Anatomy
In order to understand what pelvic organ prolapse is, we must first understand female pelvic anatomy. At the front (anterior) of the pelvis, there is the bladder and urethra, in the middle there is the vagina, and in the back (posterior) there is the rectum. The vagina has two main walls, the anterior wall and the posterior wall. What supports these structures is a muscular sling known as the pelvic floor.
Causes
When the pelvic floor and ligaments supporting the pelvic organs weaken, the pelvic organs can descend causing a bulge, or prolapse, of one or more walls of the vagina. This can be caused by any condition that increases pressure on the pelvic floor such as pregnancy and vaginal delivery, chronic cough, chronic constipation, obesity, or repetitive heavy lifting. Prolapse can also occur after hysterectomy or pelvic surgery.
Symptoms
A person with pelvic organ prolapse may experience incontinence, difficulty having a bowel movement, pain or numbness during intercourse, and/or the sensation of heaviness around their vaginal opening.
Management
Many conservative treatments can be used to manage the symptoms of pelvic organ prolapse, such as:
- Breathing correctly to manage pressure placed on the pelvic floor
- Performing pelvic floor exercises to improve the strength of slow and fast twitch muscles of the pelvic floor
- Improving body mechanics while lifting heavy objects
- Treating constipation by increasing fiber/water intake, correcting toileting body mechanics, and using breath to decrease straining during bowel movements
- Strengthening core and hip muscles to support the pelvic girdle
- Using a pessary, a device inserted into the vagina to support the vaginal walls
Hormone therapy and surgery are also options used to treat pelvic organ prolapse if conservative measures do not improve symptoms. If you suspect you may have prolapse, you should consult with your primary care doctor, gynecologist, or pelvic floor physical therapist for treatment.
