What is Pelvic Organ Prolapse?

When a pelvic organ becomes displaced or slips down in the pelvis, it is referred to as a prolapse. You may have heard women refer to their “dropped bladder” or “fallen uterus.”

This problem afflicts over 3 million women in the United States.

What causes pelvic organ prolapse?

Pelvic organ prolapse occurs when muscles and ligaments in the pelvic floor are stretched or become too weak to hold the organs in the correct position in the pelvis. Potential risks include pregnancy and childbirth, aging and menopause, obesity, pelvic tumors, chronic coughing, chronic constipation, heavy lifting, prior pelvic surgeries, some neurological conditions and certain genetic factors.

What are some of the symptoms?

Symptoms of pelvic organ prolapse can include:

• Pressure or discomfort in the vaginal or pelvic area, often made worse with physical activities such as prolonged standing, jogging or bicycling.
• Diminished control in the bladder and/or the bowels.
• Painful intercourse. 

What type of Pelvic Organ Prolapse do I have? 

Cystocele

A cystocele forms when the upper vaginal wall loses its support and sinks downward.

This allows the bladder, which is located above the vagina, to drop. When a cystocele becomes advanced, the bulge may become visible outside the vagina. The visible tissue is the weakened vaginal wall. The symptoms caused by cystoceles can include pressure, slowing of the urinary stream, overactive bladder and an inability to fully empty the bladder.

Rectocele

A rectocele forms when the lower vaginal wall loses its support, allowing the rectum to bulge into the vagina. This creates an extra pouch in the rectal tube. Larger rectoceles can bulge beyond the vaginal opening. Rectoceles may cause difficulty with bowel movements— including the need to strain more forcefully, a feeling of rectal fullness even after a bowel movement, increased fecal soiling and incontinence of stool or gas. Some patients have to push on the back of the vagina to have a bowel movement.

Vaginal Vault Prolapse

Vaginal vault prolapse occurs when the uterine or vaginal support structures holding the upper part of the vagina are weakened. If the uterus has been removed and the upper part of the vagina is dropping down it is usually referred to as vaginal vault prolapse. When the uterus is present this is called uterine prolapse. When the apical prolapse becomes advanced, the bulge may become visible outside of the vaginal opening. The symptoms may include: pressure, pain, bladder infections and difficulty urinating.

Enterocele

An enterocele typically forms when the small intestine bulges through the top of the vagina after a hysterectomy. In some women the intestine may slide between the back of the vagina and the rectum as shown in this picture with  a uterus. The symptoms can be vague, including a bearing down pressure in the pelvis and vagina, and perhaps a lower backache.

Your physician will be able to assess which type of pelvic organ prolapse you may have and review potential treatment options. We invite you to contact us to learn more. Consult with Dr. Balaloski and decide on a treatment plan that’s right for you. Take action to discover more about available treatment options.

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REFERENCES:

1.   Wu JM, Hundley AF, Fulton RG, et al. Forecasting the prevalence of pelvic floor disorders in U.S. women
2.   Pelvic Organ Prolapse. Voices for PFD. www.voicesforpfd.org/pelvic-organ-prolapse
3.   Pelvic Organ Prolapse: Symptoms and Types. Voices for PFD. www.voicesforpfd.org/pelvic-organ- prolapse/symptoms-types