What is pelvic organ prolapse?

Dec 09, 2020

Pelvic organ prolapse occurs when a pelvic organ—such as your bladder—lowers (prolapses) from its normal place in your abdomen and pushes against the vaginal wall. This can happen when the pelvic floor muscles get weak or stretched from childbirth or surgery.

Many women will have some kind of pelvic organ prolapse. It can be uncomfortable or painful. But it isn't usually a big health problem. It doesn't always get worse. And in some women, it can get better with time.

More than one pelvic organ can prolapse at the same time. Organs that can be involved when you have pelvic prolapse include the:

 

  • Bladder -This is the most common kind of pelvic organ prolapse.
  • Urethra
  • Uterus
  • Rectum
  • The vaginal wall itself

What causes pelvic organ prolapse?

Pelvic organ prolapse is most often linked to strain during childbirth. During childbirth the pelvic floor muscles can get weak or stretched. If they don't recover, they can't support your pelvic organs.

Pelvic organ prolapse can be made worse by anything that puts pressure on your belly, such as:

  • Being very overweight (obesity).
  • A long-lasting cough.
  • Frequent constipation.
  • Impact exercises (without proper engagement of the pelvic floor)

What are the symptoms?

Symptoms of pelvic organ prolapse include:

  • Feeling pressure from pelvic organs pressing against the vaginal wall. This is the most common symptom.
  • Feeling tissue as you are wiping or washing.
  • Feeling a pull or stretch in your groin area or pain in your lower back.
  • Releasing urine without meaning to (incontinence), or needing to urinate a lot.
  • Having pain in your vagina during sex.
  • Having problems with your bowels, such as constipation.

How is it treated?

Decisions about your treatment will be based on which pelvic organs have prolapsed and how bad your symptoms are.

The first place to start for treatment is pelvic health physical therapy. Your physiotherapist will guide you through the proper exercises to help strengthen the pelvic floor muscles. They will also direct you in lifestyle changes you may have to make to help with your symptom management.

If you still have symptoms, your doctor may have you fitted with a device called a pessary to help with the pain and pressure of pelvic organ prolapse. A pessary is a removable device that you put in your vagina. It helps hold the pelvic organs in place. But if you have a severe prolapse, you may have trouble keeping a pessary in place.

Surgery should be the last treatment option considered for a pelvic organ prolapse. If you do require surgery, doing exercises to make your pelvic floor muscles stronger will help you recover faster from surgery. The two together can help you, more than surgery alone.

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