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1. Porter Regional Hospital: How to Treat Pelvic Floor Prolapse

   Mar 19, 2015 | NWI Times

   ...“A weakened pelvic floor, also called pelvic floor prolapse, can be minor or it can be more severe,” said Dr. Robert Lai, board certified urologist who is part of the Porter Physician Group...

Client Attorney Privileged/Attorney Work Product/At Request of Counsel

Online Sources

1. Porter Regional Hospital: How to Treat Pelvic Floor Prolapse

   Mar 19, 2015 | NWI Times

   If you are a woman who is experiencing bladder leakage, trouble with bowel movements or experiencing pain and pressure in your abdomen, you may have pelvic floor prolapse.

   “A weakened pelvic floor, also called pelvic floor prolapse, can be minor or it can be more severe,” said Dr. Robert Lai, board certified urologist who is part of the Porter Physician Group.

   Dr. Lai is one of the only urologists in Northwest Indiana who specializes in women’s urology. He has been treating the condition since 2000.

   Pelvic floor prolapse is a weakness in the pelvic floor, and symptoms of the problem can present itself in numerous ways.

   “Think of the pelvic floor as a bowl. A healthy pelvic floor is made out of porcelain, while an unhealthy one is made out of stretchy rubber,” he said. “The stretchy rubber can start to collapse onto itself and fall.”

   When the condition is minor, symptoms can include trouble with bowel movements and trouble emptying the bladder.

   In extreme cases, however, the organs can start to fall through the pelvic floor and into the vagina, Dr. Lai said, and can impact the uterus, rectum and bladder.

   “It can start with stress incontinence, or bladder leakage with a sneeze, or a laugh, or by standing up and down,” he said. “But in extreme cases, it may feel like something is falling down internally, and women may feel a lot of pain.”

   Dr. Lai, a graduate of McGill University Faculty of Medicine in Montreal, completed his internship and residency at the University of Toronto. He is fellowship trained in neurourology, neurobiology and female urology. He won the Valentine Scholarship, and was able to pursue a fellowship in female urology at the New York Academy of Medicine.

   Dr. Lai said giving birth contributes to whether women will suffer from this condition.

   “There was a good study done by a Norwegian group in 2000 that said childbirth plays a big role,” he said. “The more children you have, the more risk you have for developing it. Also, the method of childbirth matters. If you deliver vaginally, you’re at an increased risk than if you deliver by C-section.”

   Heredity can also play a role, Dr. Lai said.

   “If your mother or grandmother had it, then you are at an increased risk,” he said. “And if you have it, then it is more likely your daughters will have it.”

   Age also plays a role, with risk increasing as you age and the supporting structures in the pelvis weakening.

   Behavioral factors, such as smoking, might also increase the risk, according to the Norwegian study.

   There is no way to prevent pelvic floor prolapse completely, but several things might be able to decrease the risk or lessen the symptoms.

   Doing Kegel exercises, or even practicing yoga, might help prevent incontinence, Dr. Lai said.

   “Weight also plays a factor, so if you can keep your weight down, that can help prevent incontinence, as well,” he said.

   If you feel like you might have these symptoms, visit your primary care physician or gynecologist, and that doctor can refer you to a urologist, if necessary.

   “They can take a complete medical history and do a pelvic exam to assess the risk,” he said. The doctor might suggest exercises to try before seeking surgical intervention.

   If the case is severe and surgery is necessary, Dr. Lai said there are a variety of methods from which to choose.

   Some doctors prefer to use tissue from the abdomen to reinforce the pelvic floor.

   Other doctors prefer to use tissue from a cadaver for the procedure, and others choose to use mesh.

   “Each way of doing the procedure has its benefits and risks,” he said. “Patients should have extensive conversations with their doctor to determine which surgery is correct for them.”

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