Pelvic Organ Prolapse
Pelvic organ prolapse (POP) is a common condition in which there is a weakness in the pelvic muscles and other connective tissues that provide pelvic support. The weakness allows one or more of the pelvic organs — bladder, uterus, rectum, and vagina — to move from their normal positions into the space of the vaginal canal and, in severe cases, outside the vaginal opening. It often results in a vaginal bulge.
Two-thirds of women who have delivered children have anatomical evidence of POP, and 10-20% will need to undergo a corrective surgical procedure. POP is not life-threatening but can be a distressing and disruptive problem that negatively impacts the quality of life.
Despite how common an issue it is, many women are reluctant to seek help because they are too embarrassed to discuss it with anyone or have the misconception that there are no treatment options available. They may also fear that surgery will be the only solution.
What Are the Symptoms of Pelvic Organ Prolapse?
POP can give rise to a variety of symptoms, depending on which organ is involved and the extent of the prolapse. The most common symptoms include:
- Vaginal bulge or lump
- The sensation of insides falling outside the body
- Pressure sensation in the vagina
In addition, sexual complaints are also common because POP often causes vaginal looseness.
The bladder is the organ that is most commonly involved in POP. POP can vary from minimal descent—causing few, if any, symptoms—to major descent, where one or more of the pelvic organs prolapses outside the vagina at all times, causing significant symptoms. The degree of descent varies with position and activity level, increasing with the upright position and exertion and decreasing with lying down and resting.
When the bladder or rectum descends into the vaginal space, there can be an obstruction to the passage of urine or stool. This situation often requires splinting, the act of placing one or more fingers in the vagina to manually push back prolapsed organ and hold it in place. Doing so will straighten the “kink” in order to facilitate the emptying of the bladder or bowels.
How Is Pelvic Organ Prolapse Treated?
Depending on the severity of the prolapse, treatment may be noninvasive and conservative, including pelvic floor muscle training and the use of pessaries (a device inserted into the vagina to provide structural support to the organs).
However, should conservative methods of treatment fail, pelvic reconstruction surgery may be necessary and will vary based on the type of prolapse. New Jersey Urology (NJU) offers urology specialists who are highly trained and skilled in pelvic floor reconstruction techniques.