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Pelvic Organ Prolapse

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Pelvic organ prolapse refers to the organs in your pelvis, such as your uterus, bladder, and rectum, moving down from their position in your lower abdomen, usually into the vagina.

Cause
Normally the uterus, bladder, and rectum are supported by the tissues and muscles of the pelvis (pelvic floor), keeping them in the appropriate position. If these tissues and muscles weaken, the organs in the pelvis will move down or prolapse.
  1. Multiple pregnancies and multiple vaginal births.
  2. Being older.
  3. Chronic cough.
  4. Constipation.
  5. Obesity.
  6. Lifting heavy objects and doing exercises that put pressure on the pelvic floor.
  1. Stage 1: Uterus, bladder, and rectum descend halfway into the vagina.
  2. Stage 2: Uterus, bladder, and rectum descend lower than halfway into the vagina, but not outside of the vagina.
  3. Stage 3: Uterus, bladder, and rectum descend partially out of the vagina.
  4. Stage 4: Uterus, bladder, and rectum descend completely out of the vagina.
  1. Discomfort and pressure in the genital area.
  2. Heaviness in the pelvis.
  3. Pain in the vagina, lower back, and/or lower abdomen.
  4. Vagina discharge, especially in premenopausal women.
  5. Urinary incontinence, slow flow of urine, inability to empty bladder, and/or frequent urination.
  6. Recurrent urinary tract infections.
  7. Tissue extends against the vaginal entrance or out of the vagina, causing pain, burning, or a wound.
  8. Discomfort during sexual intercourse.
  1. Difficulty urinating or unable to empty bladder.
  2. Leakage of urine when sneezing or coughing.
  3. The tissue or mass that extends out of the vagina causes friction and leads to injury.
Medical history and symptoms, physical examination, and internal (vaginal) exam.
  1. Exercise: If the prolapse is mild, pelvic floor exercises is a simple way of strengthening the pelvic floor. It can be done anytime and anywhere. Contract the pelvic floor like you are trying to stop the flow of urine. (Do not do these exercises while you are urinating.) Hold the contract for a count of 10 and slowly release. Repeat 10 times and do 4 sets each day.
  2. A vaginal pessary is made from rubber and shaped like a donut. The doctor will place the pessary in your vagina and push it up to move the pelvic organs back to their original position. This is a temporary solution and must be removed regularly to be cleaned. It must also be removed before sexual intercourse.
  3. Surgery is usually an option in severe cases where the vaginal wall prolapses or the uterus, bladder, and rectum prolapse quite far down. Surgery can be done to repair the problem, removed the uterus, treat urinary incontinence, etc. The doctor will discuss all surgical options with you, including the risks and benefits of each type of surgery, and together you will make a decision most appropriate for you.
  1. Do pelvic floor exercises regularly, especially before and after childbirth.
  2. Avoid becoming constipation as bearing down (pushing) too much can impact the pelvic floor muscles.
  3. Maintain a healthy weight by choosing your food carefully and exercising.
  4. Avoid smoking. If you are a smoker, quit as soon as possible. Smoking can cause chronic cough, which can in turn weaken the pelvic floor.
  5. Avoid carrying heavy objects.
  6. Talk to your doctor about hormone replacement therapy (HRT) if you are menopausal. This can prevent muscle weakness and prolapse of the uterus. However, HRT has certain risks. Please discuss this option thoroughly with your doctor so you understand the risks and benefits of this treatment.
  7. Avoid too many pregnancies and births.

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