Pelvic organ prolapse occurs when a weakening of the vaginal muscles and tissues leads to a herniation of the vagina, allowing one or more of the pelvic organs to shift from their normal position. Organs that can be affected include the uterus, bladder, rectum, vaginal walls and small intestine.Pelvic weakening is often caused by injury sustained during pregnancy and vaginal delivery. Pelvic surgery, menopause, aging, chronic constipation with straining, obesity, heavy lifting, smoking and intense repetitive exercises are also associated with weakening of the pelvic muscles and tissues.
Women who suffer from pelvic organ prolapse may experience pelvic fullness and painful sex. Depending on the organ(s) affected, other symptoms can include loss of bowel or bladder control, urinary frequency, stress urinary incontinence, difficulty with bowel movements, and lower back pain.
Some women with pelvic organ prolapse choose to manage the condition with dietary changes, pelvic floor exercises (Kegel) or physical therapy with biofeedback. These options may be effective if symptoms are mild. If you are experiencing more severe symptoms, talk with your OBGYN about other ways to manage or treat pelvic organ prolapse.
One non-surgical treatment option your gynecologist may recommend is a vaginal pessary. This small, plastic device is inserted into the vagina to lift the bladder or apply pressure to the urethra to prevent leakage.
Other non-surgical treatments include bladder control medications such as tricyclic antidepressants to relax smooth bladder muscles, anticholinergics to decrease the urge to urinate, antidiuretics to reduce urine production, antispasmodics to quiet bladder muscle activity.
If conservative treatment methods are unsuccessful at controlling pelvic organ prolapse symptoms, talk with your gynecologist about whether or not pelvic organ prolapse surgery is right for you. Pelvic reconstructive surgery is done to restore pelvic organs to their normal position. Reconstructive surgery may be performed through an incision in the abdomen or laparoscopically.
Many women with pelvic organ prolapse find it difficult to discuss the topic with their OBGYN. Make a list of symptoms to take with you to your next visit to start the conversation and ask about available treatment options.
