Pelvic organ prolapse: types, symptoms, causes, diagnosis

Pelvic organ prolapse (POP) occurs when a pelvic organ falls out of its normal position due to surrounding muscle weakness or injury. POP usually occurs after pregnancy, childbirth and sometimes menopause. Organs affected may include the uterus, cervixvagina, prostate, bladder, urethraor rectum.

Many cases of POP are not accompanied by noticeable symptoms, but some people experience pressure or bulging in the vaginal area and other similar signs. After a diagnosis, treatment options may involve close observation, vaginal device support, or surgery.

This article discusses the different types of pelvic organ prolapse, outlining the general symptoms, diagnostic process, and treatment options for this condition.

Types of pelvic organ prolapse

The different types of pelvic organ prolapse are classified according to the organ they affect. For example:

• Uterine prolapse: A uterine prolapse involves the uterus descending into the vagina and sometimes protruding from the vagina.
• Prior vaginal wall prolapse (or cystocele): A vaginal wall prolapse occurs when the bladder descends, pushing against the front wall of the vagina.
• Prolapse of the posterior vaginal wall (or rectocele): This occurs when the rectum descends and bulges into the back wall of the vagina.
• Uterine prolapse: A utero-vaginal prolapse involves the fall of several organs, such as the bladder, uterus and rectum, for example.
• Vaginal vault prolapse: A prolapse of the vaginal vault occurs after a hysterectomy (surgery to remove the uterus), in which the top of the vagina falls down and creates a bulge.

Symptoms of pelvic organ prolapse

There may be no noticeable symptoms for many people with pelvic organ prolapse. When symptoms occur, they may include:

• Feel or see a bulge protruding through the vaginal opening
• Feeling of pressure, discomfort, or fullness in the pelvic area
• Leakage of urine or difficulty with a saddles
• Difficulty inserting buffers
• Sexual dysfunction

What causes pelvic organ prolapse?

There are several different causes of pelvic organ prolapse. Two of the most common are pregnancy And childbirthbecause these experiences can put a strain on pelvic floor muscle and connective tissues.

Other causes of POP include:

• Aging
• Hormonal changes during menopause
• Previous pelvic surgery or hysterectomy
• Abdominal pressure or strain from lifting heavy objects, obesity, chronic cough or constipation
• family history

How is pelvic organ prolapse diagnosed?

A medical professional diagnoses pelvic organ prolapse. During an office visit, it usually starts with questions about your symptoms, medical history, and a pelvic exam. This involves the healthcare provider inserting a tool called a speculum inside the vagina so they can better see the pelvic organs and assess for POP.

Additionally, they will look for any POP complications such as urinary incontinence, faecal incontinenceOr bladder obstruction. Sometimes an imaging test known as a computed tomography (CT) scan may be ordered in more severe cases of POPs.

How is pelvic organ prolapse treated?

There are several different treatment options for pelvic organ prolapse, depending on the type, severity, and factors such as age and general health.

The goal of treatment is to relieve symptoms, improve quality of life and sexual function, and prevent a new prolapse from occurring. A healthcare provider may recommend one or a combination of the following options:

• Observation: For mild cases without many symptoms, this involves follow-up visits to make sure the prolapse is not getting worse
• pessary: A removable device is inserted into the vagina to support any prolapsed organs and relieve symptoms
• Surgery: Minimally invasive procedures to support the vagina, uterus, and pelvic floor exist and have been shown to be effective in more severe cases of POPs

Other parts of a treatment plan may include hormone therapyespecially if you have had a hysterectomy or pelvic floor exercises (Kegel exercises) to build muscle control in that part of the body.

Research has found that the more educated patients are about home care and pessary use, the lower the risk of complications.

Prognosis

Pelvic organ prolapse is not life-threatening, but living with this condition can still be embarrassing if you experience symptoms.

Although many people experience no symptoms at first, it is possible to begin to feel a bulge which can be quite uncomfortable. Fortunately, surgery to treat POP is usually successful, with some research showing improvement in symptoms and other problems in follow-up scans.

Separately, it is not uncommon for people with POP to have another pelvic floor disorder, such as urinary incontinence, overactive bladder, or fecal incontinence. Experts recommend being routinely screened for these conditions.

Summary

Pelvic organ prolapse (POP) is a common condition in which one of the pelvic organs falls out of its usual position and creates a bulge near the vaginal opening. Organs affected include the uterus, cervix, prostate, bladder, urethra, and rectum. This is caused by weak or injured pelvic floor muscles and surrounding tissues, which can develop after pregnancy or childbirth. Treatment options include observation, supportive devices, or surgery.