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Pelvic Organ Prolapse

Find relief from the pressure and pain of pelvic organ prolapse
Treatments can strengthen and support

Pain or pressure in your pelvis or lower back might be a sign of pelvic organ prolapse, which affects one in five women in the United States, according to the Office on Women’s Health.

Because pelvic organ prolapse can lead to urinary or fecal incontinence, many women are embarrassed to talk about their symptoms. However, you don’t need to live with the pain. There are a variety of treatments that can make you more comfortable and confident.

What is a pelvic organ prolapse?

Like a hammock, the pelvic floor is a group of muscles and tissues in the pelvic area that supports your bladder, uterus and cervix, vagina, small bowel and rectum and keep them in the right place.

When these muscles and tissues weaken or become loose, one or more of the organs can droop and descend into or outside the vagina or rectum. The drooping is known as a prolapse.

For women, the most common type of pelvic organ prolapse is cystocele, which is when the bladder protrudes into the vagina.

What are the risk factors for developing pelvic organ prolapse?

There are several reasons why you might develop pelvic organ prolapse, including:

  • Pregnancy and childbirth, especially if you gave birth vaginally versus by cesarean section.
  • Being overweight, which can put pressure on your pelvic floor.
  • Chronic constipation.
  • Jobs or frequent activities that involve heavy lifting.
  • Persistent coughing.
  • Disorders that affect the body’s connective tissue, such as Ehlers-Danlos syndrome (EDS).
  • Aging and menopause. About 37 percent of women with pelvic floor disorders are 60 to 79 years old; about half are 80 and up, reports the Office of Women’s Health.
  • A hysterectomy (the surgical removal of the uterus).
  • Family history. Researchers are studying genetic links.

What are the symptoms of pelvic organ prolapse?

You might feel as though something is protruding into the vagina or slipping out of it. In addition to pressure, you might have some achiness. These sensations might happen more often when you’re physically active or having sex. The might get worse when you stand for a long time or cough, and there might be bleeding and discharge.

If the bladder has dropped, you might leak urine or feel as though you frequently need to urinate. If the rectum has prolapsed, you may experience problems having a bowel movement, constipation or fecal incontinence.

You might have only a few symptoms with a significant prolapse or many symptoms with a small amount of drooping. Alert your health care provider about any pressure or achiness in the pelvic area—no matter how small.

How will my doctor diagnose pelvic organ prolapse?

A detailed pelvic exam will typically uncover the problem. The doctor will ask you to strain or cough. You may need an ultrasound for an image of the organs.

What is the treatment for pelvic organ prolapse?

Pelvic organ prolapse is rarely life-threatening. However, treatments can help if the prolapse is causing you pain or discomfort.

In some cases, Kegel exercises are all you need to strengthen the pelvic floor. To do them correctly, you need to contract and hold specific muscles. Your health care provider or a physical therapist can help you locate them.

Other treatments include:

  • A pessary, a removable device that comes in different shapes and sizes. During an in-office procedure, it’s inserted into the vagina to act as a brace for the prolapsed organ. If it’s the right fit, you shouldn’t feel it. You will need to regularly remove it for cleaning.
  • Surgery. There are many different types of surgery for prolapse. The decision is based on the organ affected, as well as individual factors in your life. You and your surgeon should discuss all of the options and arrive at a shared decision about the best surgery for you. For example, you may decide to use surgical mesh to support the pelvic floor after discussing its risks, or you may choose only to use sutures and allow your own tissue to repair itself.

The physicians at ChristianaCare Center for Urology and Pelvic Surgery are board-certified in obstetrics and gynecology and are the only urogynecologists in Delaware board-certified in female pelvic medicine and reconstructive surgery. Nearly 100 percent of the surgeries are minimally invasive, which results in a faster recovery time.

What can I do to prevent pelvic organ prolapse?

  • Lose weight if needed to reduce the pressure on your pelvic floor.
  • Stop smoking, which can cause chronic coughing.
  • Eat a nutritious diet to avoid constipation.
  • Do Kegel exercises.

Also, discuss any symptoms with your health care provider, no matter how embarrassing. Pelvic organ prolapse is highly treatable, and you don’t need to suffer.

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