One day last summer, Lenore Quintiliano decided to help some friends put in a new patio.
Part of the job meant she had to hoist 25-pound pavers into place. Not an easy gig, but still a great way to help friends.
But when Quintiliano, 68, returned home for a shower, something felt terribly wrong in her pelvic area.
“I noticed there was something happening over the past year, but this was the worst,” she said. “I was like, ‘It’s time to get this taken care of.’”
She called her gynecologist right away.
An examination revealed she had suffered vaginal vault prolapse, which happens when the top of the vagina drops down into the vaginal canal and sometimes even outside of the vagina.
In Quintiliano’s case, her bladder had also prolapsed into her vagina, which meant weakened tissue between the bladder and vagina had allowed the bladder to sag.
Based on a recommendation from her neighbor, Quintiliano opted to make the three-hour drive from her home in Charlevoix, Michigan, to Grand Rapids so she could seek care from Nima Shah, MD, a urogynecologist with Spectrum Health Medical Group.
On the first visit, Quintiliano listened as Dr. Shah explained what happened.
“Honestly, a lot of women think, ‘This must be a tumor,’” Dr. Shah said. “After I talk to them and examine them, I explain what prolapse is and how it can occur.”
She aims to assuage their fears and dispel certain myths, explaining that prolapse is typically not cancer. Also, while the organ might hang down, it’s never going to fall out of your body. You can’t hurt it or poke a hole in it, either.
“Once they understand what’s happening, they can make a decision about what to do,” Dr. Shah said.
Dr. Shah talked with Quintiliano about her options, which included pelvic floor physical therapy to strengthen her pelvic floor using a pessary, a vaginal insert that helps support the prolapsed tissue and hold it in place.
Patients can also opt for surgery.
That’s what Quintiliano chose, hoping that a surgical procedure would ensure the best path back to her active lifestyle. She enjoys bicycling and is a member of a ski team at Nub’s Nob Ski Area in Harbor Springs.
For surgery, Dr. Shah placed sutures at the top of the vagina and under the bladder, affixing the prolapsed part to strong ligaments. This moved things back into their rightful place.
She also placed a sling under the urethra to treat urinary leakage.
While every case is different, Quintiliano had several risk factors that contributed to her prolapse: Her children were delivered vaginally, she had a previous hysterectomy and she had a previous uterine prolapse.
Age also increases risk, Dr. Shah said.
Quintiliano said her recovery has been manageable and she continues to do Kegel exercises, which Dr. Shah recommended be done throughout the day.
“I feel great,” Quintiliano said.
While she had to sit out the 2018-19 ski season, she’s now looking forward to hitting the slopes next winter.
Dr. Shah encourages women to take control of their health.
“As women, we deserve the best care possible and we should not just have to live with something because we’re busy caring for everyone else,” Dr. Shah said. “There are physicians who can help with cases of prolapse and urinary incontinence. No longer is it the norm to just live with it. Don’t accept that.”
Patients should start the journey with their primary care providers or gynecologists.
“There are things we can do to help,” she said.