UAB Medicine patient Malinda Upchurch experienced years of symptoms and inconvenience caused by pelvic organ prolapse, a condition caused by a weakening of tissue and muscles in the pelvic floor. About 40% of women are affected by some form of it.

Upchurch says it reached a point that it took control of her life. But thanks to successful treatment by her UAB Urogynecology care team, she returned to her normal, healthy, and active lifestyle.

What is prolapse?

The organs of the human body usually stay firmly in place through the support of connective tissue and muscles. For various reasons, sometimes related to childbirth, the connective tissue in a woman’s pelvic floor may weaken. As a result, one or more of the pelvic organs – including the uterus (womb), bladder, and the last part of the bowel (rectum) may slip down. This condition is called pelvic organ prolapse, which is also known as vaginal prolapse or genital prolapse. If the womb slips down, it is called uterine prolapse.

Both uterine and vaginal prolapse can accompany other related prolapse conditions, including small bowel prolapse (enterocele), urethral prolapse (urethrocele), prolapse of the bladder (cystocele), and rectal prolapse (rectocele). Bladder prolapse – where the bladder pushes down and against the wall of the vagina – is the most common. For some women who experience prolapse, the condition is mild and may not require treatment. However, it can get worse over time and become increasingly bothersome.

‘Everything is an emergency’

During her years of coping with symptoms, Upchurch was still not aware of the extent of the bladder and rectal prolapse that was taking place in her body. But she was all too familiar with the discomfort and inconvenience they caused.

“For the past 6-7 years, I was experiencing urgency to urinate,” Upchurch said. “I already knew that a curve existed in the rectal area that met the vagina, and that the vaginal wall had been made very weak by several births I had. That condition caused a lot of problems with constipation. But the bladder issue just took over. It was urgent beyond where you say, ‘If I can get to the restroom, I will be okay.’ For me, there was often no getting there. Living in Alabama and with family in Indiana, we made many long drives. They were nerve-wracking, because I was hitting every rest stop and restroom along the interstate. That function of my body was becoming overwhelming. The urgency and frequency continued to increase, so that basically turned everything I did into an emergency. I planned my life around how easily I could get to a bathroom.”

Her condition eventually became more difficult to manage, and Upchurch chose to seek medical help after she reached a mental and emotional breaking point.

“It came down to being fed up,” Upchurch said. “It reached a breaking point when I was working out or stretching and I could hear sounds of my vaginal area going in and out. One day I left the gym in tears. My situation was inconvenient, embarrassing, and mentally and emotionally taking a toll. I had made so much progress with exercise and being active; I was feeling good about my overall health and the physical condition of my body. But this problem was taking all that way from me. At 54 years of age, I’m not ready to live in incontinence diapers. I wanted answers, so I made a decision to get help early in 2023. The options for a solution with my doctors in Tuscaloosa were limited, so they referred me to UAB.”

Getting her life back

During her first visit with UAB Medicine urogynecologist Thomas Powell, M.D., Upchurch learned the full extent of her condition. It was a matter of hearing some bad news and then getting very good news.

“I was diagnosed with bladder, rectal, and vaginal vault prolapse,” Upchurch said. “Dr. Powell also explained all the issues in detail, showing me that, actually, both sides of my vaginal walls were collapsed, and the top had fallen. I remember thinking, ‘No wonder this has been so bad.’ But Dr. Powell explained my options for surgery, and most important of all, he gave me the confidence that the procedure would help me get back to the normal life I wanted. I also learned that these conditions are classified as types of hernias, so they were covered by my medical insurance.”

Upchurch underwent a successful procedure in May 2023. “It was an incredible experience,” she said. “That’s partly because of the up-to-date procedures, such as robot-assisted surgery, the wonderful nursing team, and the communication with my husband throughout the procedure. If I could have Dr. Powell as my family physician and not just a specialist – even though I live an hour away from UAB – I would do so in a heartbeat. Thanks to him and the team, I have my normal life back.”

UAB Urogynecology provides complete care for the full range of women’s pelvic floor disorders. Click here to learn more.