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.

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.