Pelvic Organ Prolapse

Pelvic organ prolapse takes place when the muscles and ligaments that support the woman’s pelvic organs become weak, the pelvic organs go out of place, creating a prolapse, or a bulge in the vagina.

This usually occurs years after childbirth or after a hysterectomy. It can also happen after menopause. Over time, when left untreated, pelvic organ prolapse can become worse.

While most women affected by pelvic organ prolapse do not experience the symptoms. But the most common, and probably most bothersome is when the uterus or other organs press against the vaginal wall. There are several symptoms of pelvic organ prolapse. These include:

• Pelvic pressure
• Feels as if something is falling out if the vagina
• Stretching in the pelvic area
• Low backache
• Bleeding or spotting
• Painful intercourse
• Bladder problems i.e. incontinence
• Constipation and other bowel movement problems

The cause of pelvic organ prolapse is the damage of tissues supporting the pelvic organs. This result in the organs shifting out of their normal positions and causing them to press against the walls of the vagina.

Most cases of pelvic organ prolapse are a result of vagiunal birth, which can strongly weaken and stretch the pelvic support structures. On the other hand, childbirth thru a C-section does not have that same impact to the pelvic area.

Low levels of estrogen may also be blamed for having a pelvic organ prolapse. During and after menopause, the hormone estrogen significantly drop. Less estrogen means less collagen, a protein known to help the pelvic connective tissues to stay stretchable.

Hysterectomy or the removal of the uterus, can also cause pelvic organ prolapse, as well as obesity, lung disorders and chronic coughing, and conditions that affect the spinal cord, such as multiple sclerosis and muscular dystrophy.

At times, a pelvic organ prolapse can be difficult to diagnose. When the condition does not cause any symptom, it is usually discovered during a routine physical exam. If the doctor suspects a prolapse, he or she will take your medical history, which includes your symptoms, history of pregnancies, and health issues, if there are any.

Several tests can be done to diagnose pelvic organ prolapse. These include:

• Cystoscopy: This test involves looking or examining the inside lining of the urethra and bladder.
• Intravenous pyelogram: It is a type of x-ray exam that shows the size, shape, as well a the position of the bladder, kidneys, ureters, and urethra.
• Computed tomography scan or CT scan: This process creates images of pelvic area structures.
• Urodynamic tests: This test is conducted to monitor how the body stores and releases urine.

Although you may not be able to prevent the damage to your pelvic organs caused by childbearing, you may be able to control the progression of pelvic organ prolapse. Lifestyle changes that may slow the prolapse process include:

• Maintaining a healthy weight
• Not smoking
• Treating constipation
• Avoiding lifting heavy objects
• Avoiding jumping
• Doing Kegel exercises or pelvic strengthening exercises

The following factors put you at a higher risk of getting pelvic organ prolapse:

• Labor and vaginal childbirth
• Obesity
• Smoking
• Constipation
• Constant heavy lifting
• Pelvic surgery
• Nervous system disorders (muscular dystrophy, multiple sclerosis)
• Genetic factors