Pelvic Organ Prolapse
Pelvic organ prolapse (POP) develops when the muscle and ligaments supporting the organs surrounding the vagina weakens and leading to a bulge in the vagina. The organs involve include the bladder, uterus and bowel/rectum.
Common Symptoms of Pelvic Organ Prolapse may include:
- Sense of fullness in the vaginal area
- Incomplete bladder emptying along with a weak urinary flow
- Recurrent urinary tract infection
- Pain with urination and bowel movement
- Bulge seen coming to or out of the opening of the vagina
- Constipation
- Urinary leakage
- Back pain
Pelvic Organ Prolapse Risks
Pelvic organ prolapse unfortunately is not an uncommon condition. Those risks increase with age and childbearing.
Other risk may include:
- Genetics as many patients have relatives who may have weaken supportive tissues.
- Injury to the pelvic floor during vaginal childbirth, radiation, pelvic trauma/fracture
- Removal of the female reproductive organ (hysterectomy) may lead to loss of pelvic floor support
- Obesity
- Constipation
- Tobacco use
Workup for POP includes a detail history and thorough physical examination focusing on the pelvic region. In addition, cystourethroscopy along with a urodynamic study are often perform as well. Occasionally, renal, bladder, and pelvic imaging is obtained using modalities such as ultrasound, computerized tomography or magnetic resonance imaging.
Pelvic Organ Prolapse Treatment
Depending on the degree of pelvic organ prolapse, surgical intervention vs. observation maybe indicated.
Conservative measure includes pelvic floor strengthening routines, weight loss, correction of constipation.
Another non-surgical method of correction of POP is the use of a pessary. Vaginal pessary comes in all shapes and sizes depending on application. Our, nurse practitioner, is well versed in the fitting of these devices in patients who may chose a minimally invasive option.
Surgical therapy of POP is an option for those individuals who have either failed or are not good candidates for conservative therapy.
Depending on the degree of prolapse and the organ structure involves, a urologist may often work in conjunction with another specialist such as a gynecologist and / or a colorectal specialist to correct the pelvic organ prolapse.
Surgical interventions have evolved from major abdominal procedures to trans-vaginal approaches using either synthetic mesh or commonly known as “lift-kits.” More recently, the transition has return to a trans-abdominal approach by adopting the benefits of the DaVinci robotic surgical system and laparoscopy to perform a procedure called sacrocolpopexy.
