Description

Pelvic organ prolapse is when one or more pelvic organs drop from their position. This causes a lump in the vagina, it is called prolapse.

The muscles and the connective tissue of the pelvic floor muscles tend to hold the pelvic organs in place. Pelvic organs include the vagina, the bladder, uterus, cervix, urethra and the rectum. Pelvic organ prolapse occurs when the muscles and tissues of the pelvic floor muscles weaken. This can be due to pregnancy, childbirth or the menopause.

Pelvic organ prolapse can be treated. Often, the non-surgical treatment helps. Sometimes, surgery may be necessary to put the pelvic organs in place.

Symptoms

Sometimes, the pelvic organ prolapse do not have symptoms. When symptoms do occur, they may include:

  • To see or feel a bulge of tissue at or beyond the opening of the vagina.
  • Pelvic pressure, heaviness, or pain.
  • Back pain.
  • Not be able to maintain a buffer.
  • Urinary changes. These may include increased urination, feeling an urgent need to urinate, not being able to empty your bladder all the way, or have a weak urine stream.
  • Bowel changes, such as not to empty the stool all the way or having to put the fingers into the vagina to support the bulk to be able to pass the stool. This is called the placement of a splint.
  • Sexual problems, such as pain with sex.

The weakness of the pelvic floor often affects more than one area. For example, if one of the organs of the pelvis is a prolapse, you are more likely to have another type of pelvic organ prolapse.

Causes

The cause of pelvic organ prolapse is the weakening of the tissues and muscles that hold the pelvic organs. The most common cause is having a baby vaginally.

Risk factors

Risk factors for pelvic organ prolapse include:

  • Having more than one baby, a vaginal birth, high birth weight deliveries and use of tools.
  • Be greater.
  • Being obese.
  • After you have had pelvic surgery.
  • The voltage produced by a continuous cough, such as chronic obstructive pulmonary disease, constipation, in progress, or lifting heavy objects.
  • Having a family history of prolapse of pelvic organs or connective tissue conditions.

Diagnosis

The diagnosis of pelvic organ prolapse begins with a clinical history and an examination of the organs of the pelvis. This can help your healthcare provider find the type of prolapse you have.

Some tests may also be required. Tests for pelvic organ prolapse may include:

  • Pelvic floor strength test. A health professional to test the strength of the muscles of the pelvic floor and sphincter muscles during a pelvic exam. This test the strength of the muscles and ligaments that support the vaginal walls, uterus, cervix, rectum, urethra, and bladder.
  • The function of the bladder tests. Some tests show that if the bladder leaks when it is held in place during the pelvic exam. Other tests can measure how well the bladder empties.

Imaging, such as mri or ultrasound, can be used by people whose pelvic organ prolapse is complex.

Treatment

The treatment depends on the symptoms and how much they bother you. If the prolapse of the pelvic organs doesn't bother you, your health care professional may suggest any treatment or for the treatment of prolapse without the need for surgery. If the symptoms get worse and affect your quality of life, you may need surgery.

The prolapse may not be the cause of urinary and bowel symptoms, although they can be linked. If the symptoms are not linked to the prolapse, then the treatment for prolapse may not improve.

Drugs

Many people with prolapse who are also in the menopause. Menopause reduces levels of estrogen. Very little estrogen can weaken the vaginal tissue and lead to vaginal dryness. Talk with your health care professional about whether estrogen treatment is right for you. The use of vaginal estrogen may be an option.

Physical therapy

Your health care professional may suggest pelvic floor exercises using biofeedback to strengthen the muscles of the pelvic floor. Biofeedback involves the use of monitoring devices with sensors that are placed in the vagina and the rectum or in the skin. How to do an exercise, a computer screen displays if you are using the right muscles. It also shows the strength of each grip, it is called a contraction. This helps them to learn how to do the exercises properly. Over time, making the muscles of your pelvic floor stronger could help to relieve the symptoms.

Pessaries

The use of a pessary is a non-surgical to support pelvic organ prolapse. These silicone devices come in many shapes and sizes. They are placed in the vagina to support the pelvic organs in place.

Some people who use pessaries can learn to do them in the evening, clean up and replace it in the morning. Others may need to visit your health care professional every three months to replace the pessary.

Surgery

If the prolapse of the pelvic organs bothers you, surgery may help. The goals of surgery are to get rid of vaginal bulge and improve some of the symptoms.

Most often, surgery may correct the prolapse and its goal is to put the pelvic organs in place. This is called reconstructive surgery. The approach of the surgery depends on where the prolapse is and if there is more than one area of prolapse.

  • Anterior prolapse.The most common site of prolapse is the front, also called anterior vaginal wall. An anterior prolapse of the majority of the times it involves the bladder. This type of prolapse is called a cystocele. Anterior prolapse repair is performed through a cut, called an incision, in the wall of the vagina. A surgeon pushes the bladder and protects the connective tissue between the bladder and the vagina to hold the bladder in place. This is called a colporrhaphy. The surgeon also removes the excess tissue. If you have urinary incontinence, the surgeon may suggest a bladder neck suspension or sling to support the urethra.
  • Posterior prolapse.This type of prolapse is in the back, also called the posterior vaginal wall. A prolapse involves the rectum. This type of prolapse is called a rectocele. A surgeon ensures the connective tissue between the vagina and the rectum to make the package smaller. The surgeon also removes the excess tissue.
  • The uterine prolapse. If you do not plan to have children, the surgeon may suggest surgery to remove the uterus. This is called a hysterectomy.
  • Prolapse of the Vaginal vault.In people who have had a hysterectomy, the upper part of the vagina can lose its support and release. This type of prolapse may involve the bladder and the rectum. The small intestine is often involved. When this is the case, the lump is called an enterocele. The surgeon may perform the surgery through the vagina or abdomen. In a vaginal approach, the surgeon uses the ligaments that hold the uterus in order to correct the problem. An abdominal can be performed laparoscopically, a robot, or as an open procedure. The surgeon attaches the vagina to the tailbone. Small pieces of mesh could be used to help support the vaginal tissues. If you are concerned about the use of mesh materials, talk with your surgeon about the benefits and possible risks.

Anterior prolapse. The most common site of prolapse is the front, also called anterior vaginal wall. An anterior prolapse of the majority of the times it involves the bladder. This type of prolapse is called a cystocele.

Anterior prolapse repair is performed through a cut, called an incision, in the wall of the vagina. A surgeon pushes the bladder and protects the connective tissue between the bladder and the vagina to hold the bladder in place. This is called a colporrhaphy.

The surgeon also removes the excess tissue. If you have urinary incontinence, the surgeon may suggest a bladder neck suspension or sling to support the urethra.

Posterior prolapse. This type of prolapse is in the back, also called the posterior vaginal wall. A prolapse involves the rectum. This type of prolapse is called a rectocele.

A surgeon ensures the connective tissue between the vagina and the rectum to make the package smaller. The surgeon also removes the excess tissue.

Prolapse of the Vaginal vault. In people who have had a hysterectomy, the upper part of the vagina can lose its support and release. This type of prolapse may involve the bladder and the rectum. The small intestine is often involved. When this is the case, the lump is called an enterocele.

The surgeon may perform the surgery through the vagina or abdomen. In a vaginal approach, the surgeon uses the ligaments that hold the uterus in order to correct the problem.

An abdominal can be performed laparoscopically, a robot, or as an open procedure. The surgeon attaches the vagina to the tailbone. Small pieces of mesh could be used to help support the vaginal tissues.

If you are concerned about the use of mesh materials, talk with your surgeon about the benefits and possible risks.

Prolapse surgery only repairs the tissue of the bulge. If the package does not bother you, the surgery is not necessary. The surgery does not repair the weakening of the tissues. So that the prolapse can go back to.

Lifestyle and home remedies

Pelvic organ prolapse is the result of the weakening of the pelvic floor tissues which make a bundle. There are things you can do to help stop the weakness in these tissues. These steps can help keep your condition from getting worse. It can also help to keep the symptoms from coming back after a surgical repair. Try the following:

  • Stop smoking.
  • The treatment of the conditions that could put pressure on the pelvic floor, as a long-term cough or constipation.
  • To lose weight.
  • Strengthen your core and your pelvic floor.
  • Do not lift heavy objects.
  • Do not strain during bowel movements.

Preparing for your appointment

For prolapse of the uterus, you may see a specialist in conditions that affect the female reproductive system. This type of doctor is called a gynecologist. Or you can see a specialist in pelvic floor problems and reconstructive surgery. This type of doctor is called a urogynecologist.

Here's some information to help you prepare for your appointment.

What you can do

When you make the appointment, ask if there is something that you need to do before the appointment, as I do not drink or eat before you undergo certain tests. This is called fasting.

Make a list of:

  • Your symptoms , including any that seem unrelated to the reason of his appointment, and when they began.
  • Key personal information , including major stresses, recent life changes and family medical history.
  • All medications, vitamins or supplements that you take, including over-dose.
  • Questions to ask your health care team.

Have a friend or family member, if possible, to help you remember the information they give you.

For the prolapse of pelvic organs, some basic questions to ask your health care professional include:

  • What is likely causing my symptoms?
  • What are other possible causes of the symptoms?
  • What tests do I need?
  • Is my condition likely to disappear or to be of long duration?
  • What are my treatment options?
  • I have other health conditions. How can I best manage them together?
  • There are restrictions that must be followed?
  • You should see a specialist?
  • Are there brochures or other printed material I can have? What websites that you think might be useful?

Be sure to ask all the questions that you have.

What to expect from your doctor

Your healthcare provider is likely to ask you questions, such as:

  • Do your symptoms come and go or do you have all the time?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Symptoms and treatment of Pelvic organ prolapse