Living Life to the Full: An Active Octogenarian is Prolapse-Free Since Reconstructive Surgery

Jessica Reiner is feeling back to herself, thanks to a recent surgical procedure to remedy her pelvic organ prolapse: a condition that occurs when one or more of a woman’s pelvic organs fall through her vagina. 

Jessica lives on New York’s Lower East Side, and the windows of her apartment look out on the East River. That’s one of the many things she feels thankful for. 

An 84-year-old widow with a daughter and twin grandchildren, Jessica says she takes pleasure in being a grandmother, but she also enjoys living on her own. 

She finds her art classes especially rewarding, which makes sense in light of her former career as an interior designer. 

“New York is a great city to grow old in,” Jessica says, citing nearby art and exercise classes, public transportation and high-quality health care as top reasons for that assertion. But a short time ago, she was far less pleased with her quality of life. 

Like many women her age, she was suffering from urge incontinence, also known as overactive bladder (OAB). She was forced to plan her day around where to find available restrooms. That turned out to be a difficult process to manage, so she decided to make an appointment with Dr. Larissa Rodriguez, Chair of the Department of Urology, Professor of Urology and Urologist-in-Chief at Weill Cornell Medicine. Dr. Rodriguez also directs the institution’s recently established Center for Female Pelvic Health. 

“Deciding where to receive care was easy,” Jessica says. Her late husband had Marfan syndrome, a genetic disorder affecting the connective tissues that support our organs. The condition typically affects the heart, eyes, skeleton and blood vessels. In her husband’s case, Marfan was interfering with the functioning of his aorta, the large artery that carries blood from the heart to the rest of the body—a potentially life-threatening situation.  

At the time, Jessica says, “only six doctors in the country were performing aorta replacement surgery. One of them was Dr. Leonard Girardi, currently Chair of Cardiothoracic Surgery at Weill Cornell. He operated on my husband, replacing not only his aorta but one of his heart valves. Amazingly, just 30 hours after surgery, he was walking up and down the corridors of the hospital.” 

Sadly, though, her husband died of cancer several years later. But Jessica had come to trust Weill Cornell Medicine. She trusted the quality of the care he received at every level, so when it was her turn to seek help, it was a no-brainer. Weill Cornell would be her destination, the institution where she would find a solution to her bladder issues. 

A diagnosis of pelvic organ prolapse  

During Jessica’s exam, Dr. Rodriguez quickly discovered that her new patient had pelvic organ prolapse. It’s caused by weakness in the muscles of the pelvic floor to a point where they can no longer keep the pelvic organs in place. 

Her prolapsed bladder turned out to be the source of her incontinence issues. Treatment started with a pessary, a device made of silicone that fits inside the vagina and supports the bladder. “It acts like a shelf,” Dr. Rodriguez explains. “The prolapsed organ rests on it.” 

Typically, Dr. Rodriguez adds, patients need to come in to have their pessary removed, cleaned and re-inserted once a month, but Ms. Reiner was able to manage all this herself. She ran into problems, though, when she developed a common complication: small tears in the vaginal wall.  

“When plastic rubs the skin in the same place over and over, a small tear can morph into an ulcer,” Dr. Rodriguez says. That was the source of Jessica’s new symptom: intermittent vaginal bleeding. 

The right choice 

Jessica couldn’t use the pessary at all until the tears in her vaginal lining healed. “That took a long time,” she says, “and I knew it could happen again. Surgery was the only rational choice.” 

Dr. Rodriguez presented her with a list of surgical treatments. She advised Jessica to discuss the options with a friend or family member and to choose the approach that best suited her needs and preferences. 

It turned out that her prolapse involved three organs: her bladder, uterus and rectum. Jessica settled on a procedure called a robotic sacrocolpopexy, which promised to resolve a set of issues that were compromising her quality of life.  

The procedure, a type of reconstructive surgery, is performed laparoscopically with the aid of the surgical robot. It’s designed to put all of a patient’s pelvic organs back where they belong and make sure they stay there, permanently. 

“I try not to be biased in favor of one or another of the options,” says Dr. Rodriguez. “We discussed the risks and benefits of each, including recovery. I also factored in Ms. Reiner’s excellent health. She had no other significant health issues that might have interfered with her prospects for a quick, successful recovery.” 

Jessica underwent the procedure, which also included a hysterectomy, often recommended when the uterus is contributing to a patient’s prolapse. Her recovery was speedy and relatively painless, and soon, she was back on her feet, heading back to her art and aerobic exercise classes and enjoying her grandchildren. 

“Ms. Reiner has recovered very well, Dr. Rodriguez says. “She’s in much less pain, and her urge incontinence has improved greatly.  

“Why didn’t I have this done a few years ago?” Jessica asked herself. “I didn’t realize how smoothly it would go. What’s more, I appreciated the contributions of every member of Dr. Rodriguez’s team. Each one was supportive and helpful beyond my highest expectations. I loved the entire team!” 

All of which only increases her sense of gratitude for what matters most in her life: family, rewarding activities and, in the aftermath of her prolapse repair, excellent health.