Pelvic Organ Prolapse

What Is Pelvic Organ Prolapse?

Pelvic organ prolapse occurs when one or more of the pelvic organs (bladder, uterus, rectum, small intestine, top of the vaginal wall) drop downward from their normal position, usually creating a bulge in the weakened vaginal wall.

Types Of Pelvic Organ Prolapse

There are four types of Pelvic Organ Prolapse:

1. Cystocele: bladder prolapse into the frontside of the vaginal wall
2. Rectocele: rectal prolapse into the backside of the vaginal wall
3. Enterocele: small intestine prolapse into the top of the vaginal ceiling
4. Uterine prolapse: uterus drops down into vagina

What Are The Causes Of Pelvic Organ Prolapse?

Pelvic organ prolapse is caused by trauma or injury to the tissues that causes weakness or relaxation of the muscles and tissues responsible for supporting the pelvic organs. The main causes of injury are pregnancy and childbirth, especially vaginal delivery. Obesity, aging, menopause, smoking, and prior pelvic surgery are other causes of pelvic organ prolapse.

What Are The Signs And Symptoms Of Pelvic Organ Prolapse?

Many women have no symptoms at all. But some women with pelvic organ prolapse may experience the following symptoms:

• Feeling a “fullness” or “bulge” in the vagina
• Feeling pressure or achiness in the pelvis
• Leaking urine when sneezing, laughing, or coughing
• Feeling of urinary urgency
• Feeling that they cannot completely empty their bowels or bladder without “splinting,” which is putting a finger in the vagina to help finish a bowel movement or urination

What Are The Risk Factors Of Pelvic Organ Prolapse?

The most common risk factors include pregnancy, childbirth (vaginal delivery), obesity, menopause, advancing age, and prior pelvic surgery (such as a hysterectomy). Family history is also a factor, so if you have a close blood relative who has had a Pelvic Organ Prolapse, you may be at a higher risk.

How Is Pelvic Organ Prolapse Diagnosed?

Following a review of your symptoms and medical history, your doctor can diagnose pelvic organ prolapse, and identify the type and severity, through physical examination of the pelvic area.

What Are The Possible Treatments For Pelvic Organ Prolapse?

No intervention is required for women who have no symptoms or who are not bothered by symptoms. For those women who are symptomatic, there are several possible treatments, including:

• Pelvic floor physical therapy or kegel exercises can help strengthen the pelvic floor muscles.
• A vaginal pessary is a device that is inserted into the vagina to support the bladder and help hold it in place. There are many different shapes and sizes of pessaries and will require an office visit for fitting and placement.
• Surgery can be performed to correct the anatomy and to improve bowel, bladder and vaginal function. This can be done transvaginally, abdominally, laparoscopically and/or robotically.

Are There Preventative Steps Or Measures To Avoid Pelvic Organ Prolapse?

Since obesity is a risk factor, maintaining a healthy weight is important to reducing your risk of Pelvic Organ Prolapse. Avoid smoking cigarettes and heavy lifting or other physical overexertion. Exercises such as kegels can strengthen the pelvic floor and help prevent Pelvic Organ Prolapse.

What Are The Risks If Pelvic Organ Prolapse​ Is Left Untreated?

Pelvic Organ Prolapse does not have dangerous complications if left untreated. However, it can cause discomfort that can negatively impact your quality of life.

Key Takeaways

Pelvic Organ Prolapse is often asymptomatic, but can cause discomfort. Treatment for pelvic organ prolapse depends on the severity of symptoms and can include lifestyle modifications (avoiding constipation, losing weight, pelvic floor exercises, and smoking cessation), medical devices, and surgery. The goal of treatment for Pelvic Organ Prolapse is relief from bothersome symptoms and improved quality of life.