Pelvic Organ Prolapse: Common Yet Misunderstood

Pelvic organ prolapse is a common yet frequently misunderstood health condition where one of the pelvic organs—the bladder, uterus, rectum, small intestine, or vagina—drops down from its usual position and pushes against the walls of the vagina. Up to one-third of women experience pelvic organ prolapse or a similar pelvic disorder at some point in their lives, and the experience can be embarrassing, uncomfortable, and painful.

Pelvic Organ Prolapse image

When pelvic organ prolapse isn’t present, the pelvic floor muscles hold the pelvic organs in place. But in some cases, such as after surgery or childbirth or simply with aging, these muscles weaken and fail to do their job. Instead of holding the pelvic organs in position above the pelvic opening, they allow the organs to drop and bulge into the vagina. Aside from what we’ve already mentioned, some other common causes and risk factors for pelvic organ prolapse are obesity, family history, constipation, a chronic cough, pelvic organ cancer, a past hysterectomy, or another situation where a lot of pressure is placed on the abdomen.

Types of Pelvic Organ Prolapse

Here are a few types of pelvic organ prolapse, each of which corresponds to a different organ involved:

Cystocele: This is the most common form of pelvic organ prolapse and is when the bladder drops down and bulges into the vagina.

Uterine prolapse: Prolapse of the uterus.

Enterocele: Prolapse of the small intestine/small bowel.

Urethrocele: Prolapse of the urethra.

Rectocele: Prolapse of the front wall of the rectum into the vagina.

Vaginal vault prolapse: Prolapse of the upper section of the vagina into the vaginal canal or outside the vagina.

The Symptoms

The symptoms of pelvic organ prolapse vary depending which organ has dropped. Here are some common symptoms you may notice:

  • Bulging at the opening of the vagina
  • Vaginal pressure
  • A constant urge to urinate
  • Leaking urine
  • Incontinence
  • Constipation
  • Pain during sex
  • Lower back pain or pressure
  • Pelvic pain, pressure, or fullness
  • Vaginal bleeding or spotting

Treatment

Pelvic organ prolapse can be diagnosed during a routine pelvic exam by your gynecologist, or through other procedures including MRI, ultrasound, pelvic floor strength testing, X-ray, or CT scan. These are a few different ways it can be treated:

Physical Therapy: Physical therapy is a common early treatment used to strengthen the pelvic floor muscles. This usually involves kegel exercises.

A Pessary: A pessary is a removable device that’s inserted into the vagina and used to support organs and prevent them from dropping down. A pessary is usually fitted to the individual, and is may be used in conjunction with physical therapy or on its own if physical therapy is ineffective.

Surgery: If symptoms don’t let up after physical therapy or with use of a pessary, surgery to repair the organ or tissue may be recommended. The exact surgery will vary depending on the organ involved, with some being far more simple or complex than others. If the uterus is the organ involved, a hysterectomy is often recommended. Sometimes a procedure called a sacrocolpopexy is performed on women who are at high risk of experiencing repeated prolapse.

What to do if you suspect you’re experiencing pelvic organ prolapse?

It’s important to see a doctor if you think you’re dealing with pelvic organ prolapse. In most cases, the condition isn’t harmful, but may get worse over time. It can also result in urinary tract infections or other urinary problems when left untreated.

If you have any concerns about pelvic organ prolapse and want to speak with a knowledgeable doctor, call Arizona OB/GYN Affiliates (AOA) at 602-343-6174 or visit www.aoafamily.com.

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