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PELVIC ORGAN PROLAPSE

Learn about the symptoms, causes and treatment options for pelvic organ prolapse here at Advanced Urology Institute.

PELVIC ORGAN PROLAPSE

Pelvic Organ Prolapse

There are awkward conditions, and then there is pelvic organ prolapse. It is uncomfortable, upsetting and embarrassing.

With pelvic organ prolapse (POP), there is a bulge at the opening of your vagina, which occurs because one or more of your pelvic organs has slipped or dropped down from their normal position. The organ can be your womb (uterus), bladder, bowel or the top of your vagina.

How does pelvic organ prolapse occur?

Well, usually, the pelvic organs—the uterus, vagina, bladder, and rectum—are propped and held in place by the muscles and tissues of the pelvic floor. But when these muscles weaken, the pelvic organs drop downwards into or out of the vagina.

What are the causes of urinary incontinence?

Urinary incontinence is caused by problems with the nerves and muscles that help the bladder to pass or hold urine.

Also, the pelvic floor muscles that support your urethra, bladder, uterus, and bowels may become damaged or weak after pregnancy, childbirth, or menopause. With weakened muscles, your bladder and urethra are forced to work harder to hold urine.

Unfortunately, the extra pressure or stress on the bladder and urethra can cause urinary leakage or incontinence.

Urinary incontinence may also have other causes. You may experience incontinence due to aging of the bladder muscles, being overweight, nerve damage, or surgery in the reproductive organs, such as a hysterectomy.

Certain medications, caffeine, or infection may cause temporary incontinence as well.

Furthermore, the condition may also be a result of urinary tract infection, multiple sclerosis, stroke, a brain tumor, Parkinson’s disease, spinal injury, or urinary stones.

Major types of urinary incontinence

While urinary incontinence can happen for both men and women, it is twice as common for women.

As a woman, you can have urinary incontinence at any age—though it is more frequent in older women due to hormonal changes during menopause. Plus, since the female urethra is shorter, any damage or weakness to it will likely cause urinary incontinence.

Generally, there are two types of urinary incontinence:

 

  • Stress incontinence
    As the name suggests, stress incontinence occurs when there is stress or pressure put on your bladder. Because your pelvic floor muscles are weakened, any stress or pressure easily triggers the release of urine.

    When you have stress incontinence, everyday actions that use the pelvic floor muscles, such as sneezing, laughing, jumping, lifting heavy objects, or coughing, tend to cause urine leakage. This also includes sudden physical activity and movements.

    Stress incontinence is the most common type of incontinence and the most frequent in younger women. The risk of this condition is increased when you are smoking, overweight, or have gone through childbirth.
  • Urge incontinence
    Also called overactive bladder, urge incontinence occurs when your brain and spinal cord do not work properly with the bladder to allow you to hold urine and release it at the right time. The bladder may suddenly empty itself without warning, or you may feel like you need to pass urine more frequently.

    As a rule, urge incontinence is identified by having to pass urine more than eight times a day—and usually passing only a little urine once you get to the bathroom.

    It is a common condition in older women and tends to affect those with nervous system disorders, such as stroke or multiple sclerosis.

While not a life-threatening or dangerous condition, pelvic organ prolapse is painful and distracting. When the prolapse pulls your bladder downward, it bends the ureter and causes trouble urinating fully. It can also pull your rectum downward and cause constipation.

The symptoms of pelvic organ prolapse include:

  1. An uncomfortable bulge in the vagina
  2. Feeling like something is coming down your vagina—it may feel like sitting on a small ball
  3. A dragging discomfort inside your vagina
  4. Pressure, discomfort, aching or pain in the lower back, pelvis, or both
  5. A feeling of fullness or heaviness around your lower tummy and genitals
  6. Pelvic pressure that gets worse when you cough or stand
  7. Numbness or discomfort during sex
  8. Uncomfortable pressure during sex or physical activity
  9. Constipation
  10. Urinary problems, such as urine leakage or urinary frequency
  11. Problems inserting tampons

Types of pelvic organ prolapse

  1. Cystocele
    This type of pelvic organ prolapse occurs when the bladder protrudes into the vagina and creates a bulge. It is the most frequent form of prolapse.
  2. Uterine prolapse
    When the uterus drops into the vagina, it leads to a bulge at the vaginal opening.
  3. Rectocele
    This happens when the rectum bulges into the back wall of the vagina.
  4. Posterior wall prolapse
    This form of pelvic organ prolapse occurs when the bowel bulges forward into the wall of the vagina resulting in a bulge at the vaginal opening.
  5. Vaginal sag
    This form occurs when the top of the vagina sags down. It is seen in some women after surgery to remove the uterus.

How is pelvic organ prolapse treated?

The type of treatment offered for pelvic organ prolapse depends on the form of prolapse and the severity. As a first line treatment, your female pelvic medicine and reconstructive surgery (FPMRS) physician may recommend pelvic floor therapy. That is, you perform Kegel exercises to squeeze and release the muscles in order to strengthen them and improve support for your pelvic organs.

Alternatively, your urogynecologist may prescribe a pessary, which is a silicone-based device inserted into the vagina to support the prolapsed organs. The pessary is custom-fitted and removable. But if the pessary is uncomfortable or not helping, your FPMRS physician may recommend surgery. For example, you may undergo a hysterectomy if you have uterine prolapse or sacrocolpopexy if you are at high risk of repeated prolapse.

Seek timely treatment

While pelvic organ prolapse is an embarrassing condition to talk about, it is something you really should discuss with a urogynecologist as soon as possible. Letting it go untreated will allow urine to be retained in your bladder, resulting in chronic urinary tract infections.

At Advanced Urology Institute, we encourage women to seek timely treatment for pelvic organ prolapse. Our knowledgeable and experienced urogynecologists encourage frank and open consultations, which ensure proper diagnosis.

And our treatments are tailored to suit the needs of every patient. Which means you can rest assured that you will receive appropriate treatment and recover from your condition. For more information on pelvic floor disorders, female pelvic medicine and reconstructive surgery, visit the Advanced Urology Institute website.

PHYSICIANS WHO SPECIALIZE IN
PELVIC ORGAN PROLAPSE

Pelvic Organ Prolapse
David DiPiazza, MD
Specialties:
  • Board Certified in Urology
  • Board Certified in UroGynecology
  • Robot Surgery Expert
  • Cancer Surgery
  • Pelvic Floor Reconstruction for Vaginal Prolapse
  • Rishi Modh, MD, MBA
    Specialties:
  • Enlarged Prostate
  • Men's Sexual Health
  • Urinary Incontinence
  • Kidney Stones
  • Vasectomy
  • Robotic Surgery
  • Pelvic Floor Reconstruction
  • Urolift/Rezum
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