Pelvic organ prolapse (POP) is a pelvic floor disorder in which the muscles, ligaments, and connective tissues that support your pelvic organs become weakened to keep them in place.
Your pelvic floor muscles operate as a strong sling, supporting organs such as your vagina, uterus, bladder, and rectum. The pelvic organs usually move out of place if these muscles are too weak or damaged.
Pelvic organ prolapse is one form of pelvic floor disorder others are stress urinary incontinence and fecal incontinence.
How Serious is Pelvic Organ Prolapse?
Prolapse is not a serious condition, although it may be uncomfortable for most women. Prolapse symptoms include pelvic or pressure in the vaginal canal, trouble emptying your bowels or bladder, and discomfort if uterine tissue bulges out of the vaginal opening.
What Causes Pelvic Organ Prolapse?
Pelvic organ prolapse happens when the pelvic muscles or tissues do not function properly. The following are the most common causes:
· The pelvic floor can be stretched and strained during vaginal delivery. Multiple vaginal deliveries increase your chances of developing pelvic organ prolapse later in life.
· Long-term abdominal pressure, such as that caused by obesity, continuous coughing, or straining during bowel movements.
· Old age – Pelvic floor disorders are more frequent in older women. Around 37% of women with pelvic floor disorders are between 60 and 79, and almost half are 80 or older.
· Menopause brings about hormonal changes. Losing estrogen during and after menopause might increase your risk of pelvic organ prolapse. The deterioration might impair the connective tissues, which support your pelvic floor muscles.
· Overweight baby during birth – Giving birth to a baby who weighs more than 9 pounds may cause your pelvic floor muscles to sustain injuries or become weaker, leading to pelvic organ prolapse.
· Family history – Researchers are examining the role of genetics in pelvic organ prolapse. Because it’s possible that some women inherit weaker pelvic floor muscles.
What Are the Symptoms of Pelvic Organ Prolapse?
Prolapse pressure can generate a bulge in the vagina, which can occasionally be felt or seen. Women with pelvic organ prolapse may experience discomfort during physical exercise or intercourse.
Other POP symptoms include:
· Vaginal enlargement, fullness, or pressure.
· Pelvic fullness, pressure, or pain.
· Aches and pains in your lower back.
· During intercourse, there may be pressure, a hitting sensation, or pain (dyspareunia).
· The presence of a bulge or pressure that worsens during the day.
· Bulge or pressure that develops when you cough or are on your feet
How Is Pelvic Organ Prolapse Diagnosed?
Your doctor will discuss your symptoms with you and do a pelvic exam. You may be asked to cough or strain during the exam so the doctor can determine whether such movements induce prolapse or urine leaks. The doctor may examine you while standing and lying down on your back.
Your doctor may also perform additional tests, such as:
· Bladder function tests let your doctor search for indicators of POP-related urinary difficulties. A cystoscopy, which allows your physician to view your bladder and urethra, may be one of the tests. Your clinician may also perform a urodynamic test to determine how well your bladder and urethra store and release urine.
· Imaging methods that enable your healthcare professional to see within your pelvic cavity. To establish the amount of your prolapse, your doctor may perform a pelvic floor ultrasound or an MRI. Except in severe circumstances, imaging is rarely used.
How do you check for pelvic organ prolapse at home?
Keep a mirror at an angle for viewing and a notebook and pen nearby to record any discoveries.
Empty your bladder first, and keep your PF muscles relaxed throughout the assessment. Cough strongly and keep an eye out for movement of a vaginal wall down to or out of the vaginal opening.
Keep an eye out for a smooth protrusion that expands towards the front or rear of your vagina or if the cervix is dropping. For 6-8 seconds, bear down firmly (pelvic floor relaxed), looking for any movement down to or out of the vaginal walls.
A severe prolapse occurs when the cervix or a vaginal wall protrudes like a golf or tennis ball.
Can I Push my Prolapse Back Up?
You can’t push your prolapsed vagina back up. Your healthcare practitioner should only treat a prolapsed vagina.
You may feel a bulge during your self-examination and need to push it back up, but forcing it back up is just temporary and will not permanently prevent pelvic organ prolapse.
How Is Pelvic Organ Prolapse Treated?
You have two options when treating POP: Non-surgical treatments and surgery
Non-surgical treatment options include:
Vaginal pessaries – A removable silicone device inserted into your vagina by your physician to support a drooping organ in place.
Kegel exercises (pelvic floor exercises) – Pelvic floor strengthening exercises. Your surgeon may send you to a physical therapist who will assess your muscle strength and give you specialized exercises to strengthen your weak pelvic floor to support your pelvic organs.
Surgical options include:
Colpocleisis is a surgical technique that results in a shortened vagina. It keeps your organs from protruding outside of your body. It’s a viable alternative if you’re too weak/old for reconstructive surgery and no longer want penetrative sex.
Colporrhaphy is a procedure that cures anterior vaginal wall prolapse or posterior vaginal vault prolapse. Your healthcare professional will conduct surgery via your vagina with colporrhaphy. They use dissolvable sutures to strengthen your vaginal walls and support your bladder and rectum.
Sacrohysteropexy – is used to address uterine prolapse. Your physician wraps surgical mesh over your cervix and vagina, then wraps it around your tailbone to pull your uterus into position. If you do not want your uterus removed, you can get sacrohysteropexy (a hysterectomy).
Vaginal mesh – For POP repair, a surgical mesh can be permanently placed to strengthen the vaginal wall. However, it’s not in use today because many women have come out after years claiming the transvaginal mesh is causing severe complications such as severe pain and recurrent POP.
If you have had a transvaginal mesh inserted and experiencing complications, don’t hesitate to contact our attorneys for help.
What questions should I ask my provider?
1. What type of pelvic prolapse do I currently have?
2. Will I be able to treat my POP symptoms without surgery?
3. What surgical treatments are available to treat my POP?
4. What are the success rates of the POP non-surgical alternatives?
5. What is the possibility that surgery will relieve all of my symptoms?
6. What are the possible complications/risk factors of surgery?
7. Will surgical treatments impact my sexual life?
What happens if the prolapse is left untreated?
Your prolapse and symptoms may worsen if left untreated. Your healthcare practitioner can monitor your prolapse and prescribe remedies such as the ones mentioned above if it becomes severe enough to impair your quality of life.
Does pelvic organ prolapse ever go away?
It can, with the proper treatment. With mild pelvic organ prolapse, you can strengthen your muscles using pelvic exercises to hold the organs in their correct position. Reconstructive surgeries strengthen the weaknesses in your pelvic organs so that your organs return to their original locations.