Women Should Not Ignore Pelvic Organ Prolapse

Half of the women who have had children will experience a form of pelvic organ prolapse later in life. More than one of every 10 women will have at least one surgery to treat pelvic organ prolapse or urinary incontinence by the age of 80.

What is pelvic organ prolapse?
Pelvic organ prolapse occurs when the pelvic floor becomes weak or damaged and one or more pelvic structures—the uterus, bladder, small bowel, or rectum—drop from their natural positions into, or even outside of, the vaginal canal.

What causes prolapse?
Childbirth is the most common cause of damage to the tissues that support the pelvic organs. Other risk factors include obesity, chronic constipation, lung diseases that result in a chronic cough, prior hysterectomy (removal of the uterus), menopause, and heavy manual labor.

What are the symptoms?
The symptoms include a bulge or pressure in the vagina, a pulling or stretching feeling in the vagina or pelvis, discomfort with sexual intercourse, delayed or slow urine stream, difficulty with bowel movements, and urinary and fecal urgency or incontinence. The symptoms can worsen over time, so the sooner a woman seeks treatment, the sooner a doctor can work on alleviating the symptoms and improving her quality of life.

What’s the best way to treat prolapse?
There are surgical and nonsurgical options. Surgery can be laparoscopic or approached through the vagina for minimal scarring.

Treatment depends on several factors, including the age and overall health of the patient, severity of symptoms, the stage of the prolapse, the patient’s anatomy and prior surgical history, and most importantly, the patient’s preference. The potential loss of childbearing ability plays a role in the treatment of younger women.

Women often have other pelvic floor disorders in addition to prolapse, such as overactive bladder, characterized by urinary frequency, urgency, and urge incontinence; or stress urinary incontinence, which is leakage of urine with coughing, laughing, or exercise. These problems need to be addressed at the same time.

DR. KATIE BALLERT is board-certified in female pelvic medicine and reconstructive surgery and practices at UK HealthCare.