Pelvic Organ Prolapse

What is Pelvic Organ Prolapse?

Pelvic organ prolapse is a condition where the pelvic organs drop from their normal position in the pelvic floor and bulge into the vaginal canal. This occurs because the pelvic floor muscles and connective tissues that support these organs become weakened or stretched. The prolapse can involve the bladder (cystocele or anterior prolapse), uterus (uterine prolapse), rectum (rectocele or posterior wall prolapse), or the top of the vagina after a hysterectomy (vaginal vault prolapse). Women with pelvic organ prolapse may experience a feeling of heaviness or pelvic pressure, a visible bulge in the vaginal opening, difficulty urinating or having bowel problems, and discomfort during sexual intercourse. Pelvic pain and urinary incontinence are also common symptoms.

What Causes Pelvic Organ Prolapse?

Pelvic organ prolapse is usually caused by a combination of factors that weaken the pelvic floor muscles and tissues. The most common causes include childbirth, especially vaginal delivery, which can stretch and weaken the pelvic support structures. Aging and menopause also contribute, as the decrease in estrogen levels can cause tissues to become less elastic. Other risk factors include obesity, chronic coughing, heavy lifting, and a history of pelvic surgery. Genetics may also play a role, as some women are naturally predisposed to weaker pelvic tissues.

Available Treatments for Pelvic Organ Prolapse

At New Jersey Urogynecology, we offer a range of treatments to manage and correct pelvic organ prolapse. The treatment plan is customized to meet the specific needs and preferences of each patient, depending on the severity of the prolapse and the symptoms experienced.

1. Pessary Fitting: A pessary is a silicone device inserted into the vagina to support the pelvic organs and hold them in place. A non-surgical option that can be particularly effective for women with mild to moderate prolapse who wish to avoid or delay surgery. Pessaries come in different shapes and sizes, and during your consultation, we will help you find the right fit to ensure comfort and effectiveness.
2. Robotic-Assisted Sacrocolpopexy: This minimally invasive surgical procedure uses robotic technology to correct pelvic organ prolapse by attaching the vaginal vault to the sacrum (the bone at the base of the spine) using a mesh. This procedure is designed to provide long-term support to the vaginal walls and prevent further prolapse. It is an excellent option for women with more severe prolapse, offering reduced recovery time and minimal scarring compared to traditional surgery.
3. Vaginal Vault Suspension: This surgical procedure treats  vaginal vault prolapse, which occurs when the top of the vagina falls after a hysterectomy. The surgery involves lifting the vaginal vault and securing it to strong ligaments in the pelvis. This helps restore normal anatomy and relieve symptoms associated with prolapse.
4. Pelvic Reconstructive Surgery: For complex cases, pelvic reconstructive surgery may be recommended. This surgery involves repairing and reconstructing the pelvic floor to restore the organs to their proper position. Our experienced surgeons at New Jersey Urogynecology use advanced techniques to ensure the best possible outcomes for our patients.

FAQs About Pelvic Organ Prolapse

What happens if a prolapse is left untreated?

If a prolapse is left untreated, the condition can worsen over time, leading to increased discomfort and complications. The affected organs, such as the bladder, uterus, or rectum, may continue to descend, causing pressure, pain, and difficulties with urination or bowel movements. In severe cases, untreated prolapse can result in significant impact on daily life, making it difficult to perform routine activities. Additionally, there may be an increased risk of infection or other complications, such as ulcers on the protruding tissue.

How do you fix a prolapse?

Prolapse can be treated through various methods, depending on the severity of the condition. For mild cases, lifestyle changes such as pelvic floor exercises (Kegels) may help strengthen the muscles supporting the pelvic organs. Pessaries, which are devices inserted into the vagina to support the prolapsed organ, can also provide relief. In more severe cases, surgical intervention may be necessary. Surgery can involve repairing the damaged tissues or, in some instances, removing or repositioning the prolapsed organ. Consulting with a healthcare provider is essential to determine the best treatment option.

How do you know if you have pelvic organ prolapse?

Signs of pelvic organ prolapse include a feeling of pressure or fullness in the pelvic area, noticeable bulging in the vagina, discomfort during sexual intercourse, or difficulties with urination or bowel movements. Some women might also experience lower back pain or feel like something is falling out of their vagina. If you notice any of these symptoms, it is important to consult with a healthcare provider for a proper diagnosis and to discuss potential treatment options.

Is it okay to live with a prolapse?

While some women may choose to live with a mild prolapse without immediate treatment, it’s important to consider the potential long-term effects and risks. Living with a prolapse can lead to ongoing discomfort, difficulty with physical activities, and a reduced quality of life. Over time, the condition may worsen, leading to more severe symptoms and complications. Therefore, it is advisable to seek medical advice to discuss the best course of action, even if the symptoms seem manageable initially.