Pelvic organ prolapse is a health condition that occurs when the muscles and tissues supporting the pelvic organs, such as the uterus, bladder, or rectum, become weak or loose. When this happens, one or more of these pelvic organs may drop or press into or out of the vagina.
There are several types of pelvic organ prolapse, including:
1. Cystocele: when the bladder drops into the vagina.
2. Uterine prolapse: when the uterus hangs down into the vagina.
3. Rectocele: when the rectum bulges into the back wall of the vagina.
4. Vaginal vault prolapse: when the upper section of the vagina loses its shape and drops into the vaginal canal or outside the vagina.
Symptoms can range from mild to severe and include discomfort or a feeling of pressure in the pelvic region, problems with sexual intercourse, and issues with bowel movements or urination. Risk factors for pelvic organ prolapse include childbirth, menopause, aging, history of pelvic surgeries, obesity, and conditions that can increase pressure in the abdomen such as chronic constipation or long-term coughing.
Treatment varies depending on the severity and can range from lifestyle changes, pelvic floor exercises (also known as Kegel exercises), using a device inserted into the vagina (pessary), to surgery. People experiencing symptoms should consult with a healthcare professional for diagnosis and treatment options.
Causes of Pelvic organ prolapse
Pelvic organ prolapse occurs when a pelvic organ—such as your bladder—drops from its normal place in your lower belly and pushes against the walls of your vagina. This can happen when the muscles that hold your pelvic organs in place get weak or stretched. Some of the most common causes for this condition include:
1. Childbirth: This is the biggest risk factor, especially if the woman had a difficult labor and delivery, or gave birth to large babies. Childbirth can weaken or damage the muscles and tissues in the pelvic area, leading to prolapse.
2. Aging: The likelihood of experiencing pelvic organ prolapse increases as a woman ages. This is because the muscles and tissues supporting the pelvic organs naturally weaken over time.
3. Menopause: The decrease in estrogen production that occurs during menopause can weaken pelvic muscles and cause pelvic organ prolapse.
4. Chronic Pressure: Regularly lifting heavy objects, being overweight, or having a chronic cough can put prolonged pressure on the pelvic muscles, weakening them over time and leading to prolapse.
5. Genetic Factors: Women who have a family history of pelvic organ prolapse are at a higher risk of developing it.
6. Prior Pelvic Surgery: Women who have had surgery to the pelvic area, especially hysterectomies (removal of the womb), may have weakened pelvic support and be at greater risk of prolapse.
7. Other Factors: Conditions such as obesity, chronic constipation – which may cause straining during bowel movements – and tumors in the pelvic area can also contribute to the cause.
It’s essential to note that while these factors can increase a woman’s risk, they do not guarantee that she will experience pelvic organ prolapse. Not all women with these factors will develop pelvic organ prolapse, and some women without any of these factors will develop it.
Risk Factors of Pelvic organ prolapse
Pelvic organ prolapse (POP) is a condition where the muscles, ligaments, and tissues supporting the pelvic organs (bladder, uterus, vagina, small bowel and rectum) weaken, allowing these organs to drop, or “prolapse,” from their normal position. There are several factors that may contribute to the development of pelvic organ prolapse:
1. Age: It’s most common in postmenopausal women who’ve had one or more vaginal deliveries.
2. Obesity: Overweight women have a higher risk of developing prolapse, possibly due to increased pressure on pelvic organs.
3. Pregnancy and childbirth: These can weaken the muscles and tissues in the pelvis. Vaginal delivery in particular can damage nerve tissues and weaken the supports for the pelvic organs.
4. Hysterectomy: Surgical removal of the uterus can sometimes lead to prolapse of the vaginal vault (the upper part of the vagina), especially if the operation involved cutting some of the supporting ligaments.
5. Genetic factors: Some women may be genetically predisposed to give birth to children with conditions that increase the risk of pelvic organ prolapse, like connective tissue disorders.
6. Chronic pressure in the abdomen: Chronic cough (such as with long-term lung disorders), constipation, strain with bowel movements, and frequently lifting heavy objects can lead to the weakening of pelvic tissues and muscles.
7. Previous pelvic surgery: Having surgery in the pelvic region can damage the supporting structures of the pelvic organs and put you at risk for POP.
8. Menopause: The decrease in estrogen that occurs during menopause can cause the pelvic floor muscles to weaken, making prolapse more likely.
While these are risk factors, having one or more does not guarantee a woman will experience pelvic organ prolapse. However, it’s important to speak with a healthcare provider if experiencing symptoms associated with POP, like a feeling of pressure or discomfort in the pelvic area, urinary or bowel incontinence, or discomfort during sexual activity.
Signs and Symptoms of Pelvic organ prolapse
Pelvic organ prolapse is a condition that occurs when the muscles and tissues supporting the pelvic organs (the uterus, bladder, rectum, and small intestines) become weak or loose. This allows one or more of the pelvic organs to drop or press into or out of the vagina. Here are some of the signs and symptoms of pelvic organ prolapse:
1. A feeling of heaviness or pulling in the pelvic area.
2. A feeling like something is falling out of the vagina.
3. A noticeable bulge or protrusion from the vagina, this may be most noticeable during standing or straining and may reduce discomfort if lying down.
4. Uncomfortable pressure, discomfort, or a ‘full’ sensation in the lower abdomen.
5. Difficulty with urination or bowel movements.
6. Lower back pain.
7. Sexual issues, such as feeling embarrassed or a decreased sexual sensation.
8. Frequent bladder infections.
These symptoms can be more severe after long periods of standing or lifting heavy objects and can improve with lying down. It’s also possible to have pelvic organ prolapse without symptoms. It is recommended to consult a healthcare provider if any of these symptoms are experienced.
Diagnosis Pelvic organ prolapse
Pelvic organ prolapse is a condition that occurs when the muscles and tissues supporting the pelvic organs (the uterus, bladder, rectum or small bowel) become weak or loose. This weakness can cause one or more of the pelvic organs to drop or press into or out of the vagina.
There are different types of this condition including:
1. Cystocele: This happens when the bladder prolapses into the vagina.
2. Rectocele: It occurs when the rectum prolapses into the vagina.
3. Uterine prolapse: This is when the uterus descends into the vagina.
4. Vaginal vault prolapse: This happens when the upper part of the vagina falls into the lower part.
5. Enterocele: It occurs when the small intestine descends into the vagina.
The causes of pelvic organ prolapse can include pregnancy, childbirth, surgery in the pelvic area, heavy lifting, chronic disease, aging, or anything else that puts pressure on the abdomen.
Women with this condition might feel discomfort, pressure, or a pulling sensation with a visible bulge in the vagina, have problems with sexual intercourse, and may also experience lower back pain, constipation, and urinary issues. However, some women experience no discomfort and may not be aware that they have a prolapse.
Treatment often involves lifestyle changes, physical exercises aimed at strengthening the pelvic floor, use of medical devices (like a pessary), and in advanced cases, surgery might be recommended.
Treatment of Pelvic organ prolapse
Pelvic Organ Prolapse is a condition in which one or more of the pelvic organs including the uterus, rectum, bladder, or sometimes even the small bowel, can drop from their normal position and prolapse (descend) into the vagina. This happens when the muscles and tissues supporting the pelvic organs weaken.
Treatment of Pelvic Organ Prolapse might differ based on the severity of the condition, personal health, the specific organ that has prolapsed, and whether the patient plans to have children in the future. Here are some methods of treatment:
1. Lifestyle modifications: Losing weight, treating constipation, or avoiding heavy lifting can ease the symptoms of pelvic organ prolapse.
2. Pelvic floor muscle therapy: Doctors may recommend pelvic floor exercises, Kegels for instance, to strengthen the muscles of the pelvis.
3. Mechanical devices: A common non-surgical treatment for pelvic organ prolapse is a pessary, which is a silicon device inserted into the vagina to support the prolapsed organs.
4. Surgery: In some severe cases, surgical intervention may be recommended. Types of surgery may include vaginal, abdominal, laparoscopic, or robotic-assisted procedure, depending on the specifics of the case.
5. Hormone treatment: Menopausal women may be given estrogen therapy. Decline in estrogen can lead to weakening of pelvic muscles. So, estrogen replacement might prevent worsening of pelvic organ prolapse.
Always remember to talk to your healthcare provider about which treatment strategy might be best for you based on your specific medical history, symptoms, and lifestyle. Keep in mind that the actual treatment may vary from patient to patient depending on their particular circumstances.
Medications commonly used for Pelvic organ prolapse
Pelvic organ prolapse is a condition where the muscles and tissues supporting the pelvic organs (uterus, bladder, or rectum) weaken, causing these organs to drop into the vagina or protrude outside of it. Although surgery is often a preferred treatment in more severe cases, medications can also be used.
1. Estrogen Therapy: Locally applied estrogens strengthen the supportive tissues in the vagina and improve the overall health of vaginal tissues by increasing blood flow. The most common types are creams, rings, or tablets containing estrogen that are inserted into the vagina. However, this treatment is not for everyone, especially for women with estrogen-dependent cancer or a history of blood clots.
2. Osphena (Ospemifene): This medication has properties of estrogen and is FDA-approved to treat painful intercourse due to menopause. It may also be used off-label to treat urinary incontinence and may have some benefits for women with pelvic organ prolapse.
3. Duloxetine (Cymbalta): Duloxetine is an antidepressant that is sometimes used off-label to treat stress urinary incontinence in Europe, but it has not been approved by the FDA for this purpose and is not a first-line therapy in the US. This drug affects the central nervous system and strengthens the muscular urethral closure. However, common side effects include dry mouth, constipation, nausea, and fatigue.
Keep in mind that the medications listed above do not cure pelvic organ prolapse; instead, they aim to help manage symptoms associated with the condition. Always consult your healthcare provider for the best treatment options based on your specific condition and overall health.
Prevention of Pelvic organ prolapse
Pelvic organ prolapse occurs when the muscles and tissues supporting the pelvic organs (uterus, bladder, or rectum) become weak or loose, allowing one or more of these organs to drop or press into or out of the vagina. There are several ways to prevent, or in some cases, manage pelvic organ prolapse:
1. Kegel exercises: Strong pelvic floor muscles can go a long way toward preventing prolapse. Kegel exercises involve contracting and then relaxing the pelvic floor muscles.
2. Regular physical activity: Regular physical exercise can help stave off weight gain and keep your pelvic floor muscles strong.
3. Healthy diet and weight: Excess weight puts additional pressure on your abdomen and pelvis. Maintaining a healthy diet will also avoid constipation, which can contribute to pelvic organ prolapse.
4. Avoiding heavy lifting: Constant or heavy lifting can significantly stress your pelvic muscles.
5. Quit smoking: Smoking is associated with chronic coughing, which can often lead to pelvic organ prolapse.
6. Regular check-ups: Regular gynaecological screenings allow your doctor to identify symptoms early before the condition worsens.
7. Proper treatment for other medical conditions: Certain chronic disorders like bronchitis, asthma, or constipation which can lead to persistent coughing or straining can increase the risk of prolapse. Therefore, appropriate treatment of these conditions can help prevent prolapse.
8. If you have gone through childbirth: Undergoing pelvic floor therapy after childbirth could reduce the risk, as pregnancy and childbirth are the most common causes of pelvic organ prolapse.
Remember, it’s important to catch any potential issues early. If you’re showing signs of pelvic organ prolapse, seek medical advice as soon as possible.
FAQ’s about Pelvic organ prolapse
Pelvic Organ Prolapse (POP) is a medical condition that occurs when the muscles and tissues supporting the pelvic organs (such as the uterus, bladder, and rectum) become weak or loose. This often results in one or more of the pelvic organs dropping (prolapse) from their normal position and pressing into the walls of the vagina. Here are some frequently asked questions about Pelvic Organ Prolapse:
1. What are the symptoms of Pelvic Organ Prolapse?
Symptoms can include a feeling of pressure, heaviness or pulling in your pelina, especially in standing position, a bulging sensation, urinary problems, sexual dysfunctions, lower back pain, constipation, and difficulties with bowel movements.
2. What causes Pelvic Organ Prolapse?
Common causes include pregnancy and childbirth, aging, obesity, and menopause. Any other factors that put increased pressure on the abdomen can also contribute to POP, such as chronic constipation and straining, heavy lifting, chronic coughing, or overweight.
3. How is Pelvic Organ Prolapse diagnosed?
Diagnosis usually includes a pelvic exam where the doctor checks for signs of POP. The doctor might ask you to bear down as if having a bowel movement to check for protrusion of pelvic organs. Furthermore, imaging tests like ultrasound or MRI might be ordered.
4. What are the treatment options for Pelvic Organ Prolapse?
Depending on the severity of the POP, treatments can range from lifestyle changes (like weight loss and pelvic floor exercises), use of a pessary device (a silicon device inserted into the vagina to support the pelvic organs), or surgery.
5. Can Pelvic Organ Prolapse be prevented?
While you cannot completely prevent POP, you can reduce your risks by maintaining a healthy weight, avoiding heavy lifting, practicing pelvic floor exercises like Kegel exercises, and managing chronic conditions that put pressure on your abdomen.
6. Does Pelvic Organ Prolapse affect fertility?
Typically, POP itself does not directly affect fertility. However, the symptoms and treatments of POP might impact sexual function and therefore indirectly affect the ability to conceive.
Remember that this is a general guide, and individual health concerns may vary. Always talk to your healthcare provider for a diagnosis and treatment options.
Useful links
Pelvic organ prolapse (POP) is a health condition that affects a large proportion of women, particularly those who are in their post-menopausal years. It happens when the muscles and tissues supporting the pelvic organs (uterus, bladder, or rectum) become weak or loose. This causes one or more of these pelvic organs to drop or press into the vagina.
Here are some useful academic and clinical resources on pelvic organ prolapse:
Please remember to check the accessibility and subscription requirements for each resource. Your institutional or academic library should be able to assist if you encounter any difficulties.
Complications of Pelvic organ prolapse
Pelvic organ prolapse occurs when the muscles and tissues that support the pelvic organs (like the bladder, rectum, and uterus) weaken or become damaged. This can result in one or more of the organs dropping (prolapsing) from their normal position and pushing against the walls of the vagina.
Complications of pelvic organ prolapse are often related to the type and degree of the prolapse and can include:
1. Incorrect Functioning of Pelvic Organs: The most significant complication is the incorrect functioning of pelvic organs. It can affect the way the bladder or rectum works, causing issues such as incontinence or constipation.
2. Pain and Discomfort: Pelvic organ prolapse can cause a lot of discomfort. It can lead to a feeling of fullness or pressure in the pelvic area along with pain during intercourse.
3. Impact on Sexual Health: It can lead to a significant impact on sexual health, leading to a lack of libido, and psychological distress.
4. Emotional and Psychological Stress: The condition can also cause a significant amount of emotional and psychological stress due to the discomfort and changes in body image associated with prolapse and its symptoms.
5. Issues with Bowel Control: In severe cases of prolapse like rectocele, women might experience problems with bowel control causing constipation or fecal incontinicity.
6. Impact on Physical Activity: The discomfort associated with pelvic organ prolapse can limit physical activities, making exercise or even walking difficult.
7. Urinary Problems: For those with cystocele (prolapse of the bladder), urination problems are common. They may include frequent instances of urinary tract infections, stress incontinence, and others.
Please note that not all women with pelvic organ prolapse experience these complications. The severity of the symptoms can vary greatly from person to person. The management and treatment of pelvic organ prolapse are generally very effective, so it is advisable to consult a healthcare professional for appropriate advice and treatment if you think you might have this condition.
Home remedies of Pelvic organ prolapse
Pelvic Organ Prolapse (POP) is a condition where the structures that support the pelvic organs i.e., uterus, bladder, rectum, small bowel, or the vagina itself weaken. This often results in the pelvic organs slipping out of position, potentially causing discomfort and a variety of urinary and sexual issues. While it’s important to seek professional medical advice for this condition, there are a few home remedies and lifestyle changes you can try to relieve symptoms:
1. Kegel Exercises: These exercises strengthen the pelvic floor muscles and can help restore muscle tone. To perform Kegels, you need to contract and relax your pelvic muscles. Imagine you are trying to stop urination mid-stream, hold for 3-5 seconds, and then relax. Repeat these exercises 10-15 times a day.
2. Maintain a Healthy Weight: Excess weight can put additional pressure on your pelvic organs. It’s recommended to maintain a healthy weight through a balanced diet and regular exercise.
3. High Fiber Diet: Consuming a high fiber diet can prevent constipation, which can exacerbate POP by putting added pressure on the pelvic floor when you strain.
4. Regular Exercise: Along with helping maintain a healthy weight, regular exercise can also help strengthen your core and pelvic muscles.
5. Hydration: Drink plenty of fluids to avoid constipation.
6. Avoid Heavy Lifting: As this will put unnecessary pressure on your pelvic floor muscles, making symptoms worse.
7. Quit Smoking: Long-term coughing from smoking can increase pressure on the pelvic organs.
8. Manage Chronic Cough: If you have a chronic cough not related to smoking, seek treatment; as constant heavy coughing can cause additional stress to your pelvic floor muscles.
9. Practice Good Bathroom Habits: Try not to strain during bowel movement as it puts extra pressure on the pelvic floor muscles.
Remember, while these home remedies can help manage symptoms of POP, you should consult a healthcare professional to discuss treatments suited for your unique circumstance, which could include pessary devices or surgery.
