What You Should Know About Pelvic Organ Prolapse
Pelvic organ prolapse is a type of a hernia that can be uncomfortable and rather awkward to manage since it often causes urinary issues, such as unexpected leakage of your urine when you laugh or a cough (stress urinary incontinence).
In fact, if your doctor has diagnosed you with urinary incontinence, it may be a signal that you’re experiencing pelvic organ prolapse. About a third of all women face problems with pelvic organ prolapse at some point in their life.
Dr. Kohli is a well-respected and nationally known urogynecologist and pelvic reconstructive specialist who has extensive experience and skill in diagnosing and treating pelvic organ prolapse.
He understands the frustration women experience with this condition and is happy to explain a few details about pelvic organ prolapse and the available treatment options.
What is pelvic organ prolapse?
Pelvic organ prolapse occurs when one or more of your pelvic organs drop from their normal position in your pelvic cavity. Situated in your lower abdomen, the pelvic cavity houses your reproductive organs, parts of your urinary system, your small intestines, and pelvic colon.
What causes pelvic organ prolapse?
Normally, a group of muscles and other strong, fibrous tissues located at the bottom of your pelvis act as a sling or hammock to hold your pelvic organs in place. We call this the pelvic floor. When these muscles and other supportive tissues weaken, your pelvic organs can “prolapse” or fall out of place and into your vagina. Your urinary bladder, for instance, may drop into your vagina and create a bulge (cystocele).
These muscles weaken for a variety of reasons, including:
Pregnancy and the extra demands placed on your pelvic floor muscles to hold your expanding uterus in place
Vaginal childbirth, during which pelvic floor muscles and other supportive structures stretch and subsequently weaken to allow your baby to pass through the birth canal
Obesity, which places a significant strain on your pelvic floor muscles
Conditions or habits that cause a chronic or a repetitive cough, such as smoking
Persistent problems with constipation and the need to strain during bowel movements
Menopause and the natural effects of aging may also play a role in pelvic organ prolapse. Estrogen helps maintain the health and strength of your vaginal muscles, and your ovaries stop producing estrogen at the time of menopause.
What are the symptoms of pelvic organ prolapse?
Your symptoms often depend on the organ affected by the prolapse. When your urinary bladder prolapses, for instance, it may cause stress urinary incontinence or leakage of urine when you laugh, cough, or run. It can also create the urge to urinate frequently or the sensation that your bladder isn’t empty after you urinate. Bladder prolapse is the most common type of pelvic organ prolapse.
Other symptoms of pelvic organ prolapse include:
Constipation, which often occurs with rectal prolapse (rectocele)
The feeling that something is falling out of your vagina
A palpable bulge in your vagina
Painful sexual intercourse
A sensation of fullness or discomfort in your lower abdomen or pelvic area
Lower back discomfort
Vaginal spotting or light bleeding between periods
How do you treat pelvic organ prolapse?
If your symptoms and prolapse are mild, we often start with conservative treatment such as Kegel exercises to strengthen the pelvic floor muscles. These are the same exercises women are encouraged to perform regularly following childbirth.
Sometimes we recommend you try a small device (pessary) that are inserted into your vagina to provide support for the drooping organs. Pessaries are typically made of silicone and are custom-fitted to your shape. They’re also easily removed should you desire.
Often, the most effective treatment for pelvic organ prolapse is surgery. The type of surgery, again, depends on the organ or organs affected. A prolapsed uterus, for instance, may require a hysterectomy. A prolapsed bladder can often be repaired, and the weakened muscles strengthened, via an incision in the vaginal wall.
Regardless of which organs are affected or the severity of your prolapse symptoms, Dr. Kohli can help. You don’t have to live with pelvic organ prolapse or the discomfort it causes. Schedule your visit today.
