Pelvic Organ Prolapse Specialist

What is pelvic organ prolapse?

Pelvic organ prolapse is a condition that occurs when a pelvic organ descends (prolapses) from its normal position and begins pressing against the vaginal wall, eventually invading the vaginal canal. There are five primary types of pelvic organ prolapse:

• uterovaginal prolapse occurs when the uterus prolapses into the vaginal canal
• cystocele, which occurs when the bladder prolapses
• enterocele caused by the descent of the small intestine
• rectocele, which occurs when the rectum prolapses
• vaginal vault prolapse, occurring when the upper portion of the vagina drops down into the lower portion of the vaginal canal

Sometimes, prolapse can be so severe, the end of the vagina may be forced out of its normal space and protrude beyond the vaginal opening, causing considerable pain and discomfort.

What causes pelvic organ prolapse?

Normally, the pelvic organs are held up and supported by a network of strong muscles and connective tissues called the pelvic floor. But sometimes, this network can become damaged or compromised so that it’s no longer able to support the organs. The most common causes of damage or injury to the pelvic floor include pregnancy and childbirth, obesity and hormonal changes, most notably those associated with menopause. Other contributing factors include chronic constipation, smoking, long-term use of steroids, older age, and prior hysterectomy.

You may be more at risk of prolapse if you’ve had one or more pregnancies with vaginal delivery, or if you delivered a large baby for your body size. A family history of connective tissue disorders may increase your risk, and women of Hispanic or Caucasian origin suffer disproportionately from pelvic prolapse.

You may reduce your risk of pelvic prolapse through several self-treatment activities. Kegel exercises, recommended after vaginal childbirth, are key to strengthening your pelvic muscles against later collapse. Seek prompt treatment for conditions such as bronchitis to prevent strain originating from prolonged coughing. Adjusting your diet can both help you reduce weight and avoid constipation, both of which can contribute to pelvic floor prolapse.

What kinds of symptoms does pelvic organ prolapse cause?

Symptoms can vary based on the type of prolapse, the extent of the prolapse, the patient’s health and other factors. Some of the most common symptoms include:

• urinary incontinence
• feelings of discomfort or pressure in the vagina
• problems emptying the bladder completely or slow urine stream
• chronic bladder infections
• pain during intercourse
• constipation and problems moving the bowels
• presence or sensation of a bulge in the vaginal canal or protrusion of the vagina
• lower back pain

Contact Dr. Bozdogan if you’re experiencing any of these symptoms and they are negatively impacting your life. It’s possible to have mild prolapse that doesn’t need treatment. However, it may be possible to interrupt the prolapse process, so have any suspicious signs or symptoms checked early, to prevent later complications.

How is pelvic organ prolapse treated?

Pelvic organ prolapse can be successfully treated with surgery, including both minimally-invasive laparoscopic surgery and robot-assisted surgery using the da Vinci surgical robot. During surgery, the organs are restored to their normal positions and the pelvic floor network is repaired or strengthened with a special mesh. Most pelvic organ surgery can be completed with very small incisions for faster healing.