who have had multiple pregnancies, particularly large babies or vaginal birth, are at an increased risk.
  • Hysterectomy: The surgical removal of the uterus can have a significant effect on the tissues and organs that surround it inside a woman's body.  The "hole" left by the absence of the uterus can thus lead to a "caving in" of other organs.
  • Menopause: This female condition is characterized by a decrease in the hormone estrogen and is often accompanied by a reduction in muscle mass, especially for women who have had one or more vaginal deliveries.
  • Occupational Hazards: Work that requires repetitive heavy lifting can place significant strain on the pelvic organs, leading to straining and weakening of the muscles that hold the pelvic organs in place.
  • Overweight and Obesity: If the gravity of a normal weight woman is enough to place continued pressure on pelvic floor muscles, then any additional body weight can contribute to the increased risk of developing pelvic prolapse.
  • Chronic Constipation: Repetitive straining during bowel movements places stress on the pelvic muscles and may eventually weaken them to the point where organ prolapse occurs
  • Lung Diseases and Disorders: Chronic bronchitis or COPD characterized by frequent strained coughing can place stress on the pelvic muscles and may eventually weaken them to the point where organ prolapse occurs.
  • Genetics: Some women are simply born with weaker muscle structures and connective tissues than others, increasing their risk of developing pelvic prolapse.
  • Aging: A woman's risk for developing pelvic prolapse naturally increases with advanced age – which is simultaneously characterized by a loss of muscle mass and elasticity.
  • Pelvic Tumors (rare)

Symptoms

Cystocele 

  • Pain, discomfort or "heavy feeling" in the vagina, lower abdomen, groin and sometimes in the lower back
  • Visible bulging of tissue through the vaginal canal
  • Difficulty or problems with urination including increased urge to urinate and not feeling "empty" or relieved after urination
  • Discomfort or pain when having sexual intercourse

Rectocele

  • A soft bulge of tissue in the vagina that may protrude through the vaginal opening
  • Difficulty with bowel movements potentially including a need to press on the "bulge" in the vagina in order for stool to pass through
  • Feeling a sense of pressure or fullness in the rectal area
  • Feeling that the rectum has not completely emptied after a bowel movement
  • Difficulty with sexual intercourse including feeling a loss of tone or an overall looseness of vaginal tissue

Uterine Prolapse

  • Pain, discomfort or "heavy feeling" in the pelvis.
  • A soft bulge of tissue through the vagina that may protrude through the vaginal opening
  • Problems with urination including leakage or lack of urine control and retention
  • Constipation or the need to strain to produce a bowel movement
  • Unusual vaginal bleeding or excessive discharge
  • Feeling as though something is "falling" out of the vagina
  • Pain, discomfort or loose feeling during sexual intercourse
  • Symptoms that may cause more discomfort in the morning and seemingly relief as the day progresses
  • Symptoms that worsen with long periods of standing or walking

Enterocele

  • A heavy or "full" feeling in the pelvis that seems to be relieved by lying down
  • Pelvic pain
  • Lower back pain or pressure that seems to be relieved by lying down
  • A soft bulge of tissue through the vagina that may protrude into the vaginal opening
  • Vaginal pain or discomfort
  • Difficulty with or pain during sexual intercourse
  • A related prolapse condition including posterior prolapse, anterior prolapse or uterine prolapse
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