Pelvic Organ Prolapse

Pelvic organ prolapse is a type of pelvic floor disorder where the muscles and tissues that hold the pelvic organs in place weaken and drop lower into the pelvis. “Prolapse” refers to the drooping of pelvic organs that include the cervix, uterus, bladder, vagina, small intestines, and rectum. Symptoms of pelvic organ prolapse can occur when there is increased pressure in the abdomen, most commonly in women who have given birth, but not always. Some women only have minor symptoms, if any at all.

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Types of Pelvic Organ Prolapse

There is more than one type of pelvic organ prolapse, including:

Cystocele – The most common condition, “dropped bladder”, where the bladder descends into the anterior wall of the vagina
Urethrocele – This is a collapse of the urethra (the tube that carries urine)
Uterine prolapse – The uterus drops down into the vagina
Vaginal vault prolapse – The vaginal vault (top of the vagina) drops down
Enterocel – A small bowel prolapse
Rectocele – Known as posterior wall prolapse, the rectum drops down and bulges into the vagina.

Causes

In addition to childbirth, risk factors for developing pelvic organ prolapse include a family history of the condition, obesity, advancing age, hysterectomy or prior pelvic surgery, menopause, intense physical activity, and more. Conditions such as asthma or constipation are a risk factor due to the increased intra-abdominal pressure.

Symptoms

Many women experience no symptoms at all, sometimes even discovering the condition during a routine gynecological exam. Symptoms vary on which organ is drooping, for example, if urine is leaking, the bladder might have prolapsed. Other symptoms include:

A feeling of constant heaviness or fullness around the pelvic area
Organs bulging out of the vagina or bulge in the vagina
Backache in the lower back
Painful intercourse
Problem having a bowel movement
Problems inserting tampons.

Pelvic Organ Prolapse Diagnosis

For successful treatment, diagnosis of the exact cause is critical. A simple pelvic or rectal examination is completed as part of a complete physical examination for a diagnosis. During the appointment, your doctor will attempt to determine the severity of the prolapse, typically by observation of the vaginal walls and cervix. Your doctor also might even ask you to strain to cough during the exam.

Treatment

Depending on the severity of uterine prolapse, your age, and other factors treatment options include:

Observation – Women experiencing no symptoms or problems receive treatment through regular exams.
Kegel exercises – A pelvic floor physical therapy where you squeeze the muscles you use to hold in gas. Ultimately, strengthening the muscles that help support the pelvic organs
Lifestyle changes – To address one of the causes of the condition, obesity, dietary changes
Pessaries – A non-surgical solution where silicone devices are inserted into the vagina to provide organ structural support
Surgery – Performed through the vagina or abdomen, or by laparoscopy depending on the support problem. The purpose of surgery is to correct the anatomy and provide better function.

If you have any pelvic health concerns, please call us at 770.720.7733 or request an appointment with one of our board-certified doctors.