Pelvic Organ Prolapse (POP) is a condition that many women face, especially as they get older. It happens when one or more of the pelvic organs, like the bladder, uterus, or rectum, drop or shift from their usual position. This happens due to weakened muscles and tissues that support these organs. POP can cause uncomfortable symptoms, but the good news is that there are various ways to treat it and improve quality of life.

What is Pelvic Organ Prolapse?

Pelvic Organ Prolapse occurs when the pelvic organs move out of their normal position and press against the vaginal walls. The pelvic organs include:

• Bladder: If the bladder drops into the vagina, it's called a cystocele.
• Uterus: When the uterus slips downward, it's called uterine prolapse.
• Rectum: A rectocele happens when the rectum moves toward the vaginal wall.

In some cases, more than one organ may be affected at once, leading to a multi-compartment prolapse.

What Causes Pelvic Organ Prolapse?

Pelvic Organ Prolapse happens when the pelvic floor muscles and tissues weaken and can no longer hold the pelvic organs in place. There are several causes and risk factors that contribute to this condition:

1. Childbirth: Vaginal deliveries, particularly multiple births or difficult deliveries, stretch and weaken the pelvic floor muscles, increasing the risk of prolapse.
2. Aging: As women age, particularly during and after menopause, estrogen levels drop. Estrogen helps maintain the strength of the pelvic tissues, so a lack of it can cause them to weaken.
3. Genetics: Some women inherit a tendency for weaker connective tissues, making them more prone to prolapse.
4. Obesity: Being overweight can put extra pressure on the pelvic floor, leading to prolapse.
5. Chronic Constipation: Straining to pass stools regularly can weaken the pelvic muscles, leading to prolapse.
6. Heavy Lifting: Repeatedly lifting heavy objects can put a strain on the pelvic floor muscles.
7. Hysterectomy: Removal of the uterus can cause the pelvic muscles to weaken, increasing the risk of prolapse.
8. Genetic Factors: Some women may naturally have weaker connective tissues, which increases the likelihood of developing pelvic organ prolapse.

Symptoms of Pelvic Organ Prolapse

The symptoms of pelvic organ prolapse vary. Some women might experience no symptoms, while others might notice a range of signs that affect their daily lives. The most common symptoms include:

1. Pelvic Pressure or Heaviness: A feeling of pressure or fullness in the pelvic area is common. Some women describe it as a "bulging" sensation in the vagina.
2. Vaginal Bulging: In severe cases, women may feel or see tissue bulging from the vaginal opening.
3. Urinary Problems: Women with pelvic organ prolapse may find it hard to urinate. They may experience frequent urination, urgency, or difficulty starting or stopping urination.
4. Urinary Incontinence: Prolapse may lead to leaking urine, particularly when coughing, sneezing, or laughing.
5. Bowel Issues: If the rectum is prolapsing, constipation or a feeling of incomplete evacuation may occur.
6. Painful Intercourse: Prolapse can cause discomfort or pain during sexual activity due to the displacement of pelvic organs.
7. Lower Back Pain: Prolonged prolapse may lead to lower back pain as the body compensates for weakened pelvic muscles.
8. Vaginal Bleeding or Discharge: In some cases, women with prolapse may notice abnormal vaginal discharge or light bleeding.

How is Pelvic Organ Prolapse Diagnosed?

If you have any of the symptoms mentioned above, it's essential to see a doctor, preferably a gynecologist, for a diagnosis. Here's how the condition is diagnosed:

1. Physical Examination: During a pelvic exam, your doctor will check for any signs of prolapse. You will likely be asked to lie down and then stand up to assess the severity of the condition.
2. Imaging Tests: Your doctor may suggest tests like ultrasound to get a clearer view of the pelvic organs.
3. Bladder Function Tests: If you're experiencing urinary symptoms, your doctor might perform urodynamics to evaluate how your bladder is working.

Treatment Options for Pelvic Organ Prolapse

Treatment for pelvic organ prolapse depends on the severity of the condition and the symptoms you're experiencing. It may range from lifestyle changes and exercises to medical treatments and surgery.

1. Lifestyle Changes

In mild cases, pelvic organ prolapse may not need surgery, and lifestyle changes can help alleviate the symptoms. These changes include:

• Weight Management: Losing excess weight can help reduce pressure on the pelvic organs.
• Dietary Adjustments: A high-fibre diet can prevent constipation and reduce the strain during bowel movements, which helps ease prolapse symptoms.
• Pelvic Floor Exercises (Kegel Exercises): These exercises strengthen the pelvic floor muscles and help provide support for the pelvic organs. A physical therapist can guide you on how to perform these exercises properly.

1. Pessaries

A pessary is a flexible device that is inserted into the vagina to support the pelvic organs. It's a non-surgical option and can be used by women who prefer not to have surgery or are not good candidates for it. There are different types of pessaries, and your doctor will help you choose the right one based on your needs.

1. Physical Therapy

Pelvic floor physical therapy can be very effective in treating pelvic organ prolapse. A specialized physical therapist will guide you through exercises and techniques to strengthen your pelvic muscles, improve tone, and reduce prolapse symptoms.

1. Surgery

For more severe cases of prolapse, or when other treatments don't work, surgery may be recommended. There are several types of surgery to address pelvic organ prolapse:

• Anterior or Posterior Repair: These surgeries aim to repair the vaginal walls where the bladder or rectum has prolapsed.
• Hysterectomy: If the uterus has prolapsed, it may need to be removed.
• Sacro colpopexy: This surgery lifts and secures the pelvic organs to the sacrum (the base of the spine) to provide long-lasting support.

Your doctor will discuss the best surgical options based on your specific condition and overall health.

Preventing Pelvic Organ Prolapse

While you may not be able to prevent every cause of prolapse, you can reduce the risk by taking the following steps:

• Maintain a healthy weight: Excess weight puts extra pressure on the pelvic floor.
• Do regular pelvic floor exercises: Kegel exercises help strengthen the pelvic muscles and provide support to the organs.
• Avoid heavy lifting: Straining during lifting can weaken pelvic muscles.
• Treat constipation: Preventing constipation through diet and hydration can reduce the strain during bowel movements.
• Practice good posture: Proper posture helps reduce pressure on the pelvic floor.

Pelvic Organ Prolapse is a common condition that many women experience, particularly as they age. It can affect a woman's daily life, but the good news is that it's manageable. With the right treatment, including lifestyle changes, physical therapy, or surgery, women can find relief from symptoms and improve their quality of life.

If you're experiencing any of the symptoms of pelvic organ prolapse, don't suffer in silence. Consult with a healthcare provider to discuss your symptoms and explore the treatment options that are right for you. There's no need to wait — take the first step toward better pelvic health today!

Struggling with pelvic organ prolapse? Reach out to us today at Mansha clinics to schedule a consultation and start your journey to better health! We're here to help you reclaim your comfort and well-being.