Pelvic Organ Prolapse

What is the pelvic organ?

The pelvic organs are a group of organs that form the lower part of the abdomen and pelvis. These organs include the bladder, uterus, ovaries, fallopian tubes, cervix, vagina, and rectum. They play important roles in reproduction, urination, bowel movements, and sexual function.

These organs are supported by a network of muscles and ligaments that help maintain their position and function. The pelvic floor muscles, in particular, have an important role in supporting the pelvic organs and controlling their functions.

What is Pelvic Organ Prolapse?

Pelvic organ prolapse (POP) occurs when the pelvic organs, such as the bladder, uterus, or rectum, descend from their normal position and bulge into the vagina. This can happen due to weakened or damaged pelvic floor muscles and ligaments that support these organs. There are three types of prolapse.

Bladder Prolapse

Bladder prolapse, also known as cystocele, occurs when the bladder bulges into the front wall of the vagina. This happens when the muscles and tissues that support the bladder become weak or stretched, often due to childbirth or ageing.

Symptoms of bladder prolapse include difficulty in emptying the bladder fully, frequent urination, and a feeling of pressure or fullness in the pelvic region.

Rectocele (Rectal Prolapse)

Rectal prolapse occurs when the rectum protrudes through the back wall of the vagina. It is caused by weakening of the muscles and tissues that hold the rectum in place, often due to chronic constipation, straining during bowel movements, or pelvic and abdominal surgeries.

Symptoms of rectal prolapse include difficulty passing stool, pain and discomfort in the anus or lower back, and a feeling of bulging from the anus,

Vaginal Vault Prolapse

Vaginal vault prolapse is a type of POP that occurs when the top of the vagina drops down into the vaginal canal. This is often seen in women who have had a hysterectomy, where the uterus is removed, leaving the top of the vagina unsupported.

Symptoms of vaginal vault prolapse include pelvic pressure, discomfort during intercourse, and difficulty inserting tampons.

It is essential to note that some women may not experience any symptoms, especially in the early stages of pelvic organ prolapse. This highlights the importance of regular check-ups and discussions with a healthcare provider.

Causes of Pelvic Organ Prolapse

Pelvic organ prolapse occurs when the muscles and tissues that support the pelvic organs become weak or damaged. This can be caused by a variety of factors, including:

Pregnancy and childbirth: The strain of carrying a baby and giving birth can weaken the pelvic floor muscles and tissues.
Menopause: The hormonal changes during menopause can also contribute to weakening of the pelvic floor.
Obesity: Excess weight puts added pressure on the pelvic organs, making them more susceptible to prolapse.
Chronic coughing: Repeated straining from coughing can weaken the pelvic floor muscles.
Genetic factors: Some women may have a genetic predisposition to pelvic organ prolapse, making them more prone to developing it.

Diagnosis of Pelvic Organ Prolapse

If you experience any symptoms of POP, it is essential to consult a doctor for proper diagnosis and treatment. In Singapore, doctors may use various diagnostic procedures, such as:

Physical examination: A pelvic exam can help identify the type and severity of POP.
Ultrasound: This non-invasive imaging test can provide detailed images of the pelvic organs and their position.
Cystoscopy: This procedure uses a thin, lighted tube with a camera to examine the bladder and urethra for any abnormalities.

How is Pelvic Organ Prolapse Treated

The treatment approach for POP depends on its type and severity. In Singapore, doctors may recommend non-surgical options such as:

Pelvic floor muscle exercises: Also known as Kegel exercises, these can help strengthen the pelvic floor muscles and improve support for the pelvic organs.
Lifestyle modifications: Maintaining a healthy weight, avoiding constipation, and quitting smoking can also help reduce symptoms of POP.
Use of pessaries: These are removable devices that can be inserted into the vagina to support the pelvic organs and alleviate symptoms.

In severe cases or when non-surgical options do not provide relief, surgery may be recommended. The type of surgery will depend on the specific organ affected and the patient’s overall health. It is essential to discuss all options with your doctor and understand the benefits and risks of each before making a decision.

After treatment, it is crucial to take steps to manage symptoms and prevent recurrence. This may include maintaining a healthy lifestyle, continuing pelvic floor muscle exercises, and regular follow-up with your doctor.

Prevention of Pelvic Organ Prolapse

While there is no guaranteed way to prevent pelvic organ prolapse, there are steps that women can take to lower their risk. These include:

Maintaining a health weight

Excess weight puts added strain on the pelvic organs, making them more vulnerable to prolapse.

Doing pelvic floor exercises regularly

Strengthening the pelvic floor muscles can help prevent or delay prolapse.

avoiding heavy lifting and straining during bowl movements

These activities can put pressure on the pelvic floor and increase the risk of prolapse.

seeking treatment for chronic cough or constipation

If left untreated, these conditions can weaken the pelvic floor muscles and contribute to prolapse.

Disclaimer: The information provided in this article is for general purposes only and should not be considered as a substitute for medical advice. Always consult with your healthcare provider before making any changes to your current treatment plan or starting any new medications.