Your chances of experiencing pelvic organ prolapse increase greatly as you age. Pelvic organ prolapse is especially common in women who have given birth.
Pelvic organ prolapse (POP) occurs when organs of the lower abdomen descend, putting pressure on the vaginal walls and causing vaginal bulging. Prolapse is typically due to pelvic floor muscle weakness or damage following surgery or childbirth.
Your bladder is one of the organs supported by the pelvic floor, and shifting or tilting can cause incontinence, pain and tissue damage. If your pelvic organ prolapse is affecting your bladder, you may require bladder surgery to repair or move it.
Signs & Symptoms
The following signs and symptoms, especially following pregnancy, childbirth, surgery, or chronic constipation, may indicate a pelvic organ prolapse. Women experiencing these symptoms should schedule an examination with their gynecologist as soon as possible.
- A heavy feeling or feeling of pressure in the vagina
- A feeling as if there is something falling out of the vagina
- Pressure or fullness in the lower abdominal area
- Urinary frequency or incontinence
- Constipation
- Pain during sexual intercourse
Your risks for pelvic organ prolapse are greatly increased by smoking, obesity, and genetic predisposition. POP is a hereditary disorder, so be sure to inform your doctor if any other women in your family have suffered from pelvic organ prolapse.
Diagnosis
Your gynecologist may order an array of tests to determine the stage of your prolapse and its effects on your bladder and other organs. Cystoscopy, pelvic ultrasound, urodynamic (urine) testing, and computed topography (CT) scans are all common tests to diagnose POP.
Your gynecologist will also perform an internal exam to assess the placement and severity of your vaginal bulge. If you have not experienced other symptoms, but you feel a bulge or extra tightness in your vagina, schedule an appointment with your gynecologist immediately.
Treatment
Women, who experience a minor pelvic organ prolapse caused by weakening muscles or a tilted bladder or uterus, can often reduce their symptoms with Kegel exercises or use of a pessary. A pessary is a firm ring inserted into the vagina to provide support to descending organs. You will need to remove and clean the pessary periodically.
If your pelvic organ prolapse is causing significant pain, discomfort, or interference with your daily life or sexual intercourse, you may have to undergo corrective surgery. Bladder surgery will only be needed if you have experienced damage to your bladder as a result of your pelvic organ prolapse.
There are three corrective surgeries for POP:
- Reconstructive surgery – The pelvic tissues supporting your prolapsed organs are repaired and reconstructed to prevent further falling or damage during this surgery. The most common surgical procedure for bladder prolapse is reconstructive.It is also the least invasive surgical option. Some reconstructive surgeries can be done through the vagina while others require laparoscopic incisions, and some require a full abdominal incision.
- Hysterectomy – A hysterectomy removes the uterus when the uterus is the organ that has prolapsed or has caused the prolapse of other organs. If your bladder prolapse is caused by pressure from a tilted or descending uterus, a hysterectomy may resolve your symptoms.
- Obliterative surgery – During this surgery your vagina is narrowed or closed completely to prevent pelvic organ prolapse. Because sexual intercourse is impossible following obliterative surgery, it is used very sparingly, most often in patients who are no longer sexually active. This surgery may be used if the damage to your pelvic tissue is too great to be repaired.
Pelvic organ prolapse surgery should take care of your prolapsed bladder symptoms. If your bladder was damaged by pressure or prolonged prolapse, you might need a separate bladder surgery to prevent further damage.
Recovery
Following pelvic organ prolapse surgery, you may feel fatigued and groggy for one to two days as a result of the anesthesia. You may experience some pelvic or abdominal soreness following surgery. It is not uncommon to require the use of a catheter for a short time following POP surgery.
You can expect to spend one to five days in the hospital following your prolapse repair surgery. Patients should abstain from sexual intercourse for six full weeks and strenuous physical activity for at least three months. This prevents further damage to your weakened tissues.
For information about pelvic organ prolapse or bladder surgery in Arkansas, contact The Women’s Clinic, at 501-664-4131 and schedule an appointment with one of our experienced gynecologists.
*photo courtesy of Renjith Krishnan through freedigitalphotos.net
