Pelvic Organ Prolapse

Many women face vagi­nal pro­lapse, or pelvic organ pro­lapse (POP), which occurs when one of the pelvic organs stretch­es or expands to pro­trude through the vagi­nal open­ing. Vagi­nal pro­lapse is very com­mon; it affects near­ly one in three women who have had a child. And POP won’t just go away on its own.

What is Vagi­nal (Pelvic Organ) Prolapse?

Pelvic organ pro­lapse is a con­di­tion that occurs when mus­cles and lig­a­ments that sup­port your pelvic organs weak­en. Your pelvic organs include your blad­der, uterus (womb) and rec­tum. A pro­lapse occurs when the lig­a­ments weak­en and cause your pelvic organs to slip from their nat­ur­al position.

Caus­es of Vagi­nal Prolapse

Vagi­nal child­birth, espe­cial­ly mul­ti­ple preg­nan­cies, obe­si­ty, chron­ic con­sti­pa­tion, chron­ic heavy lift­ing or a pri­or hys­terec­to­my are the pri­ma­ry caus­es of vagi­nal pro­lapse. Pro­longed labor and large babies can weak­en pelvic floor mus­cles that sup­port the vagi­na. Women who may not com­plete­ly recov­er from child­bear­ing may devel­op vagi­nal pro­lapse. Menopause can also affect the mus­cle tone of the pelvic region.

Signs & Symp­toms of Vagi­nal Prolapse

Many women do not expe­ri­ence any signs or symp­toms of vagi­nal pro­lapse. Most com­mon symp­toms include:

  • Feel­ing of full­ness or dis­com­fort in their vagina
  • Vis­i­ble vagi­nal bulge or protrusion
  • Feel­ing of​“some­thing falling out of the vagina”
  • Dif­fi­cul­ty uri­nat­ing or defecating

Treat­ments for Vagi­nal Prolapse

As with many med­ical con­di­tions, most physi­cians start with con­ser­v­a­tive approach­es, like pelvic exer­cis­es. If the con­di­tion does not improve, or con­ser­v­a­tive meth­ods fail, there are sur­gi­cal treat­ment options available.

Non-sur­gi­­cal options

  • Pelvic floor exer­cis­es – these exer­cis­es help to strength­en the pelvic floor mus­cles and decrease the symp­toms of pelvic organ pro­lapse. While these may strength­en the pelvic floor, they will not fix any actu­al anatom­ic abnormality.
  • Pes­sary – a plas­tic device insert­ed vagi­nal­ly, like a diaphragm, to help sup­port your pelvic organs. This device can be removed at any time by you or your physician.

Sur­gi­cal options

The goal of surgery would be to recre­ate the nat­ur­al anatom­ic sup­port for the vagi­na and reduce the pro­lapse through the vagina.

  • Vagi­nal approach – A vagi­nal inci­sion is made to repo­si­tion the pelvic organs that have fall­en to the nor­mal loca­tion in the pelvis. A hys­terec­to­my may be per­formed if necessary.
  • Abdom­i­nal approach – Typ­i­cal­ly per­formed as a min­i­mal­ly inva­sive surgery using the da Vin­ci robot­ic sur­gi­cal sys­tem (sim­i­lar to laparo­scop­ic surgery). Small abdom­i­nal inci­sions are made to allow the sur­geon to repo­si­tion the pelvic organs back in the pelvis. A hys­terec­to­my may be per­formed if nec­es­sary. Robot­ic surgery has many advan­tages over tra­di­tion­al sur­gi­cal meth­ods includ­ing less pain, less blood loss, short­er hos­pi­tal stay, short­er recov­ery time and few­er vis­i­ble scars.

For more infor­ma­tion, vis­it this link from the Amer­i­can Urog­y­ne­co­log­ic Society.