Introduction

Your doctor will diagnose you as a patient with pelvic organ prolapse, or POP, when the organs in your pelvis, like the bladder, uterus, rectum or vagina move out of their normal spots. You may have this condition because your pelvic floor (which includes the muscles and tissues holding these organs up) can no longer keep them in place. So these organs start to shift or droop into the vagina. Weak pelvic muscles can result from aging or giving birth.

What Symptoms Point to Pelvic Organ Prolapse?

The most noticeable sign is feeling a bulge in your vagina almost like something might fall out. Other signs include: A sense of fullness or pressure in the vagina A heavy or achy feeling in the pelvis Pain or discomfort during sex Changes in how you urinate or have bowel movements Leaking urine when you cough, laugh or exercise (called stress incontinence) Always feeling like you need to pee or having a full bladder sensation Difficulty with bowel movements or trouble controlling when you go

What Leads to Pelvic Organ Prolapse?

Several things can increase your chances of developing pelvic organ prolapse: Giving birth Growing older Higher body weight Long-term strain in the belly area Family background Conditions related to connective tissue such as Ehlers-Danlos syndrome, Marfan syndrome or joint hypermobility.

How do Doctors Diagnose Pelvic Organ Prolapse?

Pelvic examination: Your doctor will ask you to cough during the exam to observe how the prolapse appears when you strain versus when you relax. They could check you while you're lying down as well as when you're standing up. Other possible tests include: Tests to evaluate pelvic floor function that help assess the strength of your pelvic muscles and ligaments. Tests to check bladder function that help detect possible urinary problems often linked to POP. Doctors use imaging techniques like pelvic floor ultrasound or MRI to check how much your prolapse has progressed.

How do Doctors Treat Pelvic Organ Prolapse?

Your doctor will go over different treatment options and help you choose what might suit your condition.

1. Non-surgical options: Vaginal pessary: A doctor can place this silicone device inside your vagina to keep the prolapsed organ in position. It is removable. Pelvic floor exercises: These exercises, like Kegels, help strengthen the pelvic floor. Your doctor might send you to a pelvic floor expert or urogynecologist to measure how strong individual muscles are and to guide you through exercises designed to train and improve them.
2. Surgical options: Doctors may suggest surgery if your symptoms don’t get better with simple treatments. The surgeries are divided into two types: obliterative and reconstructive. Obliterative surgery works by shrinking the vaginal opening, stopping organs from slipping out. However, this will mean you can no longer have penetrative sex. One type of obliterative surgery is colpocleisis, which shortens the vagina and keeps the organs from bulging outside the body. This procedure is often ideal if you are not healthy enough for reconstructive options and are okay with giving up penetrative sex. Doctors use reconstructive surgery to strengthen weak areas in the pelvic floor and restore the organs to their normal positions. Sacrocolpopexy: Sacrocolpopexy helps fix uterine prolapse and vaginal vault prolapse. It involves placing mesh material to connect the vagina to a ligament near the tailbone. Colporrhaphy: This procedure repairs prolapse of the anterior or posterior vaginal walls. Surgeons operate through the vagina and use dissolvable stitches to support the vaginal walls, bladder, and rectum. Uterosacral or sacrospinous ligament fixation: This method fixes uterine prolapse or vaginal vault prolapse using your own tissues. During the surgery, the doctor secures the top of your vagina to a muscle or ligament in your pelvis with dissolvable stitches.