Pelvic Organ Prolapse
When the network of muscles, ligaments, and connective tissues, collectively known as the pelvic floor, lose their strength and elasticity, pelvic organ prolapse (POP) can occur. POP is a common condition that affects many women and is characterized by the dropping, shifting, or sagging of organs from their original position in the pelvis.
Types of Pelvic Organ Prolapse
There are six types of pelvic organ prolapse.
- Anterior vaginal wall prolapse or cystocele. This is the most common type of prolapse. It occurs when your bladder shifts out of place and bulges into your vagina.
- Vaginal vault prolapse. A vaginal vault prolapse occurs when the top part of your vagina drops down into your vaginal canal.
- Uterine prolapse. A uterine prolapse happens when your uterus shifts down into your vaginal canal.
- Urethrocele. A urethrocele is formed if the tube that carries urine from your bladder to outside your body drops down.
- Posterior vaginal wall prolapse or rectocele. When the muscles between your vagina and rectum are weak, the rectum can bulge into the back wall of your vagina.
- Enterocele. An enterocele occurs when your small intestine bulges onto the back wall or the top of your vagina.
The Onset of Pelvic Organ Prolapse
The onset of POP is often gradual, and its severity varies greatly among individuals. It can result from a combination of factors that strain or weaken the pelvic floor. Some reasons may be:
- The natural aging process
- Hormonal changes
- The physical impact of childbirth
- The aftereffects of certain pelvic surgeries
If you have a mild case of POP, you may encounter subtle symptoms like a sense of fullness or mild discomfort, which typically don't interfere much with your everyday life. However, as the condition advances, the symptoms can become more apparent, such as a noticeable bulge, bowel and bladder difficulties, and increased discomfort.
For this reason, the strategies for managing and treating POP should be customized, focusing on your unique needs and symptoms. There are many exercises and treatments that can help strengthen your pelvic floor and alleviate your symptoms. If you have signs of POP, it is important to discuss your options with your doctor.
Risk Factors for Pelvic Organ Prolapse
Pelvic organ prolapse becomes more common as you age, particularly after menopause, childbirth, or a hysterectomy. It can also develop due to conditions that put pressure on the abdomen, like chronic constipation or obesity. Factors that can increase your risk of developing POP include:
- Vaginal childbirth
- Aging, particularly post-menopause
- Hysterectomy or other pelvic surgeries
- Chronic coughing (often associated with smokers)
- Straining with bowel movements
- Heavy lifting
Symptoms of Pelvic Organ Prolapse
The symptoms associated with pelvic organ prolapse include:
- A feeling of pressure or fullness in the pelvic area
- A bulge in the vagina or a sensation of something falling out of the vagina
- Discomfort or pain during intercourse
- Urinary incontinence
- A frequent need to urinate
- Difficulty with bowel movements
Receiving a Diagnosis
Your doctor can diagnose pelvic organ prolapse through a pelvic exam where they can assess the strength of your pelvic muscles and the position of your pelvic organs. Additional tests might include:
- Urodynamic tests to evaluate the prolapse's impact on your bladder functions
Treatment Options for Pelvic Organ Prolapse
Treatment for POP varies depending on the severity of your symptoms and your overall health. Non-surgical and surgical options include:
1. Pelvic Floor Exercises (Kegel Exercises)
Pelvic floor exercises, commonly known as Kegel exercises, involve repeatedly contracting and relaxing the pelvic floor muscles. These exercises aim to strengthen the muscles that support the uterus, bladder, small intestine, and rectum. Regularly exercising these muscles can enhance tone and prevent or control the symptoms of POP.
2. Vaginal Pessaries
A vaginal pessary is a medical device made from silicone or plastic designed to support areas of pelvic organ prolapse. They are particularly beneficial for women who prefer not to undergo surgery or are waiting for surgery.
Pessaries come in various shapes and sizes, and your doctor can help select and fit the appropriate type for your specific condition. Your doctor will insert the pessary into your vagina, where it helps hold your pelvic organs in place. Regular follow-ups are necessary to ensure the correct fit and to prevent complications, such as infections or vaginal ulcers.
3. Weight Loss
Excess body weight can put additional pressure on the pelvic floor, exacerbating the symptoms of POP. Losing weight through a healthy diet and regular exercise can reduce this pressure and relieve symptoms.
4. Treating Constipation
Chronic constipation can strain the pelvic floor muscles. Managing constipation through a high-fiber diet, increased fluid intake, and regular physical activity can help reduce the strain on pelvic muscles. Your doctor might also recommend over-the-counter or prescription medications to help manage constipation effectively.
5. Surgical Treatments
Surgery may be recommended for severe cases of prolapse, especially if symptoms significantly impact your quality of life. Surgical options can include repairing the pelvic floor or supporting the prolapsed organ. Your doctor can help you decide if surgery is right for you.
Managing Pelvic Organ Prolapse
Living with pelvic organ prolapse can be challenging, but many women find relief through treatment and lifestyle adjustments. It's important to regularly follow up with your doctor to monitor the condition and adjust your treatment plan as necessary.
Frequently Asked Questions
Is pelvic organ prolapse common after childbirth?
It's not uncommon for women to experience some degree of prolapse after childbirth, especially following vaginal delivery. However, symptoms can vary in severity.
Can pelvic organ prolapse be prevented?
While not all cases of POP can be prevented, maintaining a healthy weight, practicing pelvic floor exercises, and treating conditions such as constipation or chronic coughing can reduce the risk.
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