Pelvic organ prolapse (POP) is when the tissues and muscles of the pelvic floor begin to break down, resulting in the pelvic organs dropping out of position (prolapse).
Some patients with POP are suggested to get major surgery, like a complete hysterectomy, and others have found they can treat their condition with specialized physical therapy. Unfortunately, about 10% of female patients with POP don’t receive any form of treatment.
In order to effectively treat POP, health care providers must create a safe space where patients can feel comfortable discussing their symptoms. Luckily over the past few years, patients with POP have been provided with more resources because of the information available online and health care providers receiving more adequate training on how to screen for conditions such as POP.
The weakening of the pelvic floor muscles and/or pelvic connective tissue causes organs to prolapse, this can put pressure on the vaginal area. Prolapses range from mild to severe and are usually caused by pregnancy or childbirth. However, prolapses can occur in patients who have never experienced either of these.
Patients that are more prone to POP include those who:
● Are older
● Have vaginally given birth
● Are severely overweight
● Lift heavy things regularly
● Are Caucasian or Hispanic
● Have a family history of POP
● Have previously had pelvic surgery
● Experience chronic constipation and/or coughing
Different Types of Prolapse
● Cystocele and urethrocele: Cystocele is when the bladder is pushing into the front wall of the vagina. Urethrocele prolapse is when this same protrusion is being caused by the urethra instead of the bladder.
● Rectocele: Rectocele typically makes it difficult for patients to make bowel movements because their rectum is protruding into the rear wall of their vagina.
● Uterine prolapse: This type of prolapse occurs when the uterus descends into the top of the vagina and can range from mild to severe.
● Vaginal vault prolapse: Patients who have undergone a hysterectomy experience vaginal vault prolapse where the top of the vagina descends into the lower part of the vagina.
Mild Symptoms Include
● Leg fatigue
● Lower back pain
● Discomfort or pain during sex
● Constipation or difficulty making bowel movements
● Incontinence (most commonly stress incontinence)
Patients experiencing any of the aforementioned symptoms should schedule an appointment with their gynecologist for a pelvic exam to confirm where or not they have POP.
Patients should try pelvic floor exercises, specialized physical therapy (typically covered by insurance), and/or a vaginal pessary before opting for more serious options like surgery. Unfortunately, in extreme POP cases, surgery can often be the only option.
If you are a POP patient who wants additional resources or if you’re concerned that you might have a gynecological problem that is undiagnosed, please contact Mangrove Women’s Health at (530) 345-0064, Ext 281 to set up an appointment.