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PELVIC ORGAN PROLAPSE

What is pelvic organ prolapse?

 

Pelvic organ prolapse happens when the muscles and tissues supporting the pelvic organs (the uterus, bladder, or rectum) become weak or loose. This allows one or more of the pelvic organs to drop or press into or out of the vagina. Many women are embarrassed to talk to their doctor about their symptoms or think that their symptoms are normal. But pelvic organ prolapse is treatable.

 

The pelvic muscles and tissues support the pelvic organs like a hammock. The pelvic organs include the bladder, uterus and cervix, vagina, and rectum, which is part of the bowel. A prolapse happens when the pelvis muscles and tissues can no longer support these organs because the muscles and tissues are weak or damaged. This causes one or more pelvic organs to drop or press into or out of the vagina.

Pelvic organ prolapse is a type of pelvic floor disorder. The most common pelvic floor disorders are:

  1.  Urinary incontinence (leaking of urine)
  2. Fecal incontinence (leaking of stool)
  3. Pelvic organ prolapse (weakening of the muscles and tissues supporting the organs in the pelvis)


What are the different types of pelvic organ prolapse?

 

The different types of pelvic organ prolapse depend on the pelvic organ affected. The most common types include:

 

Dropped bladder (called cystocele). This is the most common type of pelvic organ prolapse. This happens when the bladder drops into or out of the vagina.

Rectocele. This happens when the rectum bulges into or out of the vagina.

Dropped uterus (uterine prolapse). This happens when the uterus bulges into or out of the vagina. Uterine prolapse is sometimes associated with small bowel prolapse (called enterocele), where part of the small intestine, or small bowel, bulges into the vagina.

Although it is rare, pelvic organ prolapse can also happen after a hysterectomy. Any part of the vaginal wall may drop, causing a bulge into or out of the vagina.

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Pelvic organ prolapse information graphic
Different levels of pelvic organ prolapse

Treatment of pelvic pain &
pelvic organ prolapse

How is pelvic organ prolapse treated?

Treatment for pelvic organ prolapse depends on the type of prolapse you have, your symptoms, your age, other health problems, and whether you are sexually active. Your treatment may include one or more of the following:

 

Pessary. A pessary is a removable device inserted into the vagina to support the pelvic organs. Pessaries come in many different shapes and sizes. Pessaries are often the first treatment your doctor will try.7 Certain types of pessaries can treat both pelvic organ prolapse and urinary incontinence.

Pelvic floor muscle therapy. Your doctor may show you how to do pelvic floor exercises or refer you to a physical therapist to do exercises to help strengthen the pelvic floor muscles. Pelvic floor muscle exercises can also help women who have pelvic organ prolapse as well as urinary incontinence.

Changing eating habits. If you have bowel problems, your doctor may recommend eating more foods with fiber. Fiber helps prevent constipation and straining during bowel movements. Learn more about ways to treat fecal incontinence.

Surgery to support the uterus or vagina. During surgery, your doctor may use your own body tissue or synthetic mesh to help repair the prolapse and build pelvic floor support. This type of surgery is recommended for sexually active women with serious prolapse of the vagina or uterus. Surgery for prolapse can be done through your vagina or abdomen. Your doctor may use synthetic mesh to repair the prolapse through the abdomen. But, because of safety issues, mesh is no longer used to repair the prolapse through the vagina.

Surgery to close the vagina. This surgery, called colpocleisis, treats prolapse by closing the vaginal opening. This can be a good option for women who do not plan to have or who no longer have vaginal intercourse.

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