Pelvic Organ Prolapse (POP): Symptoms & Treatment

Overview

Pelvic organ prolapse (POP), a type of pelvic floor disorder, is characterized
by descent of pelvic organs from their normal
positions. It occurs when the muscles and ligaments supporting a woman’s
pelvic organs weaken, which can cause the pelvic organs drop lower in the
pelvis and create a bulge in the vagina or prolapse.

In women, POP usually occurs after childbirth,
menopause or a hysterectomy. In man, it may occur after the prostate gland is
removed.

POP can affect many women. In America, it can affect about 3% women. It is more common in white women, older women and Hispanic women.

Types

According to the position of prolapse, there
are many types of POP.

Anterior vaginal wall prolapse

  • Cystocele (bladder into vagina, the most common condition)
  • Urethrocele (urethra into vagina)
  • Cystourethrocele (both bladder and urethra)

Posterior vaginal
wall prolapse

  • Enterocele (small intestine into vagina)
  • Rectocele (rectum into vagina)

Apical vaginal
prolapse

  • Uterine prolapse (uterus into vagina)
  • Vaginal vault prolapse (roof of vagina) – after hysterectomy

Causes

Common causes of POP may include:

  • Pregnancy and childbirth (the most common causes).
  • Long-term pressure on the abdomen, including pressure from obesity, chronic coughing, or straining during constipation.
  • Giving birth to a baby weighing more than 8.5 pounds.
  • Aging.
  • Hormonal changes during menopause.
  • Pelvic organ cancers.
  • Surgical removal of the uterus (hysterectomy).
  • Family history.

Symptoms

Some women have no
symptoms, others may have some symptoms, including:

  • A feeling of pressure or fullness in the pelvic area.
  • A backache.
  • Painful intercourse.
  • A feeling that something is falling out of the vagina.
  • Urinary problems such as leaking of urine or a chronic urge to
    urinate.
  • Constipation.
  • Spotting or bleeding from the vagina.
  • Pelvic pressure that gets worse with standing or coughing for a long
    time.
  • Problems inserting tampons.

Diagnosis

POP may be found during a routine pelvic
exam, and your doctors may need you have some more test for the diagnosis,
including:

  • A cotton swab test. (Patients may be asked to strain or cough, which
    can indicate the position of the bladder.)
  • A bladder function test.
  • A pelvic-floor strength test.
  • Urinary tract X-ray.
  • CT scan of the pelvis.
  • Ultrasound of the pelvis.
  • MRI scan of the pelvis.

Treatment

Treatment for pelvic organ prolapse usually
depends on the type of prolapse, patients’ symptoms, age, other health
problems, and whether they are sexually active. Depending on different cases,
treatment can be divided into two kinds: nonsurgical treatment (conservative
treatment) and surgical treatment.

Nonsurgical Treatment
(Conservative Treatment)

  • Pessary.
  • Pelvic floor muscle therapy.
  • Changing eating habits.
  • Low-dose estrogen cream

Surgical Treatment

Doctors may perform a laparoscopic colporrhaphy
or cut the abdomen for the surgery. There are two kinds of surgery. Doctors
choose different surgery depending on specific purpose.

  • Surgery to support the uterus or vagina.
  • Surgery to close the vagina.

Home
Remedies

Some tips can relieve the symptoms and
reduce the risk of POP.

  1. Do regular pelvic floor exercises to strengthen your muscles.
  2. Maintain a healthy weight. If you’re overweight, you can lose weight.
  3. Eat a high-fiber diet to avoid constipation.
  4. Avoid lifting heavy objects.
  5. Avoid high-impact exercise, such as trampolining.
  6. Avoid smoking.

Please consult your doctors for your
treatment.

Keywords: pelvic organ prolapse; POP; pelvic
floor disorder.

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