Everything You Need to Know
Pelvic organ prolapse (POP) is a condition that affects many women, particularly as they age or after childbirth. It occurs when the muscles and tissues that support the pelvic organs weaken, causing one or more organs (such as the bladder, uterus, or rectum) to slip out of their normal position and press against or descend into the vaginal canal. This can lead to discomfort, pain, and even affect daily activities or sexual function.
Fortunately, there are treatments available for pelvic organ prolapse that can help restore normal function, relieve symptoms, and improve quality of life.
What Is Pelvic Organ Prolapse?
Pelvic organ prolapse happens when the pelvic floor muscles and ligaments become too weak to support the organs in the pelvis. The pelvic organs include the bladder, uterus, rectum, and sometimes the small intestine. When the support structure weakens, one or more of these organs can drop (prolapse) into or out of the vagina.
The severity of pelvic organ prolapse can vary, ranging from mild cases where there are no noticeable symptoms to more severe cases where the organ visibly protrudes from the vaginal opening.
Types of Pelvic Organ Prolapse
There are different types of pelvic organ prolapse, depending on which organ is affected:
- Cystocele (Bladder Prolapse)
When the bladder drops into the front wall of the vagina, it’s called a cystocele or bladder prolapse. This can lead to urinary incontinence or difficulty emptying the bladder. - Rectocele (Rectal Prolapse)
Rectocele occurs when the rectum bulges into the back wall of the vagina. This can cause difficulty with bowel movements and feelings of incomplete evacuation. - Uterine Prolapse
Uterine prolapse occurs when the uterus slips down into or outside of the vaginal canal. This is more common in women who have had multiple vaginal deliveries. - Enterocele (Small Bowel Prolapse)
Enterocele involves the small intestine dropping into the upper part of the vaginal wall. This usually occurs after a hysterectomy. - Vaginal Vault Prolapse
This occurs when the top of the vaginal wall sags after a hysterectomy. It can also affect the surrounding pelvic organs.
Symptoms of Pelvic Organ Prolapse
The symptoms of pelvic organ prolapse can vary depending on the type and severity, but common signs include:
- A feeling of heaviness or pressure in the pelvic area
- A bulge or protrusion from the vaginal opening
- Difficulty with urination or bowel movements
- Lower back pain
- Pain or discomfort during intercourse
- Feeling like something is falling out of the vagina
- Frequent urinary tract infections
Many women with mild prolapse may not experience symptoms, but as the condition progresses, these symptoms can become more noticeable and bothersome.
Causes of Pelvic Organ Prolapse
Several factors can contribute to the weakening of the pelvic floor muscles and lead to prolapse:
- Childbirth
Vaginal deliveries, particularly of large babies or multiple births, can stretch and weaken the pelvic muscles. - Aging
As women age, their pelvic muscles naturally lose strength, increasing the risk of prolapse. - Menopause
The drop in estrogen levels during menopause can cause tissues to become weaker and less elastic. - Chronic Straining
Chronic coughing, constipation, or heavy lifting can put stress on the pelvic floor muscles, leading to prolapse over time. - Obesity
Excess weight adds pressure to the pelvic organs and can contribute to prolapse.
Treatment Options for Pelvic Organ Prolapse
Treatment for pelvic organ prolapse depends on the severity of the condition, symptoms, and individual preferences. Options include both non-surgical and surgical treatments.
5. Surgical Options
For more severe cases of pelvic organ prolapse, surgery may be necessary to repair or support the affected organ. There are various surgical approaches, including:
- Anterior or Posterior Repair
This surgery involves tightening the tissues that support the bladder (anterior repair) or the rectum (posterior repair). - Vaginal Vault Suspension
This surgery is done to correct vaginal vault prolapse and involves supporting the top of the vagina with surgical sutures or mesh. - Hysterectomy
In some cases, removing the uterus (hysterectomy) may be part of the treatment plan if uterine prolapse is severe. - Sacrocolpopexy
This procedure involves attaching the vagina or cervix to the sacrum (a bone in the lower spine) to hold the pelvic organs in place. It’s often used for more severe prolapse cases and can be done using minimally invasive techniques.
Who Is a Candidate for Pelvic Organ Prolapse Treatment?
Women experiencing any of the following symptoms may be candidates for treatment:
- A feeling of heaviness or pressure in the pelvis
- A noticeable bulge in or around the vaginal area
- Difficulty with urination or bowel movements
- Pain or discomfort during sex
- Chronic pelvic pain
It’s important to consult with a healthcare provider who specializes in pelvic floor disorders to determine the best course of treatment.
The Pelvic Organ Prolapse Treatment Process: What to Expect
The treatment process for pelvic organ prolapse will depend on the chosen approach, but here’s a general outline:
1. Consultation
The first step is meeting with a pelvic floor specialist or gynecologist. During this consultation, the doctor will perform a physical exam, review your symptoms, and discuss your treatment options.
2. Treatment
Non-surgical treatments like pelvic floor exercises or pessaries can be done in an outpatient setting. Surgical treatments are typically performed in a hospital, and depending on the procedure, they may be minimally invasive.
3. Recovery
Non-surgical treatments require little to no downtime, while surgical treatments will involve a recovery period that varies based on the procedure. Minimally invasive surgeries typically have shorter recovery times, while more extensive surgeries may require several weeks of rest and limited activity.
4. Follow-Up
After treatment, follow-up appointments will be scheduled to monitor progress and ensure healing. For surgical treatments, physical therapy may be recommended to strengthen the pelvic floor muscles and prevent future prolapse.
