Pelvic organ prolapse (POP) is a condition where one or more of the pelvic organs, such as the bladder, uterus, or rectum, descend into the vaginal wall. This blog will discuss the causes, symptoms and types of pelvic organ prolapse, as well as various treatment options available.
Causes & Risk Factors
Causes of POP is multifactorial and can occur due to a number of reasons, including:
- Pregnancy: The growing uterus and foetus puts increased downward pressure on the pelvic floor muscles, causing them to stretch and become weakened.
- Childbirth: During childbirth, the pelvic floor muscles can be further stretched or sometimes torn, which can contribute to the development of POP. The risk of POP is increased by factors such as prolonged pushing during delivery and the use of forceps of vacuum during delivery.
- Menopause: The hormonal changes that occur during menopause can cause the pelvic floor muscles to become weaker, which can lead to prolapse.
- Obesity: Being overweight can put extra pressure on the pelvic floor muscles and weaken them, leading to prolapse.
- Increased abdominal pressure: Behaviours that cause an increase in intra-abdominal pressure, such as chronic coughing due to conditions such as asthma or COPD, or chronic constipation, may be more likely to develop pelvic organ prolapse.
- Genetics: Some women may be more predisposed to pelvic organ prolapse due to genetic factors.
The symptoms of pelvic organ prolapse can vary depending on the severity and location of the prolapse. Some women may experience no symptoms, while others may experience one or more of the following:
- A feeling of pressure or fullness in the pelvic region
- A sensation of “something coming out” of the vagina
- Pain or discomfort during sex
- Urinary incontinence or urgency
- Difficulty urinating or having a bowel movement
- Lower back pain
- Vaginal bleeding or discharge
- Recurrent urinary tract infections
In some cases, the symptoms of pelvic organ prolapse may be mild and manageable, while in other cases they may be more severe and interfere with daily activities. It’s important to note that the symptoms of pelvic organ prolapse can worsen over time if left untreated, so it’s important to seek help if you are experiencing any of these symptoms.
Types of Pelvic Organ Prolapse
There are different types of pelvic organ prolapse, depending on which organ is affected. These include:
- Cystocele: This occurs when the bladder bulges into the vagina.
- Uterine prolapse: This occurs when the uterus descends into the vagina.
- Rectocele: This occurs when the rectum bulges into the vagina.
- Enterocele: This occurs when the small bowel bulges into the vagina.
- Vaginal vault prolapse: This occurs when the top of the vagina bulges into the vaginal canal.
Treatment for Pelvic Organ Prolapse
The treatment for pelvic organ prolapse depends on the severity of the condition, the woman’s age, overall health, and the presence of any other conditions that may be contributing to the prolapse. Here are a few possible treatments:
- Pelvic floor exercises: Exercises that strengthen the pelvic floor muscles can help to alleviate symptoms of pelvic organ prolapse. These exercises involve contracting and relaxing the pelvic floor muscles. A Women’s Health Physiotherapist can provide guidance on the proper technique, type and frequency for performing these exercises.
- Pessary: A pessary is a device that is inserted into the vagina to provide support to the prolapsed organs. Pessaries come in different shapes and sizes, and can be an effective way to manage POP symptoms in some cases.
- Surgery: In some cases, surgery may be necessary to repair the prolapse. The type of surgery depends on the severity of the prolapse and the woman’s overall health.
- Lifestyle changes: Certain lifestyle changes can help to alleviate symptoms of pelvic organ prolapse. These may include avoiding heavy lifting, maintaining a healthy weight, quitting smoking, and treating chronic constipation or coughing.
- Hormone replacement therapy: In women who have gone through menopause, hormone replacement therapy may be helpful in reducing symptoms of pelvic organ prolapse.
It’s important to note that the appropriate treatment for pelvic organ prolapse will depend on the individual case. Women who are experiencing symptoms of pelvic organ prolapse should consult with their doctor or Women’s Health Physiotherapist for an accurate diagnosis and effective treatment plan.