As women age, their risk of developing pelvic prolapse increases. The pelvic organs include the vagina, cervix, uterus, bladder, urethra, small intestine, and rectum. Pelvic organ prolapse occurs when the muscle and fascia (connective tissue) supporting the pelvic organs become stretched, torn, or weakened with age and lead to sagging or bulging into the vagina.

Types of POP include:

  • Uterine prolapse—uterus

  • Vaginal vault—top of the vagina

  • Cystocele—bladder

  • Urethrocele—urethra

  • Enterocele—small intestine

  • Rectocele—rectum

Causes and symptoms

While many factors contribute to pelvic prolapse, the process often begins with a woman vaginally delivering a baby.

When the baby travels through the birth canal, it stretches the pelvic support system. This stretching becomes more pronounced with each delivery. Other contributors to pelvic prolapse are smoking, chronic bronchitis, obesity, diabetes, and a family history of prolapse.

Years after childbirth, loss of muscle tone and relaxation of muscles due to menopause and natural aging can cause prolapse to progress and cause symptoms, including:

  • Incontinence
  • Difficulty having a bowel movement
  • Pain during intercourse
  • Heaviness, aching, or a pulling sensation in the lower abdomen
  • Feeling of pelvic pressure, heaviness, or fullness that worsens with standing, lifting, or coughing
  • Pulling or aching feeling in the pelvis and vagina
  • Low back pain
  • Problems with inserting tampons or applicators

In severe cases, the cervix or other internal organs may actually bulge through the opening of the vagina.

Treatment

Nonsurgical treatments such as pessaries, which are plastic devices placed inside the vagina, may help support the internal organs and reduce prolapse symptoms.

However, if prolapse is severely disrupting your life, you may want to talk to your doctor about pelvic reconstructive surgery. Complications are uncommon, with high success rates and with many procedures now done vaginally instead of through abdominal incision; hospital stays and recovery time for most women are greatly decreased.

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