Prelvic Organ Prolapse: Symptoms and Treatment

Pelvic organ prolapse (POP) occurs when the organs in your pelvis—uterus, vagina, bladder, urethra, rectum or bowel—descend into or even out of the vaginal canal.

Symptoms

• Feeling of pelvic fullness or pressure
• Feeling as if a tampon were falling out
• Incontinence
• Discomfort with intercourse
• Pain or bleeding from the vagina (not menstrually related)
• Lower back pain
• Constipation

Treatment Considerations

Treatment for POP depends on the type of prolapse you have.

Nonsurgical Options

• Kegel exercises. These exercises strengthen your pelvic floor, which can help you retain your organs in the pelvic region. Pull in or squeeze your pelvic muscles as if you were trying to stop the flow of urine or keep from passing gas. Count to 10 as you hold the contraction, relax, then repeat. Aim for at least three sets of 10 contractions a day.
• Pessaries. Silicon rings can be painlessly placed in the vagina to support the pelvic organs. While a pessary isn't a cure, it can help reduce your symptoms and delay or even prevent surgery.

Surgical Options

Although hysterectomy is still commonly performed in women with symptomatic POP, there are numerous other surgical procedures available. Which one your doctor recommends depends on your condition and the specific type of prolapse. Surgeries can be performed through an abdominal incision, laparoscopically (through a small incision in your belly) or vaginally.

The goal of surgery is to reposition the prolapsed organs and secure them to the surrounding tissues and ligaments. Sometimes synthetic mesh is used to hold the organs in place, while surgery is designed to strengthen the pelvic floor itself.

Questions to Ask Your Health Care Provider

1. What type of POP do I have? Do I have more than one type?
2. What treatment do you recommend to treat my prolapse?
3. What is the success rate of the treatment you recommend? What are the benefits and potential risks?
4. Can you treat my prolapse, or do I need a referral to a physician who regularly treats patients with my condition?
5. How many patients with prolapse do you see a month?
6. How many procedures do you perform on a monthly basis to treat prolapse?
7. What are my treatment options if I still want to have children?
8. Will treatment affect my sexual function?
9. How soon after treatment can I return to my daily activities?