Pelvic Organ Prolapse

Pelvic organ prolapse is the most uncomfortable condition that afflicts women. In a normal condition, the pelvic organs such as the bladder, uterus, vagina, and rectum are supported by a group of muscles and tissues called the pelvic floor. When these muscles and tissues become weak over time, the pelvic organs drop down and bulge out of the vagina. This creates a sensation of feeling and an uncomfortable bulge in the vagina.

These organs are said to prolapse if they descend into or outside of the vaginal canal or anus. Prolapse is named depending on which organ is affected

• Cystocele: in this condition, the bladder protrudes into the vagina, creating a bulge. This is the most common type of prolapse.
• Rectocele: when the rectum bulges into the back wall of the vagina.
• Uterine: when uterus dropping into the vagina
• Enterocele: small bowel prolapses
• Urethrocele: when urethra prolapse

• Pain or pressure in the pelvis.
• A feeling of heaviness around the lower abdomen and genitals
• A dragging discomfort inside the vagina
• Feeling like -something coming down into the vagina
• Pain in the lower back (small intestine prolapse)
• Urinary problems like urine leaking or urge to urinate (bladder prolapse)
• Constipation (rectum prolapse)
• Painful intercourse (rectum prolapse)

Anything that puts intense pressure in the abdomen can lead to pelvic organ prolapse such as pregnancy, childbirth, obesity, respiratory problems, persistent cough, constipation, pelvic organs cancer, uterus removal, connective tissues may be weak for some women.

Vaginal childbirth is the most common risk factor, multiple childbirths, heavy lifting, hormonal changes, straining with constipation, birth weight of babies is more, obesity.

POP is diagnosed by performing

• Urinary tract X-ray
• CT scan of the pelvis
• Ultrasound of the pelvis
• MRI scan of the pelvis

Treatment of POP depends on how severe the symptoms are and for how long. A variety of therapies are included in the treatment.

Initially, you may be recommended for physical therapy which includes Kegel exercises. These exercises strengthen the pelvic floor muscles.

Your doctor may recommend a device called pessary; it is made from silicone. A pessary is inserted into the vagina to support the prolapsed organs.

Surgery is done for women who have tired pessary and didn’t get any relief from the symptoms. Depending upon the type and severity of the condition, and any other health problems, different surgery types are recommended. Hysterectomy is performed for women who have uterine prolapse. Women having repeated prolapse may have a procedure called sacrocolpopexy, where the surgeon works through small incisions in the abdomen to reposition the pelvic organs back to their positions.

You can do certain things to prevent pelvic organ prolapse by doing-

• Kegel exercises
• Maintain a healthy weight
• Healthy diet to avoid constipation
• Avoid smoking