Pelvic prolapse

What is Pelvic organ prolapse ?

Pelvic Organ Prolapse (POP) is the relaxation or “falling” of the female pelvic organs: uterus, bladder or rectum.  It is a common condition that affects many women between the ages of 35 – 80 and yet many women are not aware of its prevalence.

What causes prolapse ?

Prolapse is caused by the weakening of the muscles and fascia that support the bladder, uterus and rectum against gravity.  The following is a list of risk factors that weaken the pelvic floor and contribute to prolapse.  Some women with prolapse have only one of these risk factors and others have multiple.

1. multiple vaginal deliveries or at least one large baby

2. carrying extra weight around the middle

3. smoking or history of

4. job/lifestyle that includes heavy lifting or prolonged standing

5. chronic constipation

6. family member with prolapse

What are the symptoms of prolapse ?

The symptoms of prolapse depend on which organ has “dropped”.  Due to the nature of prolapse, most women will have prolapse of more than one organ.

Prolapse of the uterus (uterine descensus) may cause a vaginal bulge, pelvic aching with prolonged standing, inability to keep in a tampon.

Prolapse of the bladder (cystocele) may cause inability to empty the bladder, urge to lean forward on the toilet, frequent urination or leaking of urine.

Prolapse of the rectum (rectocele) may cause rectal pressure,  multiple BMs per day, incomplete emptying of the rectum, urge to push on the perineum or vagina to complete a BM, excessive straining or presence of hemorrhoids.

How do I know if I have prolapse ? 

Presence of the above symptoms may suggest POP but to confirm it, see a physician who specializes in women’s health.  An exam of the vagina can quickly assess the severity of the uterine prolapse, the cystocele or the rectocele.  Prolapse  is usually given a grade 0-4 (0 = no prolapse and 4 = complete prolapse with the uterus hanging outside the body).

What are the treatment options for pelvic organ prolapse ?

Treatment of POP depends on the severity of the symptoms and the degree of prolapse.  For mild prolapse, Kegel exercises, lifestyle modifications and pelvic physical therapy can be successful.  Moderate or severe prolapse usually requires surgery or pessary placement.  Prolapse will reoccur in 30% of women who undergo surgical treatment so it is important to modify your lifestyle to minimize the risk factors listed above.