Pelvic Organ Prolapse

Pelvic organ prolapse is the condition of weak pelvic floor muscles which support the pelvic organs of the bladder, uterus and rectum. Due to ageing, genetics, childbirth, gravity, obesity, chronic cough or frequent constipation.

Pelvic organ prolapse most commonly occurs in women over 55 year of age and in women with more than one natural childbirth. Contributing factors include aging, genetics, childbirth, gravity, obesity, chronic cough and frequent constipation.

Symptoms

A sense of bulging or something drooping into the vagina is the most common symptom of pelvic organ prolapse (POP). Other symptoms may include pressure in the pelvic area, back pain and pain during intercourse. Changes in bowel movements, urine leakage and recurring symptoms of urinary tract infection may also be present.

Diagnosis

A vaginal exam will determine if a pelvic organ is prolapsed or “sliding down” and how severely.  Additional tests may include aCT scan or MRI of the pelvis, ultrasound or cystoscopy – a thin tube with a light to look inside the vagina.

Pelvic Organ Prolapse (POP) Types

  • Cystocele - anterior prolapse or bladder droppage into the vagina
  • Enterocele - central prolapse or intestines pushes into the upper vagma
  • Rectocele - posterior prolapse or rectum falls into vagina
  • Uterine prolapse - The uterus falls into the vagina
  • Vaginal prolapse  (after hysterectomy)  - the top of the vagina has lost the ligament support of the uterus.

Treatment options

  • Kegel Exercises and Biofeedback – Strengthening and stretching the pelvic floor muscles may improve symptoms of leakage and pain. The anatomical defect of a hernia will not be corrected with exercises alone.
  • Pessary A small, removable device is placed in the vagina to support the pelvic organs. They can relieve symptoms but can not cure the weakness in the pelvic floor muscles.
  • Surgery puts the pelvic organs back in their normal place and reinforces the weak pelvic floor muscles.
  • Synthetic mesh  most mesh is made for a type of plastic called polypropylene.   The body may recognize the mesh as a foreign body and encapsulated  it with scar causing pain and tenderness orerode thru the vaginal wall requiring excision.
  • Biologic grafts or Biodesign grafts – cross – linked protein “new-skin” grown in lab culture or animal based advanced tecchnology graft provides a material which is pliable and has fewer complications  in the vaginal area.
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