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Pelvic Organ Prolapse: Pessary vs. Surgery

By Joseph Gauta, MD, FACOG

Pelvic Organ Prolapse:  Pessary vs. Surgery Pelvic Organ Prolapse (POP) affects 1 in 3 women. As women age, their pelvic floor, which protects and supports the internal pelvic organs may become weakened, stretched, less elastic and less resilient. The weakened pelvic floor muscles can subsequently allow organs to prolapse and fall into the vagina. It can also cause overactive bladder and incontinence issues. As if aging wasn’t hard enough, now women are faced with the inconvenience and very often painful effects of a weekend pelvic floor. Much of this is directly correlated with the lack of estrogen. Essentially, pelvic organ prolapse is herniation of the organs.

Some of the Symptoms of Pelvic Organ Prolapse May Include:
• Feeling of Pelvic Heaviness or Fullness
• Pulling or Aching Sensations in the Lower

Abdomen, Groin or Lower Back
• Leakage of Urine
• Problems Having a Bowel Movement
• Bulging of the Pelvic Organs into the Vagina

If you’ve been diagnosed with POP understanding your treatment options is essential. Your physician will help you determine which path you should take depending on your pelvic floor severity.

Treatment Options for POP
• Pelvic Floor Exercises (offers minimal relief)
• Medications & Creams (offers limited relief)
• Pessaries (non-surgical)
• Surgery

Essentially, women are faced with a decision on whether a pessary device or surgery is the best way to handle their prolapse. That decision is best made by discussing their individual condition with their physician. However, the following are a few important things to consider when choosing a treatment.

The pessary device is inserted vaginally to keep your organs supported. It is very similar to a diaphragm and will be fitted by your physician in the convenience of the doctor’s office. You will be able to

remove, clean and reinsert the device yourself. This is a non-surgical approach, but again, will not permanently move your organs back into their proper position.

Minimally invasive surgery is a permanent option that puts your organs back in place and reconnects the ligaments while strengthening the pelvic floor with a sling or mesh sometimes. Not all physicians perform pelvic organ prolapse surgery on an outpatient basis. Through Dr. Gauta’s advanced training in urogynecology he has perfected the ability to perform these surgeries on an outpatient basis which means there are no overnight hospital stays where the patients are at risk for hospital acquired infections and is at a lower cost.

What to Expect from Dr. Gauta’s POP Surgery Protocol
• All surgeries are done on an outpatient basis
• He sends a nurse to your house to check on you
and perform routine duties
• No abdominal straining for 2 weeks
• No sex for 4 weeks
• Some people have a light vaginal discharge for about 4-6 weeks
• Some people have no bowel movement for up to 5 days

You do not have to live with pelvic organ prolapse. There are several proven options for you to explore. Dr. Gauta specializes in pelvic floor weakening. He has the experience you can trust. His diagnosis, techniques, and proficiency are unparalleled. Let him help you get through POP, menopause and beyond with confidence.

Joseph Gauta MD
Dr. Gauta is certified by the American Board of Obstetrics and Gynecology in the subspecialty of Female Pelvic Medicine and Reconstructive Surgery (Urogynecology). He is the founder of The Florida Bladder Institute, the region’s premier Urogynecology practice specializing in treating women with urinary incontinence, bladder and bowel dysfunction, pelvic floor disorders, organ prolapse, pelvic floor reconstruction, and a variety of other complex women’s health issues.

Dr. Gauta realized that women would benefit significantly and achieve excellent outcomes by treating these problems with an organized and comprehensive approach rather than as individual issues. Using his expertise and resources, a full complement of the most advanced technologies and his skilled team of physicians and nurses, Dr. Gauta established the Florida Bladder Institute, which continually delivers the highest quality care with compassion, discretion, and dignity to their patients. They offer a full array of the latest diagnostic, therapeutic, rehabilitative and surgical techniques in comfortable and convenient settings all with the goal of helping women regain control and reclaim their freedom. He remains an independent practitioner, employed by neither the hospitals nor the insurance companies.

We welcome our new colleague Dr David Lustig who is also available to see new patients.

To schedule your appointment, please call 239-449-7979 or visit

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