Pelvic organ prolapses (POP) occurs when the vagina, rectum and/or uterus have dropped from their normal position in the pelvis and protrude through the vaginal wall. Your pelvic floor muscles and the connective tissue support the organs.
Symptoms:
o Lower back and abdominal discomfort
o Protruding of organ from the vaginal opening
o Loss of bladder or bowel control
o Difficulty voiding
o Urinary frequency
o Problems with bowel movements
o Feeling of pelvic/ vaginal heaviness, bulging, fullness or pain
o Recurrent bladder infection /excessive vaginal discharge
o Discomfort or lack of sensation with intercourse
Causes:
o Aging (due to the loss of muscle tone)
o Menopause: During menopause, women can experience a decrease in estrogen, which may initiate thinning and weakening of the pelvic muscles and connective tissues. This makes us more susceptible to decreased tone, elasticity and suppleness in the tissues of the pelvic floor. As your body’s hormones fluctuate through peri-menopause, these changes may occur whether you’ve given birth or not. For some women, proactively engaging in activities to strengthen the muscles, will suffice during this time. Others may require additional support such as vaginal bio-identical estrogen pessaries, available in the form of gel, cream or rings via prescription from your healthcare practitioner. This helps maintaining the tissue integrity and elasticity of the vagina, as well as reducing bladder and urethral spasm.
o Multiple vaginal deliveries
o Obesity
o Family history
o Pelvic trauma or surgery
o Repeated heavy lifting
o Chronic constipation: Preventing constipation prevents straining the pelvic floor muscles and can limit injury.
o Cough:Women who smoke are much more susceptible to pelvic floor dysfunction than those who don’t. Quitting smoking will maximize your nutrition and prevent the chronic coughing, one of the primary triggers for pelvic floor trouble.
o Medical condition e.g. diabetes mellitus, connective tissue disorders.
Pelvic floor physical therapy improves pelvic floor muscle and girdle strength and motor control which is effective for preventing prolapse and is also used to treat it once it occurs. The success rate is up to 80-90%.
How is it diagnosed?
o Thorough pelvic examination
o Diagnostic tests:
- Urodynamic study to evaluate the bladder function
- Special imaging studies to visualize the bladder or rectum
- Defeacogram
