Pelvic organ prolapse (POP) is a common but rarely discussed condition in which organs in the pelvic region shift out of their normal position, or prolapse. Pelvic organ prolapse can be both physically uncomfortable and emotionally troubling. Women with pelvic organ prolapse often limit their daily activities and avoid sex because of pelvic pain and/or the need to urinate frequently.
Common Symptoms of Pelvic Organ Prolapse (POP):
- Loss of bladder or bowel control
- Difficulty completely emptying your bladder
- Increased need to urinate
- Feelings of pelvic or vaginal heaviness, bulging, fullness and/or pain, or a feeling that something is “dropping”
- Recurrent bladder infections
- Excessive vaginal discharge
- Pain or lack of sensation during sex
The organs in your pelvic area – uterus, vagina, bladder and rectum – are held in place by a web of muscles and connective tissues that act like a hammock. When this web becomes weakened or damaged, one or more pelvic organs shift out of normal position and literally “fall,” or prolapse, into the vagina. When this happens, organs may press against the vaginal wall and produce a hernia-like bulge, causing discomfort and limiting physical and sexual activity.
Risk factors for pelvic organ prolapse include:
- Full-term pregnancy
- Vaginal delivery
- Loss of muscle tone with aging
- Family history of pelvic organ prolapse
- Chronic cough
The bladder, intestines, rectum, uterus, urethra, and vagina can all be involved in pelvic organ prolapse, though the bladder is the most commonly affected.
Several treatment options are available for pelvic organ prolapse (POP), depending on the severity of the prolapse and the associated symptoms.
Behavioral/Muscle Therapy: If symptoms are mild, Kegel exercises can be used to help strengthen the pelvic floor muscles.
Biofeedback: The patient exercises the pelvic floor muscles while connected to an electrical sensing device. The device provides “feedback” to help a woman learn how to better control these muscles. Over time, biofeedback can help a woman use her pelvic muscles to decrease sudden urges to urinate and lessen certain types of pelvic pain.
Pessary: A plastic device, called a pessary, can be inserted into the vagina to support and reposition the pelvic area. Shoemaker Gynecology recommends using vaginal estrogen along with the pessary.
Surgical Options: For women whose symptoms are severe or don’t respond to nonsurgical methods, we recommend pelvic floor reconstruction. Some of the surgical options available include synthetic mesh repair or posterior and anterior colporrhaphy. In some cases, a hysterectomy may be recommended in conjunction with other pelvic floor repair procedures.