Pelvic Organ Prolapse: Symptoms, Causes, and Treatment

Pelvic organ prolapse occurs when one or more pelvic organs, like the bladder, uterus, or rectum, descend into or outside of the vaginal canal. This happens due to weakened or damaged pelvic floor muscles and tissues, leading to discomfort and effects on daily activities.

What is pelvic organ prolapse?

Pelvic organ prolapse occurs when the pelvic floor — a group of muscles and tissues supporting the pelvic organs — becomes weakened or stretched, causing the organs to drop from their normal position. There are several types of prolapse, depending on which organ is affected:

1. Cystocele (bladder prolapse)

   • The bladder drops into the front wall of the vagina.

2. Rectocele (rectal prolapse)

   • The rectum bulges into the back wall of the vagina.

3. Uterine prolapse

   • The uterus descends into the vaginal canal.

4. Enterocele

   • The small intestine pushes into the upper part of the vaginal wall.

5. Vaginal vault prolapse

   • The top of the vagina drops, especially common after a hysterectomy.

Causes of pelvic organ prolapse

Several factors can weaken the pelvic floor muscles and tissues:

1. Childbirth

   • Vaginal deliveries, especially multiple or complicated births, can stretch or damage pelvic floor muscles.

2. Ageing

   • The natural ageing process leads to a decline in muscle tone and tissue strength.

3. Menopause

   • Decreased oestrogen levels after menopause can weaken pelvic tissue.

4. Chronic pressure

   • Conditions that increase abdominal pressure, such as obesity, chronic coughing, or heavy lifting, can strain the pelvic floor.

5. Genetics

   • A family history of pelvic organ prolapse may increase the risk due to inherited tissue weaknesses.

6. Surgery

   • Previous pelvic surgeries, including hysterectomy, can weaken support structures.

Symptoms of pelvic organ prolapse

Symptoms can vary depending on the type and severity of the prolapse but may include:

• A feeling of pressure or fullness in the pelvic area.

• A visible bulge or protrusion from the vagina.

• Discomfort or pain during intercourse.

• Urinary problems, such as incontinence or difficulty emptying the bladder.

• Bowel issues, such as constipation or difficulty having bowel movements.

• Lower back pain.

  

• Spotting or bleeding.

Treatment for pelvic organ prolapse

Treatment depends on the severity of the condition and the patient's symptoms and overall health:

1. Lifestyle changes 

   • Weight management, avoiding heavy lifting, and managing chronic cough or constipation can alleviate symptoms.

2. Pelvic floor exercises

   • Kegel exercises can strengthen pelvic muscles and provide support.

3. Pessary

   • A removable device inserted into the vagina to support the pelvic organs.

4. Medications 

   • Topical oestrogen therapy may help strengthen vaginal tissues.

5. Surgery 

   • Various surgical options are available to repair and support the affected organs. These include minimally invasive procedures and traditional open surgeries.

FAQs

What can I do to prevent pelvic organ prolapse?

Maintain a healthy weight, practise regular pelvic floor exercises, avoid heavy lifting, and manage chronic conditions like cough and constipation.

Can pelvic organ prolapse affect my ability to have sex?

Yes, pelvic organ prolapse can cause discomfort or pain during intercourse, but many treatment options can alleviate these symptoms and improve sexual function.

Is pelvic organ prolapse a common condition?

Yes, it is relatively common, especially among women who have given birth, are postmenopausal, or have a family history of the condition.

How is pelvic organ prolapse diagnosed?

A healthcare provider can diagnose pelvic organ prolapse through a pelvic exam, during which they may ask you to bear down as if having a bowel movement to observe any prolapse.

Can pelvic organ prolapse get worse over time?

Without treatment or lifestyle changes, pelvic organ prolapse can progress and worsen over time, leading to increased symptoms and discomfort.

Are there non-surgical treatments for pelvic organ prolapse?

Yes, non-surgical treatments include pelvic floor exercises, lifestyle modifications, and the use of pessaries to support the prolapsed organs.

What is the recovery time for pelvic organ prolapse surgery?

Recovery time varies depending on the type of surgery but generally ranges from a few weeks to several months. It is essential to follow your healthcare provider's post-operative instructions for optimal recovery.

Can men experience pelvic organ prolapse?

While rare, men can experience a form of prolapse known as rectal prolapse, where the rectum protrudes through the anus. However, pelvic organ prolapse primarily affects women due to the structure of the female pelvis and reproductive system.

Is it safe to exercise with pelvic organ prolapse?

Yes, but engage in pelvic floor-friendly exercises. Avoid high-impact activities and heavy lifting. Consult a physical therapist specialising in pelvic floor health for guidance.

Can pelvic organ prolapse affect my bladder or bowel function?

Yes, pelvic organ prolapse can lead to urinary incontinence, difficulty emptying the bladder, constipation, and difficulty with bowel movements. Treatment can help manage these symptoms.

Additional Support

Pelvic organ prolapse is a manageable condition with various treatment options to improve quality of life. Understanding the causes, symptoms, and treatments can empower individuals to seek appropriate care and make informed decisions about their health.

If you suspect you have pelvic organ prolapse, feel free to reach out to Thomson Medical. Our team is here to assist you with any questions and provide the support you need.