Treatment of pelvic organ prolapse by obstetrician-gynecologist Irina Ivanovna Kulbach in Dnipro.

When to See a Doctor

Pelvic organ prolapse can present with various symptoms and cause discomfort in daily life. Sometimes the signs become noticeable after physical exertion or changes in the body. It is advisable to make an appointment with an obstetrician-gynecologist if you notice any of the following with pelvic organ prolapse:

• A constant feeling of heaviness or pressure in the lower abdomen
• A bulge or "lump" in the area between the legs
• Pain or discomfort when walking or engaging in physical activity
• Occasional problems with urination or a feeling of incomplete bladder emptying
• Difficulty with bowel movements or a feeling of incomplete bowel evacuation
• Disruption of your usual lifestyle due to discomfort
• Worsening of symptoms after prolonged standing or physical strain
• Recurring symptoms that do not resolve on their own
• Symptoms appear for the first time and cause concern
• No improvement with self-care measures or after previous treatment
• Interference with normal sleep or work
• Need for consultation when planning a pregnancy or after childbirth

Even if symptoms seem minor, consulting a specialist can help thoroughly assess your situation and determine the necessary steps. Sometimes early monitoring is important to prevent complications and maintain quality of life.

Emergency Conditions or When to See a Doctor Immediately

• Sudden onset of severe pain in the lower abdomen or perineum
• A sharp increase in the sensation of pressure and bulging in the pelvic area
• Rapidly increasing bleeding from the genital tract
• Combination of severe weakness, dizziness, and rapid heartbeat
• Loss of consciousness or significant worsening of overall condition

If you experience any of these symptoms, do not wait for a scheduled appointment—seek urgent medical assistance. Our clinic offers a home visit service for prompt examination and support.

Causes and Risk Factors of Pelvic Organ Prolapse

Pelvic organ prolapse can develop due to various reasons that contribute to the weakening of supporting tissues and muscles. Understanding the potential factors helps to seek timely examination and adjust lifestyle to reduce the risk of progression.

Main Causes / Mechanisms (Briefly)

• Weakening of pelvic floor muscles and ligaments, often related to age-related changes
• Consequences of pregnancy and childbirth, especially with large babies or complicated deliveries
• Chronic increase of intra-abdominal pressure caused by coughing, constipation, or heavy physical exertion
• Genetic predisposition to reduced connective tissue strength
• Hormonal imbalances affecting the condition of vaginal and pelvic tissues

Risk Factors

• Age over 40–50 years, when tissues lose elasticity
• Multiple childbirths, especially without postpartum rehabilitation
• Excess weight and obesity, placing additional strain on the pelvic floor
• Chronic constipation or frequent straining
• Occupations involving prolonged standing or heavy lifting
• Previous surgeries on pelvic organs
• Smoking, which contributes to decreased tissue elasticity
• Lack of physical activity, leading to pelvic floor muscle weakness

Reversible Causes That Should Be Ruled Out

• Chronic cough and bronchopulmonary diseases that increase abdominal pressure
• Constipation that can be managed through diet and lifestyle changes
• Temporary hormonal imbalance, for example during menopause or when taking certain medications

Pelvic organ prolapse is a complex condition requiring medical evaluation and examination to accurately determine the causes and select appropriate measures.

Diagnosis

The diagnosis of pelvic organ prolapse aims to determine the cause and severity of the condition in order to develop an optimal plan for further examination and treatment. The physician conducts a comprehensive examination and analyzes the data progressively, taking into account the individual characteristics of the patient.

Diagnostic Approach

• Taking a detailed medical history, including complaints, childbirth history, and lifestyle
• Gynecological examination with assessment of the pelvic floor and tissues
• Discussion of existing complaints and factors affecting the condition
• Ordering basic laboratory and instrumental tests as indicated
• Performing additional assessments if necessary, including functional tests
• Analyzing results and forming a plan for further management or adjustment of treatment

Typical Tests Based on Indications

• Pelvic ultrasound to evaluate the position and condition of pelvic organs
• Urinalysis and other laboratory tests to exclude concomitant diseases
• Functional studies of the pelvic floor if there are difficulties with urination or defecation
• Magnetic resonance imaging (MRI) if needed to clarify the condition of the tissues

What to Bring to the Appointment

• Copies and results of previous examinations, if available
• A list of medications and supplements currently taken
• A symptom diary describing complaints and their manifestations
• Information about past illnesses and surgeries
• Questions or comments to discuss with the doctor

Diagnosis of pelvic organ prolapse requires a comprehensive and sensitive approach that helps to thoroughly understand the situation and prescribe the necessary examinations.

Treatment

The treatment of pelvic organ prolapse is aimed at reducing symptoms and improving quality of life. The therapy plan is tailored individually, taking into account the specific condition and overall health of the patient.

Therapy goals

• Reduce the severity of unpleasant symptoms and discomfort
• Improve pelvic organ functions and overall well-being
• Slow the progression of prolapse and prevent complications
• Increase comfort in daily life and physical activities

Main treatment approaches

• May include non-pharmacological methods aimed at strengthening the pelvic floor muscles
• Therapy options can be supplemented with medications as indicated
• Minimally invasive procedures or surgery may be considered if necessary
• Recommendations for lifestyle changes and risk factor modification
• An individualized approach that considers comorbidities and patient needs

What the doctor does

• Selects and adjusts therapy based on progress
• Takes into account comorbid conditions when developing the treatment plan
• Monitors possible side effects and treatment tolerability
• Explains therapy effectiveness criteria in clear, understandable terms
• Coordinates with other specialists as needed

What to expect: planning and monitoring

• The doctor will roughly assess symptom dynamics during follow-up
• Therapy effectiveness is evaluated based on changes in well-being and examinations
• The treatment plan is adjusted if effects are insufficient or side effects appear
• Follow-up visits and monitoring are scheduled individually as indicated

For an individualized treatment plan, please schedule a consultation with Dr. Irina Ivanovna Kulbach.

Prevention

Prevention is important for reducing the risk of pelvic organ prolapse and maintaining health. A preventive plan is tailored individually, taking into account the body's characteristics and risk factors.

Key Primary Prevention Measures

• Weight control and maintaining a normal body mass
• Avoiding excessive physical strain and heavy lifting
• Strengthening pelvic floor muscles through safe exercises (after consulting a doctor)
• Timely treatment of chronic diseases that affect tissue condition
• Quitting smoking and avoiding other harmful habits

Screening and Secondary Prevention / Regular Monitoring

• Regular check-ups with an obstetrician-gynecologist as indicated
• Monitoring the condition of the genitourinary system if symptoms are present
• Discussing with a doctor the need for additional examinations and observation

Practical Tips

• Discuss medication adjustments with your doctor if you have comorbid conditions
• Maintain regular bowel movements and avoid constipation
• Avoid prolonged standing and change position frequently if necessary
• Plan timely recovery after childbirth or surgeries
• Maintain physical activity within the specialist's recommendations

Preventive measures for pelvic organ prolapse help preserve comfort and quality of life—discuss them with your doctor to choose an appropriate plan.

Important to Know

The treatment of pelvic organ prolapse requires a careful approach that takes into account the causes and individual characteristics of each patient. Simply reducing symptoms is not enough — it is important to understand what exactly affects the condition. Early evaluation by a specialist helps to choose the right strategy, reduce the risk of complications, and slow down progression. In some cases, dynamic monitoring and adjustment of the treatment plan as changes occur are necessary. Lifestyle, stress levels, sleep quality, and the presence of comorbidities can significantly influence the course of the problem. Self-treatment in this situation is undesirable, as it may complicate diagnosis, lead to side effects, and delay seeking professional help.

• It is important to identify the causes and triggering factors, not just alleviate symptoms
• Early consultation helps select appropriate treatment and reduce risks
• Regular monitoring is required to assess effectiveness and adjust plans
• Lifestyle factors and comorbidities influence the course of the condition
• Self-treatment can obscure the clinical picture and delay important steps
• The clinic provides a comprehensive approach and monitoring in one place

For more detailed information about the treatment of pelvic organ prolapse, you can refer to our main page, which gathers key aspects of the issue and modern approaches. For any questions, a specialist consultation is recommended to help select the optimal plan based on individual characteristics.

Self-care Before the Appointment: What You Can and Cannot Do

Before seeing the doctor for pelvic organ prolapse, it is important to follow safe recommendations to avoid worsening the condition and complicating the diagnosis. If your condition deteriorates, urgently seek help from Dr. Irina Ivanovna Kulbach.

What You Can Do Before the Appointment

• Record when and how the symptoms appeared, and what worsens or relieves them
• Bring a list of all medications and supplements you are taking
• Keep a symptom diary, noting the intensity and timing of symptoms
• Reduce physical activity and avoid lifting heavy objects until the consultation
• Monitor bowel regularity and avoid straining during defecation
• Ensure adequate water intake, if there are no contraindications
• Measure and record parameters if you know how: temperature, blood pressure, pulse
• Gather information about past childbirths, surgeries, and other important events
• Prepare questions or comments to discuss with the doctor
• Maintain personal hygiene to avoid additional irritation

What You Should Not Do Before the Appointment

• Do not change prescribed medications or their dosages on your own
• Do not start taking new drugs or remedies without consulting a doctor
• Do not use folk remedies promising quick cures without evidence
• Do not postpone a visit to the doctor if symptoms worsen or new complaints arise
• Do not try to diagnose yourself or interpret examination results independently
• Do not neglect rest or continue intense activities if experiencing severe discomfort
• Do not ignore the appearance of bleeding or severe pain — this is a reason to seek help

If signs of an emergency arise, immediately seek medical assistance from Dr. Irina Ivanovna Kulbach.

How I Can Help as a Physician with Pelvic Organ Prolapse

When addressing concerns related to pelvic organ prolapse, I conduct a comprehensive assessment to identify the causes and determine the optimal treatment plan. The consultation includes reviewing your symptoms and medical history, evaluating the severity of the condition, and selecting an individualized management strategy. During the appointment, you will gain a clear understanding of the next steps and monitoring criteria, which will help reduce risks and improve your quality of life.

In a consultation for pelvic organ prolapse, I can assist you with the following:

• Analyzing your complaints and medical history to identify possible causes
• Assessing the severity of symptoms and identifying risk factors influencing the condition’s progression
• Reviewing current treatments and their tolerability, adjusting them if necessary
• Developing a plan for examinations and further actions, taking your individual characteristics into account
• Considering any comorbidities and medications you are taking when formulating the treatment plan
• Providing lifestyle and regimen recommendations tailored specifically for you
• Discussing therapy effectiveness criteria and when to schedule follow-up visits
• Conducting initial diagnostics and ruling out other potential causes of your symptoms
• Monitoring the progression of your condition and adjusting the treatment plan if there is no improvement

This approach allows for a systematic solution—from accurate diagnosis to therapy outcome monitoring. It is important that you understand each step, and that the treatment is built around all your needs and health specifics.

What questions can I ask the doctor about pelvic organ prolapse?

During your appointment regarding pelvic organ prolapse, you can discuss the following issues with Irina Ivanovna Kulbach:

• A feeling of pressure or heaviness in the lower abdomen and perineum
• The presence of a bulge or lump in the pelvic area
• Pain or discomfort when walking or during physical activities
• Problems with urination, such as frequent or difficult urination
• Constipation or a sensation of incomplete bowel emptying
• Recurring symptoms or worsening condition after treatment
• Desire to get a second opinion on examinations or treatment results

If you experience sudden severe pain, bleeding, or worsening of your general condition — seek emergency care immediately and do not wait for a scheduled appointment.

Questions you may want to ask during the consultation:

• What is happening to me, and what could this be?
• Why have the symptoms appeared just now?
• How can I understand whether this is related to pelvic organ prolapse or something else?
• What examinations are necessary in my case?
• Which tests and investigations are truly essential, and which can be postponed?
• How should I prepare for the examinations and the appointment?
• What treatment options and management plans are available, and how do they differ?
• Is this condition fully curable, or does it require ongoing monitoring?
• What should I do if the prescribed treatment does not bring improvement?
• Is it possible to manage without surgery or medication?
• How long does the treatment last, and how often is follow-up needed?
• What signs indicate my condition is improving or worsening?
• What should I do if symptoms suddenly worsen or flare up?

If you have any of these questions or are experiencing the described symptoms, a consultation will help clarify your situation and determine the best treatment approach tailored to your needs and safety.

How the Consultation Proceeds

A consultation with an obstetrician-gynecologist regarding pelvic organ prolapse includes discussing complaints, assessing the current condition, and developing a plan for further action. The extent of examinations is determined individually, based on indications and taking into account the specifics of each patient. During one visit, the doctor forms a preliminary understanding of the situation and outlines the steps for further examination and treatment.

1. Identifying complaints and the purpose of the visit: what concerns you, when symptoms began, what aggravates or relieves them, and what you expect from the consultation.
2. Collecting medical history, including previous childbirths, surgeries, chronic diseases, and lifestyle factors affecting pelvic floor condition.
3. Discussing prior examinations and prescribed treatments; patients are asked to bring test results and a list of current medications.
4. Performing a gynecological exam and, if necessary, additional functional tests to assess the condition of the pelvic organs.
5. Preliminary analysis of the gathered information to determine probable causes and to rule out other possible issues.
6. Recommending further examinations based on indications, which may include pelvic ultrasound, laboratory tests, and other methods.
7. Developing an overall treatment and management plan aimed at alleviating symptoms and preventing complications.
8. Discussing condition monitoring: timing of follow-up visits, criteria for evaluating therapy effectiveness, and recommendations on when to seek earlier consultation if the condition changes.

If this is your first visit, the consultation will focus on thoroughly clarifying your symptoms and exploring possible causes. If previous treatments have been ineffective, special attention is given to analyzing reasons and adjusting the management strategy.

Preparation for the Appointment

To ensure an effective consultation with the obstetrician-gynecologist regarding pelvic organ prolapse, it is important to prepare in advance and bring the necessary documents and records. This will help speed up the creation of a preliminary plan for examination and treatment.

• Bring a list of all current medications with names and dosages, if known
• Bring results of previous examinations, pelvic ultrasound scans, and laboratory tests
• Write down your main complaints: when the symptoms started, what worsens or relieves them
• Prepare questions and notes you want to discuss with the doctor
• Do not stop taking prescribed medications without consulting your doctor
• Arrive 10–15 minutes before the appointment time for registration (if required)
• Do not apply creams, lotions, or other cosmetics to the pelvic area before the examination (if applicable)
• Check with the reception if you need to come on an empty stomach (if yes — usually 8–12 hours fasting unless otherwise instructed)
• If you wear contact lenses, ask if you need to remove them before the examination (if required)
• Bring documents related to previous childbirths or surgeries (if any)

If you have any doubts about the preparation, it is best to clarify details when making the appointment and avoid changing your medication regimen without consulting your doctor.

About the Doctor

Irina Ivanovna Kulbach is an obstetrician-gynecologist with over 40 years of experience. She specializes in managing patients with pelvic organ prolapse, including cases with recurring symptoms and chronic conditions.

In her work, she pays special attention to differential diagnosis and dynamic monitoring, which helps to promptly adjust treatment. She often works with patients for whom previous treatments were ineffective or who have comorbidities.

During the consultation, you will receive a clear understanding of your situation and a plan for the next steps, taking into account all the specifics of your condition.

Why Patients Choose Dr. Irina Ivanovna Kulbach

In her work with patients suffering from pelvic organ prolapse, Irina Ivanovna adopts a step-by-step treatment approach, paying attention not only to the symptoms but also to the underlying causes of the condition. She reviews the complete medical history and previous prescriptions to select a safe therapy without unnecessary examinations. Special emphasis is placed on monitoring the progress and timely adjusting the treatment plan if the expected results are not achieved. Patients appreciate clear explanations about the therapy and prognosis, as well as the opportunity to bring their own test results for interpretation. This approach helps reduce the risk of complications and maintain quality of life.

• Clear, step-by-step treatment plan with explanations of each stage and monitoring
• Examinations only when indicated — no unnecessary tests or procedures
• Consideration of comorbidities and medications to ensure safe and effective treatment
• Monitoring of therapy effectiveness with flexible adjustments if no improvement occurs
• Analysis of previously performed test results for more accurate diagnosis
• Simple and accessible explanations of treatment goals, possible risks, and alternatives
• Focus on preventing complications and recurrent exacerbations through comprehensive care

This systematic and attentive approach provides patients with maximum clarity and support at every stage of pelvic organ prolapse treatment. It enables the development of a long-term program tailored to individual characteristics and disease progression.

Case Studies

Initial Consultation for Symptoms of Lower Abdominal Pressure

A middle-aged female patient presented with complaints of a heavy sensation and bulging in the pelvic area, which worsened after physical exertion. It was important to rule out other possible causes, such as inflammatory processes or neoplasms. A detailed medical history was taken and a comprehensive examination was performed; additional tests were ordered if necessary. Over time, the condition stabilized and the symptoms became less pronounced. Regular monitoring and tailored supportive therapy considering individual characteristics were recommended.

Adjustment of Management Strategy in the Absence of Effect from Previously Prescribed Treatment

A woman around 50 years old sought help due to recurring symptoms of pelvic organ prolapse despite prior treatment. The physician conducted an in-depth review of previous prescriptions and identified possible reasons for the insufficient effectiveness. The management plan was adjusted taking into account comorbidities and drug tolerability. In the following weeks, an improvement in well-being and a reduction in symptom severity were observed. Regular follow-up and therapy adaptation continue.

Chronic Course with Comorbidities

An elderly female patient with a long history of pelvic organ prolapse and concomitant cardiovascular disease came for consultation. Careful attention was given to the interaction of conditions and the selection of a safe treatment approach. A comprehensive assessment was conducted, with monitoring of progress and regular plan adjustments. Follow-up results showed a stable condition and improved quality of life.

Symptom Exacerbation and Increased Discomfort

A young woman with previously mild symptoms presented with progressively worsening sensations of pressure and discomfort. Prompt evaluation was needed to exclude complications and adjust management. Additional examinations were performed, and therapy was reviewed. As a result, symptom intensity was reduced and a plan to prevent further exacerbations was developed. The patient was referred for periodic monitoring and supportive care.

Repeat Consultation for Diagnosis Clarification and Second Opinion

A patient sought additional evaluation following inconclusive test results at another center. The goal was to reanalyze symptoms and studies, highlight key features, and develop a clear action plan. The specialist carefully reviewed the medical history and examination data and outlined sequential steps for diagnosis clarification and monitoring. Positive progress was noted at follow-up, with ongoing systematic management.

How long does the consultation last?

The consultation usually takes between 30 to 60 minutes; please check the exact duration when booking.

How should I prepare for the appointment?

Write down your complaints, symptoms, and any questions you want to discuss with the doctor.

What should I bring to the appointment?

Bring the results of previous examinations, tests, medical records, and a list of medications you are currently taking.

Do I need to come on an empty stomach or are there any restrictions?

Usually no, unless specified otherwise when scheduling your appointment.

How many visits are typically needed?

The number of visits depends on your condition and chosen treatment plan, usually it involves several appointments.

When can I expect to see the first results of the treatment?

Initial changes are assessed individually throughout the course of monitoring.

What should I do if my condition worsens before the appointment?

If symptoms worsen or red flags appear, you should seek medical assistance immediately.

Can I combine the treatment with my current medications?

This will be discussed during the appointment; do not change your medication regimen on your own.

Is it possible to have an online consultation?

Yes, online consultation is available; please confirm the details when booking.

Can I come with tests I have already done?

Yes, bring all available test results for evaluation.

Do I need to come for follow-up visits and how often?

Follow-up visits are scheduled individually to monitor your condition and adjust treatment.

Can I get a second opinion?

Yes, you can discuss your situation and results with the doctor for an additional evaluation.

What should I do if symptoms return after improvement?

It is advisable to contact the doctor to adjust your treatment plan.

What is the treatment approach for pelvic organ prolapse?

Therapy depends on the cause, severity, and accompanying factors; the doctor will personalize the approach.

Can I come for an appointment without prior booking?

It is better to book in advance to avoid waiting.

Can I bring children to the appointment?

If it is not a separate service, check with the clinic in advance about the possibility of accompaniment.

How do I choose the best time for the visit?

Specify a convenient time when booking, considering your schedule and the clinic’s hours.

Can I cancel or reschedule the appointment?

Yes, it is recommended to notify the clinic in advance to adjust the schedule accordingly.