You probably don’t think about body organs shifting and moving, but it happens. Pelvic organ prolapse, where organs shift from their original location in the pelvis, affects millions of women in the United States.
In fact, according to the American College of Obstetricians and Gynecologists, prolapse becomes increasingly more common as we get older, affecting 1 in 4 women in their 40s, 1 in 3 women in their 60s, and 1 in 2 women in their 80s. If you experience some type of pelvic organ prolapse, Northeast Georgia Physicians Group Urogynecology can help you find the best treatment option to meet your needs.
What is pelvic organ prolapse?
Pelvic organ prolapse is a pelvic floor disorder that occurs when the muscles and tissues surrounding and supporting organs in the pelvis loosen or weaken. When this happens, pelvic organs can drop or slip, sometimes “prolapsing” out of the body through the vagina.
There are multiple types of pelvic organ prolapse, differing by the organ or organs affected:
- Cystocele, also called anterior vaginal wall prolapse, occurs when muscles above the vagina weaken and cause the bladder to slip out of place and bulge onto the vagina.
- Enterocele occurs when weakened pelvic muscles cause the small intestine to bulge onto the back wall or the top of the vagina.
- Rectocele, also called posterior vaginal wall prolapse, occurs when muscles in between the vagina and rectum weaken and cause the rectum to bulge onto the back wall of the vagina.
- Urethrocele occurs when the urethra, the tube that carries urine from the bladder to the outside of the body, droops. This type of prolapse often accompanies rectocele.
- Uterine prolapse occurs when a weakened pelvic floor causes the uterus to drop into the vaginal canal.
- Vaginal vault prolapse occurs when muscles in the pelvic floor weaken and cause the top part of the vagina—the vaginal vault—to drop into the vaginal canal.
Cystocele, sometimes called “dropped bladder,” is the most common type of pelvic organ prolapse.
What causes pelvic organ prolapse?
Tissues and muscles in the pelvis often weaken during pregnancy and vaginal childbirth, but prolapse can also occur in women who have never given birth. Pelvic organ prolapse becomes more common as we get older. Other causes and risk factors include:
- Chronic constipation and straining during bowel movements
- Chronic coughing caused by lung disease
- Diseases that weaken connective tissue
- High-impact activities, including exercise and certain jobs
- Hormonal changes related to menopause
- Hysterectomy
- Obesity
- Pelvic floor injuries
Women who have a family history of pelvic organ prolapse are also at an increased risk.
What are the symptoms of pelvic organ prolapse?
If prolapse is mild, it may not cause any noticeable symptoms, but the symptoms of pelvic organ prolapse can include:
- Constipation
- Difficulty having a bowel movement
- Difficulty inserting tampons or having intercourse
- “Looseness” in the vagina
- Lower back pain
- Pelvic pressure, discomfort, or fullness
- Pelvic pressure that worsens when standing, coughing, or otherwise straining
- Urine leakage or an inability to fully empty the bladder
Women with prolapse may also see or feel a bulge near the opening of the vagina.
How is pelvic organ prolapse diagnosed?
If you’re experiencing symptoms that may be caused by prolapse, your provider will perform a pelvic exam to thoroughly examine and palpate the pelvis. During the exam, you may be asked to cough or bear down to check for urine leakage or other symptoms that may occur with strain.
In many cases, pelvic organ prolapse can be diagnosed based on the findings of a pelvic exam. A urogynecologist may also perform a rectal exam or order other tests, such as bladder function tests or imaging scans, to help confirm a diagnosis.
How is pelvic organ prolapse treated?
Mild pelvic organ prolapse may not require treatment, but more severe cases of prolapse can be treated in several ways. An NGPG urogynecologist can help you find the most appropriate treatment plan based on your specific needs. Treatment may include:
Colpocleisis
During this procedure, a urogynecologist surgically closes off the vagina, preventing organs from bulging outside the body. Because the procedure seals the vagina, vaginal intercourse isn’t possible after surgery.
Colporrhaphy
During this procedure, a urogynecologist accesses the body through the vagina and reinforces the vaginal wall with dissolvable sutures. These sutures support the bladder and rectum, treating vaginal wall prolapse.
Lifestyle changes
Healthy lifestyle habits may help alleviate the symptoms caused by pelvic organ prolapse. Women who are overweight or obese can benefit from losing even a small amount of weight to take pressure off the pelvis. Dietary changes, including increasing water and fiber intake, can help treat chronic constipation, which often contributes to prolapse. It can also be beneficial to perform exercises to strengthen your core, including the abdominals, lower back, and pelvis.
Pelvic floor therapy and exercises
Exercises that strengthen the pelvic floor, also known as Kegel exercises, can help rebuild the pelvic muscles, including the bladder and vagina, and may slow the progression of prolapse. A urogynecologist may provide guidance on how to perform these exercises or refer you for pelvic floor therapy.
Pessary
A pessary is a small device that is inserted into the vagina to support the pelvic muscles. These devices often alleviate bulging symptoms and urine leakage.
Sacrocolpopexy
During this procedure, a urogynecologist attaches surgical mesh to the vaginal walls and the tailbone, which lifts the vagina back into place. Sacrocolpopexy is used to treat both enterocele and vaginal vault prolapse.
Sacrohysteropexy
During this procedure, a urogynecologist attaches surgical mesh to the vagina and cervix, then connects it to the tailbone, which lifts the uterus into place. Sacrohysteropexy is used to treat uterine prolapse.
Sacrospinous ligament suspension
During this procedure, a urogynecologist reattaches the top of the vagina to connective tissue in the pelvis. Sacrospinous ligament suspension is typically performed after a complete hysterectomy, which removes both the uterus and the cervix, and can be used to treat uterine prolapse or vaginal vault prolapse.
Uterosacral ligament suspension
During this procedure, a urogynecologist reattaches the top of the vagina to the uterosacral ligaments, which is a thick connective tissue connecting the cervix to the spine. Uterosacral ligament suspension is typically performed after a complete hysterectomy, and it can be performed using minimally invasive techniques or by accessing the body vaginally.
Choose NGPG for pelvic organ prolapse treatment
When you’re experiencing pelvic organ prolapse, you deserve the care of a team of experts. That’s what you’ll find at NGPG Urogynecology, where we have unique expertise in treating conditions affecting female pelvic health. Guided by training that encompasses both urology and gynecology, our urogynecologists can provide specialized care for prolapse, including surgery when needed.
If surgery is required to treat pelvic organ prolapse, procedures are performed at Northeast Georgia Medical Center. There, we can offer our patients minimally invasive or robotic procedures when possible, which provide a quicker recovery and minimal side effects.
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