What is pelvic organ prolapse?
Pelvic prolapse is the gradual moving or "dropping" of a pelvic organ to a lower position in the pelvis. The top of the vagina, the bladder, or the rectum may be the main prolapsed organ. If the uterus has not been removed, it too may prolapse. A careful pelvic exam should reveal which organs have dropped. A woman with prolapsed organs may experience lower back pain, pelvic pressure, loss of bladder or rectal control, or difficulty emptying the bladder or bowels. In severe cases, the vagina or uterine cervix is felt or seen as a bulge outside the body.
What causes pelvic organ prolapse?
Weak supporting pelvic tissues and muscles may allow the pelvic organs to prolapse into the pelvis. Childbirth, chronic cough, and constipation may lead to this pelvic muscle weakness. Prolapse also may occur more commonly within specific families or certain ethnic groups.
What can be done?
The vaginal skin is delicate; merely rubbing against underclothes may cause inflammation or skin breakdown. For this reason, the vagina should be protected from external exposure and possible irritation. Potential methods include:
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Pessary - A supportive device placed in the vagina to elevate it. Placed similarly to a contraceptive diaphragm, the pessary uses the strength of the pelvic bones to support the vagina. Pessaries come in a variety of shapes and sizes and most commonly are made from either silicone or latex. Patients may continuously wear their pessary, but should remove and clean it on a regular schedule. Pessaries may be used as a temporary aid prior to surgery or as a permanent treatment for prolapse.
CLICK HERE for more information about pessaries.
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Surgery - Techniques that use permanent suture to attach the vagina to the pelvic bones rely on the strength of these bones to support the vagina. The surgery may involve a vaginal or abdominal incision, or both. Determining the precise urinary problem prior to surgery ensures selection of the best surgical procedure and optimum postoperative outcome for each patient.
CLICK HERE for more information about frequently asked questions about surgical correction of pelvic organ prolapse.
With either treatment of prolapse, women should avoid strenuous physical activity, especially lifting heavy objects. Increased physical straining adds to the force against these weak pelvic muscles, possibly resulting in worsening prolapse or damage to a surgical repair.
Gynecology and Fertility Clinic
Aston Ambulatory Care Building
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Dallas, Texas 75390-8865
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