Understanding Pelvic organ Prolapse
Understanding Pelvic Organ Prolapse:
Pelvic Organ Prolapse (POP) is a challenging condition that can significantly impact a woman's quality of life. The physical discomfort and emotional toll it brings can be immense. It's a condition that's not widely understood, which can lead to feelings of isolation and loneliness for those living with it. So, what exactly is POP and why does it happen?
What is Pelvic Organ Prolapse?
Pelvic organ prolapse occurs when the pelvic organs, including the bladder, uterus, or rectum, descend from their normal position and bulge into the vaginal canal. POP can affect different areas of the vagina, including the front wall (cystocele/anterior wall), back wall (rectocele/posterior wall), uterus (uterine prolapse), or the top of the vagina (vault prolapse), and as such you may hear it described using differing terminology. It is also possible to experience prolapse of more than one organ simultaneously.
This condition occurs when the muscles and connective tissues in the pelvic floor become stretched or too weak. Vaginal prolapse is very common, affecting up to 50% of women, and while pelvic organ prolapse is typically not life-threatening, it can have a significant impact on an individual's quality of life.
Symptoms of pelvic organ prolapse may include:
Pelvic Pressure: Many women with POP describe a sensation of heaviness or pressure in the pelvic area, often likened to the feeling of having a tampon or ball lodged in the vagina. If POP is severe there may be a palpable bulge protruding from the vaginal opening.
Urinary Symptoms: POP can lead to urinary issues such as urinary incontinence (leakage of urine), frequent urination, or difficulty fully emptying the bladder.
Discomfort During Intercourse: Some women experience pain or discomfort during sexual intercourse due to the displacement of pelvic organs.
Bowel Symptoms: POP may also cause problems with bowel movements, particularly difficulty with bowel emptying.
2. What Causes Pelvic Organ Prolapse?
Various factors contribute to pelvic organ prolapse, including pregnancy and childbirth, ageing and menopause, obesity, chronic cough, chronic constipation, and heavy lifting. Additionally, pelvic surgeries such as hysterectomy can increase the risk of prolapse.
The primary cause of POP is weakened pelvic floor muscles and connective tissues, which can no longer adequately support the pelvic organs. Several factors contribute to this weakening:
GENETICS! Most of the time prolapse is dependent on the type of connective tissue you have, and there is very little you can do about this genetic makeup and how tissues respond to the factors below. We often see a family history of prolapse, incontinence and surgeries in sisters, mothers, aunties and grandmothers on the same side of the family- this may give you a clue as to your connective tissue genetics.
Pregnancy and Childbirth: Vaginal childbirth, especially multiple deliveries or traumatic births, can significantly stretch and weaken the pelvic floor muscles. This strain increases the risk of pelvic organ prolapse later in life.
Ageing: As women age, hormonal changes and natural wear and tear on the body can weaken the pelvic floor muscles and tissues, leading to POP.
Obesity: Excess weight can put additional pressure on the pelvic floor, leading to weakened muscles and an increased risk of pelvic organ prolapse.
Chronic Constipation: Straining during bowel movements due to chronic constipation can weaken the pelvic floor muscles over time, contributing to POP.
Heavy Lifting: Activities that involve repetitive heavy lifting or straining can strain the pelvic floor muscles and increase the risk of pelvic organ prolapse.
Understanding these risk factors can help women take preventive measures, such as pelvic floor exercises, maintaining a healthy weight, and practicing proper lifting techniques, to reduce their risk of developing pelvic organ prolapse. Seeking early treatment and support from healthcare providers is essential for managing POP and improving quality of life.
3. Who do you see about pelvic organ prolapse and what will they do?
Diagnosing pelvic organ prolapse typically involves a physical examination by a healthcare provider, this could be a GP, gynaecologist or pelvic floor physiotherapist. Treatment options vary depending on the severity of symptoms and may include pelvic floor exercises, lifestyle modifications, pessaries (devices inserted into the vagina to support the organs), or surgical intervention in more severe cases.
4. Can you fix or cure pelvic organ prolapse?
It's important to note that treatment decisions are ultimately up to the individual, and there are various options available to manage pelvic organ prolapse and improve quality of life. If symptoms are not bothersome or impacting on daily activities you may safely choose to do nothing and simply monitor the prolapse over time.
Living with pelvic organ prolapse can present unique challenges, both physically and emotionally. Seeking support from healthcare providers, joining support groups, and discussing concerns with loved ones can all be beneficial for those navigating this condition. With proper management and support, many women with pelvic organ prolapse can find relief and regain their quality of life.
Anyone who has been diagnosed with prolapse should be given access to this information sheet (link below) by the Australian Commission on safety and quality in healthcare https://www.safetyandquality.gov.au/sites/default/files/migrated/Treatment-Options-POP-Consumer-Info.pdf
