While many women find it difficult or embarrassing to discuss pelvic organ prolapse and its symptoms, understanding the facts can help.
This common condition affects one in four women in their 40s, one in three by their 60s, and half of all women in their 80s.
What Is the Pelvic Floor?
The pelvic floor is a group of muscles that stretch like a hammock or sling across your pelvic opening. Those muscles hold up the pelvic organs, including the bladder, uterus, vagina, small bowel, and rectum.
What is Pelvic Organ Prolapse?
Pelvic organ prolapse occurs when one or more of your pelvic organs drop from their normal position. Types of pelvic organ prolapse include:
Cystocele - This condition occurs when the tissue around your bladder and vagina becomes weak and stretches, causing your bladder to protrude into your vagina.
Rectocele - Rectoceles occur when weak rectal and vagina tissue allows your rectum (the bottom part of your large intestine) to protrude into the back wall of your vagina.
Enterocele - An enterocele results when your small intestine bulges into your vagina.
Uterine - Uterine prolapses occur when your uterus sags or drops into your vagina.
Who Is At Risk?
There are many causes of pelvic organ prolapse, but these are the most common risk factors:
At least one vaginal birth
Being older when you have your first baby
Giving birth to a large baby
The weakening of the pelvic muscle with age
Being obese, which increases your risk by 40 - 75%
Prior pelvic surgery, such as a hysterectomy
Chronic constipation or straining during bowel movements
Family history of weak connective tissue
Being Hispanic or white
Chronic coughing, such as from smoking
Having a vaginal tear during delivery
Hormonal changes caused by menopause
What Are the Symptoms of Pelvic Organ Prolapse?
The symptoms of this condition vary, but different types of pelvic organ prolapse have common symptoms because they all involve one or more of your pelvic organs bulging into your vagina.
Bladder prolapse can cause:
Urine leakage
Difficulty urinating
Feeling the need to urinate urgently and often
Uterine prolapse can cause:
Urine leakage
A feeling of “fullness” in your pelvis
Lower back pain
Constipation
Discomfort during intercourse
Rectoceles may have no symptoms or may cause:
Vaginal pressure
Rectal fullness
Constipation
Pain during intercourse
A soft bulge of tissue that you can feel in your vagina or protrudes outside your body.
Lastly, an enterocele can cause:
A pulling sensation in your pelvis or lower back pain that lessens when you lie down
A tissue bulge in your vagina
Painful intercourse.
How Does Your Doctor Diagnose Pelvic Organ Prolapse?
A simple pelvic exam is often enough to diagnose pelvic organ prolapse. If your doctor believes more than one of your pelvic organs is out of place, they may order an ultrasound to create images of your pelvis.
A dynamic pelvic MRI scan can confirm a pelvic organ prolapse and determine its severity. These detailed, three-dimensional images help your doctor decide if you need surgery.
A cystoscopy allows your doctor to view the inside of your bladder by inserting an endoscope, a thin tube with a small light and camera at the tip, through your urethra.
A cystourethrogram is an X-ray that takes pictures of your bladder before and during urination.
A pelvic CT scan.
Treatment for Pelvic Organ Prolapse
If your prolapse is mild, it may go away without any treatment. However, it can also worsen over time. The first line of treatment is physical therapy. Your physical therapist might recommend kegel exercises, in which you tighten and then release the muscles in your pelvic floor to strengthen them.
Another treatment option is a pessary, a silicone device inserted into your vagina to help support the prolapsed organs. Lastly, your doctor may recommend surgery if other less invasive options don’t relieve your symptoms. The type of surgery varies according to the location and severity of the prolapse.
When to See a Urologist
If you have any symptoms of pelvic organ prolapse, see your urologist. The compassionate, knowledgeable physicians at Norman Urology Associates can help diagnose pelvic organ prolapse and identify your best treatment options. Let us know how we can help.