POP, or pelvic organ prolapse, is a health issue where the muscles in your pelvis are weak. Due to that, you can experience sagging of one or multiple pelvic organs, which include the uterus, vagina, small bowel, rectum, and bladder. The pelvic floor consists of muscles that support the abovementioned organs to keep them in place and maintain their proper functioning. 

There are different levels of pelvic organ prolapse, where sometimes, in more severe cases, the organs bulge onto others or even reach the outside of the patient’s body. For many women, this occurs after giving birth or from aging. Whatever the case, when a person suffers from pelvic floor issues, different disorders can develop, such as POP, urinary tract incontinence, or anal incontinence. 

In today’s blog post, we wanted to share more information on this condition, including pelvic prolapse symptoms, risk factors, and treatment options. Clinics such as the Women’s Health Partners offer counseling and different services of gynecological care in Boca Raton and Boynton Beach, FL, so if you have additional questions after reading this article, feel free to reach out to their expert teams. 

POP 101

When an organ prolapses, it descends or drops from its original position. In POP, it means that the organs of the pelvis are moving down, either onto other organs or outside of the vaginal canal. Depending on which organ is affected, we can recognize the following conditions: 

  • Urethrocele occurs when the urethra (carrying the urine) prolapses 
  • Uterine prolapse
  • Cystocele occurs when the bladder prolapses onto the vagina (most common, also called anterior vaginal wall prolapse)
  • Vaginal vault prolapse is where the top of the vagina drops into the vaginal canal 
  • Enterocele is when the small bowel moves downwards
  • Rectocele is when the rectum prolapses (also called posterior vaginal wall prolapse)

Pelvic Prolapse Symptoms and Causes 

Portrait of Beautiful Mature Woman Doctor Holding Digital Tablet and Looking at Camera.

Causes of pelvic prolapse are various, but they are all connected to the increased pressure on the abdominal area, leading to this condition. The causes can be:

  • Obesity
  • Labor 
  • Pregnancy
  • Age (declining estrogen levels)
  • Giving birth 
  • Collagen deficiency 
  • Issues with the respiratory system, such as chronic cough 
  • Constipation 
  • Cancer of the pelvic organs 
  • Previous hysterectomy 
  • Genetics 

Prolapse of the pelvis can affect both men and women, but there is a bigger risk when the patient is female. Up to 11% of women experience this condition, and one-third are over 60 years old. Still, men can also suffer from POP regarding the bladder and the rectum. 

When it comes to pelvic prolapse symptoms, it is interesting to mention that some women do not experience any symptoms at all, but when the symptoms are existent, they can include:

  • Pressure in the pelvic area
  • Pain in the lower back
  • Pain during sexual intercourse 
  • A bulging feeling in the vagina
  • Issues with the urinary tract, such as urine leakage or urges to constantly urinate 
  • Constipation 
  • Loss of control over your bowel movement 
  • Spotting or vaginal bleeding 
  • A feeling of fullness in the vagina 
  • Aching in the pelvis 
  • Pressure when standing too long or coughing 

The symptoms depend on the type of POP you are suffering from. For example, if your bladder drops, you will face issues with urine leakage; if the rectum is the problem, then you will most probably have issues with constipation and pain during intercourse; if you are suffering from uterine prolapse, you might experience backaches and pain during sex, etc. Sharing all the symptoms with your doctor will help them locate the weakest spots of your pelvis and create a proper treatment plan. 

Diagnosis of the Condition 

As soon as you start noticing any of the mentioned symptoms, it is essential to contact your chosen medical professional. The conversation will help them understand what you are experiencing, and the pelvic examination will guide them on how to proceed. 

Sometimes POP is diagnosed during regular gynecological exams women do yearly. Other times, if the doctor suspects that you might be suffering from issues concerning the pelvis, they might order a variety of different tests that can determine which organs have moved, if you are suffering from a severe pelvic prolapse, if there are other conditions affecting your body, etc. 

The most common tests are:

  • X-ray of the urinary tract so that the doctor can get an overview of the kidneys, bladder, etc., and their functioning
  • Function tests for the bladder to check how well your bladder is working
  • Pelvic CT scan to rule out any additional conditions 
  • Cystourethrogram, which shows the condition of your bladder and urethra before and after urination
  • Pelvic ultrasound to get an image of the pelvic organs and their position 
  • Pelvic MRI, which is a 3D image of the organs and the muscles so that the doctors can determine the severity of the situation 

After all the testing and examinations, the doctors will often classify your condition using the POP-Q (Pelvic Organ Prolapse Quantification system), where they determine if your organs have shifted and how much. This is done by dividing the condition into stages, where stage zero means the patient’s organs have not moved at all. On the other hand, stage four means the patient is suffering from severe pelvic prolapse, i.e., a complete prolapse. In this case, the organ is bulging out of the body, and urgent treatment is needed. 

What About Prevention?

As people often say, prevention is better than cure, so here are some prevention tactics that can be used to reduce the potential of suffering from a POP:

  • Kegel exercises for pelvic muscle strength 
  • A balanced diet and regular exercise to maintain a healthy weight 
  • Avoiding being constipated for a more extended period of time
  • Not smoking because it can cause a chronic cough 
  • If you engage in heavy lifting, try to use your legs more than your abs or back 

How Do You Treat POP?

Doctor and Patient at Office

Pelvic floor therapy is different for different people. The treatment plan depends heavily on the type of POP you are suffering from and the severity of your condition. The treatment tactics can be divided into nonsurgical and surgical treatments.

Nonsurgical treatments include the insertion of a vaginal pessary, a device made of silicone used to support the vagina and keep it in place, and Kegel exercises, which are used as pelvic floor therapy to strengthen the pelvic floor muscles. 

When it comes to surgical treatments, there is a wide variety of them; they are offered when other treatments do not give results and you do not want to have children anymore because giving birth after such surgeries can worsen your previous condition. The surgeries can be obliterative and reconstructive and are recommended on a case-to-case basis. 

In obliterative surgeries, the doctors sew the vagina shut so the organs are prevented from falling out. When you choose reconstructive surgery, the doctors try and repair parts of the pelvic floor. Surgeries that are most common are colpocleisis, colporrhaphy, sacrocolpopexy, sacrohysteropexy, uterosacral ligament fixation, etc. 

Contact Us!

Even with this solid overview of the pelvic organ prolapse condition, our team is always at your disposal. If you have any additional concerns, questions, or wishes, contact our clinic and schedule an appointment.