You may have heard someone reference the body’s “pelvic floor.” Don’t feel alone if you’re not quite sure what that means. This group of muscles remains a mystery to many people because they’re out of sight. The pelvic floor is a group of muscles and ligaments in the pelvic region that support the bladder, rectum, and uterus/vagina. (1)
For women, when the muscles holding the pelvic organs in place are stretched or weakened over time (or due to physical changes from childbirth) the structures of the pelvis can descend into the vagina. This shifting of anatomy, known as Pelvic Organ Prolapse (POP), can occur in four primary ways. In some cases, women may experience a combination of multiple varieties.
Types of Pelvic Organ Prolapse
Cystocele (or anterior vaginal wall prolapse) – This is the most common type of POP and occurs when the bladder drops behind the wall of the vagina.
Uterine (or apical) – This type of prolapse involves the uterus (or, after a hysterectomy, the top of the vagina) dropping into or out of the vagina.
Enterocoele – This occurs when the small intestine, or small bowel, creates a bulge into the vagina.
Rectocele (or posterior vaginal wall prolapse) – This happens when the rectum creates a bulge into the vagina. (2)
Symptoms of Pelvic Organ Prolapse
Each woman is different, and the severity and symptoms of each individual’s POP will vary. Some women may experience no noticeable symptoms, and only be made aware of the condition by an exam from their gynecologist or urologist. Other women may experience pressure, urinary issues, difficulty with bowel movements, or a bulge at the opening of or protruding from the vagina. Prolapse does not typically cause pain, even if it is advanced.
There are a variety of treatment options available to women suffering from POP. The best treatment option will depend on the type and severity of prolapse.
Pelvic floor exercises, commonly known as Kegel exercises, can help strengthen the pelvic muscles to prevent prolapse from worsening and help to lessen symptoms.
Another non-surgical option is a removable device known as a pessary that is placed into the vagina to provide stability and support to the structures of the pelvis. The device is initially fit by your doctor and is then removed periodically to prevent irritation of the vagina. Most patients are usually able to manage the pessary at home. However, some women opt to have the pessary removed at the Virginia Urology office.
Some POP cases require surgery as part of treatment. Fortunately, there are several minimally invasive approaches that are used to make the necessary surgical repairs. To further improve outcomes, our physicians are also equipped to perform prolapse repairs using robotic surgery. This approach usually results in less pain, less blood loss and faster recovery times. If you are a candidate for surgery, your doctor will discuss with you what can be expected for your particular case.
Prolapse surgery is performed in a hospital and typically requires an overnight stay. Most patients can resume normal daily activities almost immediately. Once patients are back home, physically strenuous activity is usually avoided for about 6 weeks while they heal. Your urogynecologist will walk you through your unique recovery plan to help you reach your post-treatment goals.
Virginia Urology Can Help
Virginia Urology can provide you with physical therapy, non-surgical, and surgical solutions to Pelvic Organ Prolapse – all in house. Your urogynecologist will work to help you find relief from your symptoms and return to your lifestyle.
Treatment for Pelvic Organ Prolapse is continually improving, with the majority of women benefiting from successful treatment. There is hope, let Virginia Urology Women’s Health team help.