Pelvic organ prolapse is part of a group of conditions called pelvic floor disorders, which also includes urinary incontinence and fecal incontinence. In the condition, weakened muscles, ligaments, and support structures around the pelvic organs cause them to drop out of place. It's especially common in women due to childbirth or as they age.
Depending on the type of pelvic organ prolapse and your symptoms, several treatments are available. From non-surgical options to surgery, your OB GYN can help you choose the best pelvic organ prolapse treatment for you.
Types of pelvic organ prolapse
There are a few different types of pelvic organ prolapse based on the pelvic organ that is affected. Doctors may also classify your pelvic organ prolapse by the degree of severity - or how much the organ has dropped.
According to the American College of Obstetricians and Gynecologists, the pelvic organs that may drop and bulge into the vagina include:
- Top of the vagina (vaginal vault prolapse)
- Uterus (uterine prolapse)
- Bladder (cystocele)
- Small intestine (enterocele)
- Rectum (rectocele)
Symptoms and diagnosis
In some cases, you may not know you have pelvic organ prolapse until your OB GYN finds it during a routine pelvic exam. However, the most common symptom is the feeling of a bulge in the vagina.
Pelvic organ prolapse can also cause:
- Feelings of heaviness, pressure, or fullness
- Pain with sex
- Urinary or bowel problems
- Back discomfort
Non-surgical options
Especially if your symptoms aren't bothersome, you may start by trying non-surgical care options first for pelvic organ prolapse. Some treatments include:
- Waiting on treatment: The American Urogynecologic Society says that women who have pelvic organ prolapse that isn't interfering with daily life may choose to watch and wait before starting treatment.
- Diet and lifestyle: Changes like managing fluid intake or increasing fiber can help with urinary or bowel symptoms. Other lifestyle changes such as maintaining a healthy weight or quitting smoking can also help.
- Pelvic floor therapy and exercises: Physical therapy for your pelvic floor is another option. A trained physical therapist can teach you how to strengthen and support your pelvic floor through exercises, such as Kegal exercises.
- Pessary: This medical device is inserted into the vagina to help support the pelvic tissues that have been affected by prolapse. It does not cure the condition, but it does provide some symptom relief.
Surgery for pelvic organ prolapse
When non-surgical options don't help resolve your symptoms, surgery for pelvic organ prolapse is an option. According to the Pelvic Floor Disorders Network, nearly 20% of women will end up needing surgery for either pelvic organ prolapse or urinary incontinence by the time they reach the age of 80.
During reconstructive surgery, a surgeon may use your own tissue or surgical mesh to help lift pelvic organs and return them to their normal place. Some surgeries are performed through the vagina, while others are performed using small incisions in the abdomen. Currently, surgical mesh is only approved by the FDA for abdominal pelvic organ prolapse surgeries.
Women with uterine prolapse who are finished having children or do not wish to get pregnant in the future may opt to have a hysterectomy. Surgery can also be performed to completely close off the vaginal opening. However, this is only an option for women who no longer plan to have vaginal intercourse.
Specialized care for pelvic health
As you navigate your treatment options, it's important to see a physician who specializes in the care of pelvic organ prolapse. OB GYNs who are board-certified in Female Pelvic Medicine and Reconstructive Surgery have expertise in the various non-surgical and surgical options for the condition. They can provide you with guidance and information to help you find the right option to relieve the symptoms of pelvic organ prolapse.