Pelvic organ prolapse occurs when a pelvic organ—such as your bladder—drops (prolapses) from its normal place in your lower belly and pushes against the walls of your vagina. This can happen when the muscles that hold your pelvic organs in place get weak or stretched from childbirth or surgery.
Many women will have some pelvic organ prolapse. It can be uncomfortable or painful. But it isn’t usually a significant health problem. It doesn’t always get worse. And in some women, it can get better with time.
More than one pelvic organ can prolapse at the same time. Organs that can be involved when you have pelvic prolapse include the:
• Bladder. This is the most common kind of pelvic organ prolapse.
• Small bowel.
Pelvic organ prolapse is most often linked to strain during childbirth. Usually, your pelvic organs are kept in place by the muscles and tissues in your lower belly. During delivery, these muscles can get weak or stretched. If they don’t recover, they can’t support your pelvic organs.
Pelvic organ prolapse can be made worse by anything that puts pressure on your belly, such as:
• Being very overweight (obesity).
• A long-lasting cough.
• Frequent constipation.
• Pelvic organ tumors.
Older women are more likely to have pelvic organ prolapse. It also tends to run in families.
Symptoms of pelvic organ prolapse include:
• Feeling pressure from pelvic organs pressing against the vaginal wall. This is the most common symptom.
• Feeling full in your lower belly.
• Feeling as if something is falling out of your vagina.
• Feeling a pull or stretch in your groin area or pain in your lower back.
• Releasing urine without meaning to (incontinence), or needing to urinate a lot.
• Having pain in your vagina during sex.
Having problems with your bowels, such as constipation.
Your doctor will ask questions about your symptoms and any pregnancies or health problems. Your doctor will also do a physical exam, which will include a pelvic exam.
Decisions about your treatment will be based on which pelvic organs have prolapsed and how bad your symptoms are.
If your symptoms are mild, you may be able to do things at home to help yourself feel better. You can relieve many of your symptoms by adopting new, healthy habits. Try special exercises (called Kegels) that make your pelvic muscles stronger. Reach and stay at a healthy weight. Avoid lifting heavy things that put stress on your pelvic muscles.
If you still have symptoms, your doctor may have you fitted with a pessary device to help with the pain and pressure of pelvic organ prolapse. It is a removable device that you put in your vagina. It helps hold the pelvic organs in place. But if you have a severe prolapse, you may have trouble keeping a pessary in place.
Surgery is another treatment option for severe symptoms of pelvic organ prolapse. But you may want to delay having surgery if you plan to have children. The strain of childbirth could cause your prolapse to come back.
You may want to consider surgery if:
• You have a lot of pain because of the prolapsed organ.
• You have a problem with your bladder and bowels.
• The prolapse makes it hard for you to enjoy sex.
Types of surgery for pelvic organ prolapse include:
• Surgery to repair the tissue that supports a prolapsed organ.
• Surgery to repair the tissue around your vagina.
• Surgery to close the opening of your vagina.
• Surgery to remove the uterus (hysterectomy).
Pelvic organ prolapse can come back after surgery. Doing Kegel exercises to make your pelvic muscles stronger will help you recover faster from surgery. The two together can help you more than surgery alone.
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