Pelvic Organ Prolapse — A Common Problem For Many Women

Pelvic Organ Prolapse — A Common Problem For Many Women

Pelvic Organ Prolapse is a very common condition, particularly in women who have children and as women age.  Pelvic organ prolapse is a general term to describe the loss of normal support of the organs in the pelvis (bladder, uterus, rectum) allowing them to drop into the vagina.

Normal support of the bladder, urethra, uterus, and rectum is provided by muscles, connective tissues (ligaments) and nerves that control the muscles.  These muscles and tissues can naturally weaken with age and as a result of stretching during pregnancy.  Frequent heavy lifting or straining from chronic constipation, and long term coughing from smoking, asthma, and bronchitis are common conditions which can stretch or break these tissues so they can no longer support the pelvic organs.

The symptoms of prolapse can be mild to severe.  In general, women may feel pressure in the vagina or feel as if something is “falling down,” discomfort or pain in the lower abdomen and/or lower back, and pain during sexual intercourse such as the feeling as though her partner is “bumping into something.”  Often these symptoms worsen throughout the day and with prolonged standing.  Urinary symptoms can include leaking urine with straining such as lifting, coughing, sneezing, and laughing.  Accidental urine loss is not considered a normal part of aging.  With severe prolapse some women will suffer from poor urine stream, straining to empty the bladder, incomplete emptying, and general difficulty in passing urine or stool.

Pelvic organ prolapse is diagnosed through a detailed discussion with the patient and a thorough pelvic examination.  The examination should not be uncomfortable.  Each area of the pelvis is examined to look for breaks in the support tissues allowing each organ to fall into the vagina.  Additionally, a urine sample and a study of the bladder may be performed to evaluate the possible causes of involuntary urine loss.

There are a number of surgical and non-surgical options available today to treat prolapse.  The choice of treatment depends on a variety of factors such as the type of prolapse you have, the severity of your symptoms, your age and other health issues, whether or not you want to have children in the future, and your personal preferences.

In mild cases, muscle strengthening (Kegel) exercises may be used to strengthen the pelvic muscle.

A vaginal pessary is a small device, similar to a diaphragm, which is inserted into the vagina to hold the prolapsed organs in place.  Pessaries are made of latex or silicone and come in many different shapes and sizes.  Pessaries are generally recommended as treatment for women who are waiting for surgery, women who want to have more children in the future, and women who are unable or choose not to have surgery.

The third option of treatment is surgery.  This involves identifying and repairing the specific breaks in each tissue that is causing the prolapse.  At times, this may involve removing the uterus (hysterectomy) to obtain a better and longer lasting result.  A woman’s ovaries do not need to be removed if a hysterectomy is performed unless the patient desires it.  Therefore, she does not need to be on hormones if she has not yet gone into menopause.

If involuntary urine loss is the only problem multiple surgical procedures exist, some of which can be performed on an outpatient basis allowing the woman to go home one or two hours after surgery.  If other prolapse problems are also present, all repairs can be performed at the same time.

You can help prevent prolapse from occurring or worsening.  Do not strain to move your bowels.  If you have trouble with constipation make sure your diet contains an adequate amount of fiber.  Avoid frequent heavy lifting.  Stop smoking and for those with chronic lung problems make sure it is well controlled to avoid frequent coughing.  If you are overweight, modify your lifestyle to include diet and exercise.

Comments are Closed