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.
- 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.
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.