Understanding Pelvic Organ Prolapse

Evelyn Rodriguez
March 2, 2024

Understanding Pelvic Organ Prolapse

At All-Inclusive Preventative Care in Miami, our team is dedicated to ensuring your health and well-being, especially when it comes to conditions like Pelvic Organ Prolapse (POP). This comprehensive guide is designed to empower you with knowledge about POP, including its symptoms, causes, diagnostic procedures, and the variety of treatment options available. Our goal is to provide you with the insights needed to maintain optimal pelvic health and take preventive steps against this common condition.

What is Pelvic Organ Prolapse?

Pelvic organ prolapse (POP) occurs when the pelvic floor muscles and connective tissues weaken, causing the pelvic organs like the uterus, bladder, rectum, small intestine, and vaginal walls to drop from their normal position. This may lead to uterine prolapse, cystocele, rectocele, enterocele, or vaginal vault prolapse after hysterectomy.

As the pelvic floor and its muscles and ligaments stretch, these pelvic organs can protrude downward into the vaginal canal or even bulge past the vaginal opening in severe prolapse cases. This can cause uncomfortable pelvic organ prolapse symptoms and affect urinary, bowel, and sexual function.

Pelvic floor muscle training like Kegels along with preventive measures can help maintain pelvic floor strength and hopefully avoid progressive organ prolapse that requires treatment like pessaries, estrogen therapy, or reconstructive surgery to repair and relieve symptoms. Proper diagnosis through pelvic exams and treatment options should be discussed with your doctor or pelvic floor physical therapist.

Signs and Symptoms of POP

Many women may experience concerning pelvic organ prolapse symptoms as they age, after pregnancy and vaginal childbirth, or due to weakening of connective tissues and muscles in the pelvic floor. Common pelvic prolapse symptoms include:

  • Feeling heaviness, pressure, or bulge in the pelvic area due to dropped organs like the uterus, bladder, or rectum
  • Seeing or feeling a protruding bulge from the vaginal opening or canal
  • Lower back pain from the pelvic discomfort
  • Pelvic pain during intercourse due to the prolapsed organs
  • Trouble fully emptying the bladder or leaking urine due to urinary incontinence
  • Constipation, straining, or fecal incontinence due to rectocele
  • Recurring bladder infections resulting from the prolapsed bladder

Noticing any persistent pelvic floor disorder symptoms may warrant a pelvic exam and discussion of treatment options with your doctor to help relieve and repair the prolapse. Kegel exercises can also help strengthen pelvic muscles to support organs.

When to See a Doctor

Consult your doctor if you notice any concerning vaginal bulging, pelvic pressure, urine leakage, or difficulty with bowel movements. Timely evaluation and treatment can help manage prolapse progression and discomfort. Seek urgent care if you cannot urinate or if pelvic tissue is protruding past the vaginal opening.

Experiencing symptoms of POP? All-Inclusive Preventative Care is here to help. Connect with us at (305) 200-3141 or request an appointment for expert guidance and support.

How is Pelvic Organ Prolapse Diagnosed?

If a woman experiences concerning symptoms like pelvic pressure, bulging tissue, leaking urine, or difficulty with bowel movements, she should get evaluated for possible pelvic organ prolapse. To diagnose POP, the doctor of female pelvic medicine will start with a detailed medical history looking for risk factors like pregnancy, vaginal childbirth, menopause, chronic cough, constipation, heavy lifting, or family history of pelvic floor disorders.

A thorough pelvic exam is key for assessing pelvic organ prolapse. The woman lies back and the doctor visually examines the vaginal canal and opening to see if any organs like the uterus, bladder, rectum or small intestine are visibly bulging into the vagina. The doctor will also manually check for prolapse by inserting gloved fingers into the vagina and rectum to feel if there is any concerning descent of organs.

If POP is suspected, the doctor may order additional tests to fully evaluate the type and severity of prolapse:

  • Vaginal ultrasound to visualize pelvic anatomy and see which organs are affected
  • Urine flow studies to check for incomplete bladder emptying related to a cystocele
  • Colon transit studies if severe constipation indicates possible rectal prolapse
  • Cystoscopy to view inside the bladder and urethra for prolapse issues
  • Defecography to get images of rectal function during bowel movements
  • X-rays to assess pelvic alignment

For mild cases, observation and pelvic floor physical therapy may be recommended first. More severe prolapse requires treatment like pessaries, surgery, or reconstructive surgeries to repair and reposition the affected pelvic organs. Catching prolapse early allows for more treatment options to relieve symptoms and prevent worsening prolapse.

Causes of Pelvic Floor Dysfunction

Some key factors that can weaken and stretch the pelvic floor over time:

  • Pregnancy, vaginal childbirth, and multiple births
  • Menopause and the associated drop in estrogen
  • Aging - pelvic tissues lose strength over time
  • Chronic coughing, constipation, heavy lifting, or obesity placing pressure on pelvic muscles
  • Conditions like chronic bronchitis or asthma causing frequent coughing
  • Genetics making connective tissue prone to deterioration
  • Pelvic surgery like hysterectomy

How is Pelvic Organ Prolapse Treated?

Treatment for mild pelvic organ prolapse depends if symptoms are minimal. However, more severe cases are treated through:

Pelvic Floor Exercises: Physical therapists can guide you through Kegel exercises, biofeedback training, and other techniques to strengthen weak pelvic floor muscles to support the pelvic organs.

Pessary Devices: These removable plastic or silicone devices fit inside the vagina to help hold pelvic organs in place. They provide support without surgery.

Estrogen Therapy: Local vaginal estrogen helps strengthen vaginal tissues in postmenopausal women. This can be combined with a pessary device.

Prolapse Surgery: Different reconstructive procedures can repair prolapse through the abdominal or vaginal approach. Surgical options may include uterine suspension, sacrospinous ligament fixation, or using mesh implants to support organs.

Your doctor will help determine suitable treatment options based on factors like age, plans for future pregnancy, severity of the posterior vaginal wall prolapse, and impact of symptoms on quality of life.

Risks of Untreated Prolapse

Leaving POP untreated allows gradual worsening of the protruding organs, potentially leading to:

  • Increasing difficulty with urination or bowel movements
  • Pelvic pain and discomfort interfering with daily life
  • Ulceration of the thin vaginal tissue
  • Urinary tract infections
  • Bowel obstruction in cases of severe prolapse

Seeking timely treatment helps prevent complications and worsening prolapse that could eventually protrude past the vaginal opening.

How to Prevent Pelvic Organ Prolapse

You can take proactive measures to maintain pelvic floor strength to reduce your risk factors and avoid any POP symptoms, including:

  • Maintaining a healthy weight to avoid extra pressure on pelvic floor muscles
  • Practicing regular Kegel exercises to strengthen and tone the pelvic floor
  • Avoiding constipation and bearing down during bowel movements
  • Stopping smoking, as coughing can worsen prolapse
  • Avoiding frequent heavy lifting that strains pelvic muscles
  • Getting checked by your gynecologist after pregnancy or menopause
  • Considering physical therapy to optimize pelvic floor function

Prioritizing pelvic floor health is key, whether you want to help prevent pelvic organ prolapse or slow progression after diagnosis. Pelvic organ prolapse is common, but this guide covers the key aspects to understand the causes, symptoms, diagnosis, and different treatment options. Speak with your doctor to determine the most suitable approach for your individual case.

Take Action for your Pelvic Health

If you're experiencing symptoms of POP or have concerns about your pelvic health, don't wait to seek help. Contact All-Inclusive Preventative Care in Miami at (305) 200-3141 or request an appointment online for expert guidance and support. Together, we can work towards restoring your comfort and confidence, ensuring you lead a healthy, fulfilling life.

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