No Need to Suffer From Pelvic Organ Prolapse

Pelvic organ prolapse is a very common condition among women. It is estimated that half of women who have children will experience some form of prolapse; however, many women don’t seek help from a qualified doctor. Pelvic organ prolapse occurs when the pelvic floor becomes weak or damaged and can no longer support the pelvic organs. The womb (uterus) actually falls into the vagina. When the bladder and bowel slip out of place, they push up against the walls of the vagina. While prolapse is not a life threatening condition it may cause a great deal of discomfort and distress. There are a number of different types of prolapse that can occur in a woman’s pelvic area and these are divided into three categories according to the part of the vagina they affect: front wall, back wall, or top of the vagina. It is not uncommon to have more than one type of prolapse.

  1. Prolapse of the anterior (front) vaginal wall
    1. Cystocele (bladder prolapse) - When the bladder prolapses, it falls towards the vagina and creates a large bulge in the front vaginal wall. It’s common for both the bladder and the urethra to prolapse together. This is called a cystourethrocele and is the most common type of prolapse in women.
  2. Prolapse of the posterior (back) vaginal wall
    1. Rectocele (prolapse of the rectum or large bowel) -This occurs when the end of the large bowel (rectum) loses support and bulges into the back wall of the vagina.
    2. Enterocele (prolapse of the small bowel) - Part of the small intestine may slip down between the rectum and the back wall of the vagina. This often occurs at the same time as a rectocele or uterine prolapse.
  3. Uterine prolapse is when the womb drops down into the vagina. It is the second most common type of prolapse.

Different factors contribute to the weakening of the pelvic floor support over time, but the most significant factors are thought to be:

  • Pregnancy and childbirth
  • Aging and menopause
  • Weight gain
  • Chronic coughing or strain
  • Heavy lifting
  • Previous pelvic surgery

Symptoms may include:

  • Feeling a lump or heavy sensation in the vagina
  • Lower back pain that may ease when you lie down
  • Pelvic pain or pressure
  • Pain or lack of sensation during sex

When symptoms do occur, however, they tend to be related to the organ that has prolapsed. A bladder or urethra prolapse may cause incontinence (leaking urine), frequent or urgent need to urinate or difficulty urinating. A prolapse of the small or large bowel (rectum) may cause constipation or difficulty defecating. Some women may need to insert a finger in their vagina and push the bowel back into place in order to empty their bowels. Women with uterine prolapse may feel a dragging or heaviness in their pelvic area, often described as feeling ‘like my insides are falling out.’

If you have any of the symptoms of prolapse, particularly if you can see or feel something near or at the opening of your vagina, make an appointment to see your health care provider. Many women with prolapse avoid going to the doctor because they are embarrassed or afraid of what the doctor might find, but prolapse is very common and is nothing to be ashamed of. It may be difficult at first to talk about your symptoms, and some women find the examination uncomfortable, but it only takes a few
minutes and, by having your symptoms checked, you are taking an active role in your health and well-being.

Questions to ask your doctor about your prolapse:

  • What type of prolapse do I have?
  • What treatment/surgery do you recommend and why?
  • What if I choose not to have any treatment?
  • What can I do to ease the symptoms?

What to expect at your appointment:
You will be asked about any signs or symptoms. Remember, you don’t have to be nervous; we talk about
these problems every day. Also, your doctor will need to do a thorough pelvic examination. You may be asked to cough or strain during the examination. This enables the doctor to see if any urine leaks or if any of the pelvic organs prolapsed into the vaginal walls. If you have bowel symptoms the doctor may need to feel for bowel prolapse, asking you to strain or bear down. A good doctor will explain what he is doing throughout the examination, but if you have any questions, ask for an explanation.

Treatment Options

Most of the time, treatment will require a surgical procedure or a combination of surgical procedures to re-support the pelvic floor and surrounding structures. Often referred to as anterior (bladder), posterior (rectum) and enterocele (top of vagina), these surgeries are most often performed vaginally. Hospital stay is usually limited to one overnight stay, with many patients going home the same day! After discharge, patients can resume simple daily activities immediately. Patients can typically drive in a week and return to work in two to three weeks. However, your recovery should be individualized for your particular situation.

If you feel like you suffer from any of these conditions or have any questions regarding your gynecological health, please feel free to contact Dr. Don Wilson and/or one of his partners at The Jackson Clinic, Dept of OB/GYN , 731-660-8300.

Dr. Don Wilson is a board certified Obstetrician/Gynecologist at The Jackson Clinic.

With more than 25 years of surgical experience, having performed over a thousand vaginal repair surgeries, Dr. Wilson is one of the highest qualified, pelvic organ prolapse surgeons in the Southeastern United States.