Pelvic Prolapse

Pelvic prolapse is a disorder of the pelvic floor, affecting about one-third of all women over their lifetime. The "pelvic floor" is a group of muscles across a woman’s pelvic opening. Normally, these muscles hold pelvic organs (bladder, uterus, vagina, small bowel, and rectum) in place. Pelvic floor disorders develop in some women following childbirth. Pelvic organ prolapse and other pelvic floor disorders also become more common as women age.

When pelvic floor disorders develop, one or more of the pelvic organs may cease functioning properly. A few of the conditions associated with pelvic floor disorders include:

• Pelvic organ prolapse
• Urinary incontinence
• Anal incontinence

"Prolapse" refers to a descending or drooping of organs. Pelvic organ prolapse refers to the descending or drooping of any of the pelvic floor organs, including:

• Bladder
• Uterus
• Vagina
• Small bowel
• Rectum

These organs are said to prolapse if they descend into or outside of the vaginal canal or anus.

Pelvic organ prolapse can be caused by anything that puts increased pressure in the abdomen, such as:

• Pregnancy, labor, and childbirth (the most common causes)
• Obesity
• Respiratory problems with a chronic, long-term cough
• Constipation
• Pelvic organ cancers
• Surgical removal of the uterus (hysterectomy)

Some women notice nothing at all with pelvic organ prolapse, but others report these symptoms:

• A feeling of pressure or fullness in the pelvic area
• A backache low in the back
• Painful intercourse
• A feeling that something is falling out of the vagina
• Urinary problems such as leaking of urine or a chronic urge to urinate
• Constipation
• Spotting or bleeding from the vagina

Diagnosis and Treatment

Your doctor may discover pelvic organ prolapse during a routine pelvic exam, such as the one you get when you go for your Pap smear. Your doctor may order a variety of tests:

• Urinary tract X-ray (intravenous pyelography)
• CT scan of the pelvis
• Ultrasound of the pelvis
• MRI scan of the pelvis

Treatment of pelvic organ prolapse depends on the severity of the symptoms. Treatment can include a variety of therapies, including:

• Kegel exercises to strengthen the pelvic floor muscles
• Inserting a small plastic device called a pessary into the vagina, helping provide support for the organs
• Surgery to repair the affected tissue or organ or to remove the organ (such as removal of the uterus by hysterectomy)

To prevent Pelvic Organ Prolapse, try these steps:

• Do Kegel exercises daily for good muscle strength in your pelvic area
• Maintain a healthy weight
• Avoid constipation
• Do not smoke. Smoking can affect tissues, and a chronic cough often seen in smokers increases the risk of problems.

Don’t let Pelvic Organ Prolapse affect your lifestyle. Discuss your treatment options with one of our women’s health specialists, Dr. James (Jim) DeRossitt or Dr. Robert (Bob) Chin at the OB/GYN Clinics of East Arkansas Medical Group.