Pelvic Organ Prolapse

Pelvic Organ Prolapse is a condition in which one or more organs in the pelvis i.e. bladder, bowel, top of the vagina or uterus drooping from their normal position and bulge into the vagina. It is mainly caused due to the loosening or weakening of the muscles supporting the pelvis.

One-third of all women in the world are said to have Pelvic Organ Prolapse

TYPES OF PELVIC ORGAN PROLAPSE

  • Cystocele (most common): prolapse of the bladder
  • Enterocele: prolapse of the small bowel
  • Rectocele: prolapse of the rectum
  • Urethrocele: prolapse of the urethra
  • Uterine prolapse: prolapse of the uterus
  • Vaginal vault prolapse: prolapse of the vagina

SYMPTOMS

The following symptoms can be observed:

  • Constant pressure in the pelvic region which gets worse while standing or coughing
  • Low backache
  • Constipation
  • Numb or painful intercourse
  • Constant urge to urinate or leakage of urine
  • Bleeding or spotting from the vagina
  • A feeling of ‘something coming out’ of the vagina
  • Difficulty using tampons

CAUSES

Genetic hereditary can be a cause of Pelvic Organ Prolapse if it is in the family history or if the connective tissues are weak in some women. The other causes are given below

  • Childbirth, especially giving birth to a child more than 8.5 pounds
  • Pelvic organ cancer
  • Obesity
  • Chronic respiratory problems
  • Hysterectomy
  • Hormonal imbalances due to menopause
  • Long-term constipation
  • Constant heavy lifting

TREATMENT

Some of the women do not experience any symptoms in this condition. In that case or if the symptoms are very mild she does not need any treatment. However, if the symptoms are severe the followed treatment is recommended:

  • Pessary: Pessary is a removable device that is used by doctors in the initial stage of treatment. It is used to support the pelvic organs. It is effective for pelvic organ prolapse as well as urine incontinence.
  • Food Habits: The doctors also recommend losing weight if the woman is obese or overweight. Incorporating more fibre into the diet can help in preventing constipation and with bowel movements and ultimately avoid strain on the pelvis.
  • Pelvic floor muscle therapy: A physical therapist can treat pelvic organ prolapse as well as urine incontinence with the help of pelvic floor muscle exercises.
  • Surgery to support uterus or vagina: This type of surgery is best for sexually active women. It is done through the vagina or abdomen where the doctor uses the body tissue of the women to decreases the bulge or maintain pelvic floor support.
  • Colpocleisis: This option is taken if the symptoms are severe and can cause further complications. An OBGYN (obstetrician-gynaecologist) or a urogynecologist (reconstructive surgeon) specialise in these surgeries.

Colpocleisis is performed to close the vaginal opening. It is aimed for women who do not have an active sexual life.

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