Pelvic organ prolapse (POP) is a medical condition characterized by the descent of one or more pelvic organs from their normal position, protruding into the vagina. Affecting nearly 3% of women in the United States, this condition arises when the supportive muscles and tissues of the pelvic floor weaken, unable to maintain organ stability.
Symptoms of Pelvic Organ Prolapse
Symptoms of POP encompass discomfort during sexual intercourse, a sensation of vaginal heaviness or pressure, and difficulties with urination and bowel movements.
Causes of Pelvic Organ Prolapse
Several factors contribute to the development of POP, including obesity, pregnancy, childbirth, aging, and certain medical conditions such as joint hypermobility syndrome and Marfan syndrome. Various types of POP can manifest concurrently, involving anterior, uterine, vaginal vault, or posterior wall prolapse, each with distinct symptoms and presentations.
Types of Pelvic Organ Prolapse
Patients may experience one or more of the following types of prolapse simultaneously:
- Anterior prolapse, also known as cystocele, occurs when the bladder protrudes into the front wall of the vagina.
- Uterine prolapse involves the descent or protrusion of the uterus into the vagina.
- Vagina vault prolapse occurs when the vagina descends after a hysterectomy.
- Posterior wall prolapse results in the forward bulging of the bowel into the back wall of the vagina.
- Enterocele refers to the prolapse of the small bowel, while urethrocele describes the prolapse of the urethra. A rectocele involves the prolapse of the rectum into the back wall of the vagina.
Pelvic Organ Prolapse Diagnosis
Diagnosis typically involves a thorough internal pelvic examination, supplemented by additional tests like urine analysis and cystoscopy to assess bladder function and identify any associated complications. Treatment approaches for pelvic organ prolapse range from conservative measures such as physical therapy and pessary use to surgical interventions tailored to the individual’s symptoms and preferences.
Treatment Options
While medications may offer relief in some cases, women experiencing menopause-related muscle tone decline due to reduced estrogen levels often encounter prolapse issues. Estrogen treatment may alleviate prolapse symptoms in these cases, though it’s not universally suitable.
Physical therapy, including Kegel exercises, strengthens pelvic floor muscles and can mitigate prolapse symptoms. Biofeedback devices utilizing sensors aid in improving muscle tone and prolapse symptoms. Pessaries, silicone devices inserted into the vagina, provide internal organ support. Surgical interventions, such as ligament tightening or mesh sling placement, offer options for organ support restoration.
For patients experiencing bothersome symptoms of POP, physical therapy can provide relief by strengthening core muscles and alleviating pelvic pressure. In cases where conservative methods are insufficient, surgical options like sacrospinous ligament suspension or vaginal uterosacral ligament suspension may be recommended to restore pelvic organ support. However, it’s essential that treatment decisions consider potential risks and benefits, particularly with regards to surgical procedures involving synthetic mesh, which may pose complications.
Choose UCI Pelvic Health Center
At UCI Pelvic Health Center, we offer comprehensive evaluation and personalized treatment plans for individuals with pelvic organ prolapse. Our experienced team is dedicated to providing compassionate care, whether through conservative measures or surgical interventions. If you’re experiencing symptoms of pelvic organ prolapse, don’t hesitate to contact us for expert evaluation and support.