Pelvic Organ Prolapse: Causes, Symptoms and Treatment

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With the gradual increase in life expectancy in developed countries over the past century, doctors are expected to be familiar with disorders of the elderly population. Pelvic organ prolapse and urinary incontinence are common conditions affecting many adult women nowadays.

A pelvic floor is a group of muscles and ligaments in the pelvic region. The pelvic floor acts like a sling to support the organs of the pelvis including the bladder, rectum, uterus or prostate. Contracting and relaxing these muscles allows controlling bowel movements, urination and for women particularly, sexual intercourse.

In this article:

What is a Pelvic Floor Disorder?
What is Pelvic Organ Prolapse?
Causes of Pelvic Organ Prolapse
Symptoms of Pelvic Organ Prolapse
Diagnosis of Pelvic Organ Prolapse
Treatment for Pelvic Organ Prolapse
Prevention of Pelvic Organ Prolapse

A Guide for Pelvic Organ Prolapse

What is a Pelvic Floor Disorder?

Pelvic floor disorder is the inability to correctly tighten and relax the pelvic floor muscles to have a bowel movement. Signs and symptoms include constipation, urine or stool leakage and a frequent need to urinate. Treatments include biofeedback, medication or surgery. The most common types are –

  • Pelvic organ prolapse is weakening of the muscles and tissues supporting the organs in the pelvis
  • Urinary incontinence is leaking of urine
  • Fecal incontinence is leaking of stool

It forces to contract the muscles rather than relax them and as a result, there is difficulty having a bowel movement. If left untreated, it can lead to discomfort, long-term colon damage or infection.

pelvic organ prolapse stages

What is Pelvic Organ Prolapse?

Pelvic organ prolapse refers to a descending or drooping of any pelvic floor organs which include –

These organs are said to be prolapsed if they descend into or outside of the vaginal canal or anus and the conditions referred to in these ways are –

  • Cystocele – prolapse of the bladder into the vagina which is the most common condition
  • Urethrocele – prolapse of the urethra which is a tube that carries urine
  • Uterine prolapse
  • Vaginal vault prolapse – prolapse of the vagina
  • Enterocele – a small bowel prolapse
  • Rectocele – prolapse of the rectum

It is a type of pelvic floor disorder, can affect many women. In fact, about one-third of all women are affected by prolapse or other similar conditions.

Causes of Pelvic Organ Prolapse

Anything that puts increased pressure in the abdomen can lead to pelvic organ prolapse and the common causes include –

  • Pregnancy, labor, and childbirth (the most common causes)
  • Giving birth to a baby weighing more than 8.5 pounds
  • Aging
  • Hormonal changes during menopause
  • Obesity
  • Long-term pressure on the abdomen
  • Respiratory problems with a chronic, long-term cough
  • Constipation
  • Pelvic organ cancers
  • Surgical removal of the uterus called hysterectomy
  • Family history

Symptoms of Pelvic Organ Prolapse

Sometimes no symptoms are seen by some women, but others report these symptoms with pelvic organ prolapse-

  • A feeling of pressure or fullness in the pelvis or around the area
  • A backache low in the back
  • Painful intercourse
  • A feeling that something is falling out of the vagina
  • Urinary problems like leaking of urine or a chronic urge to urinate
  • Constipation
  • Spotting or bleeding from the vagina

Basically symptoms somewhat depend on which organ has prolapsed. If bladder prolapses, urine leakage may occur. If the rectum prolapsed, constipation and uncomfortable intercourse often occur. A backache as well as uncomfortable intercourse often accompanies small intestine prolapse and also uterine prolapse is also accompanied by backache and uncomfortable intercourse.

Diagnosis of Pelvic Organ Prolapse

The doctor may discover pelvic organ prolapse during a routine pelvic examination, such as the one has done when doing Pap smear. The doctor may order a variety of diagnostic tests –

Treatment for Pelvic Organ Prolapse

Treatment of pelvic organ prolapse depends on how severe the symptoms are seen. Treatment can include a variety of therapies, including –

  • Behavioral treatments such as doing Kegal exercises designed to strengthen the pelvic floor muscles.
  • Mechanical treatments such as inserting a small plastic device called a pessary into the vagina to provide support for the dropping organs.
  • Surgical treatment either to repair the affected tissue or organ or to remove the organ (such as removal of the uterus which is done by a hysterectomy).

Prevention of Pelvic Organ Prolapse

Many risk factors for pelvic organ prolapse are out of control which includes –

  • Family history
  • Advancing age
  • A difficult vaginal delivery
  • Having had a hysterectomy

But to reduce the likelihood there will be some problems, so try these steps –

  • Do kegel exercises daily to maintain good muscle strength in the pelvic area
  • Maintain a healthy weight or lose weight (if overweight)
  • Choose foods with fiber
  • Avoid constipation
  • Do not smoke, as it can affect tissues and a chronic cough often seen in smokers boosts the risk of problems

Conclusion

Many women are embarrassed to talk to the doctor about the symptoms or think that they are normal but pelvic organ prolapse is treatable. Talk to the doctor about the symptoms to get a proper diagnosis. There are several home remedies that can be done before restoring to medication or surgery for treatment.

References

https://www.ncbi.nlm.nih.gov/pubmed/28762694

https://www.webmd.com/urinary-incontinence-oab/pelvic-organ-prolapse#1

https://www.womenshealth.gov/a-z-topics/pelvic-organ-prolapse

Hope this article was of help to you! Please share your comments/queries/tips with us and help us create a world full of Happy, Healthy and Empowered Women!!

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