by Kimberly Allen, RN
Pelvic organ prolapse is one of those conditions that is more common than people think affecting millions of women every year. As many as 1 out of 2 women in the US will develop some form of pelvic organ prolapse.
In a woman’s pelvis there is a vast network of muscles and ligaments as well as tissue that make up a complex support system that holds the pelvic organs in place. When something causes the muscles and ligaments to weaken one or more of the pelvic organs drops and pushes on the walls of other organs, usually the vagina. Although there are a variety of conditions that can lead to pelvic organ prolapse the most common cause is straining during childbirth. During the process of childbirth the pelvic muscles get stretched and weakened. If they aren’t allowed to properly heal and recover after childbirth they can’t adequately support the pelvic organs. That’s one of the reasons it’s so important to follow your doctor’s instructions about lifting, etc. after childbirth. Also, women that have multiples, i.e. twins or more, as well as those with multiple pregnancies have a greater risk of developing pelvic organ prolapse. Pelvic organ prolapse is also more common as women age. This is a result of the changes in the level of estrogen, the female hormone. Lower levels of estrogen causes weakening of are tissue. Pretty much anything that causes pressure on the pelvic organs can lead to pelvic organ prolapse including obesity and chronic constipation. A history of pelvic injury or surgery also tends to weaken the pelvic muscles increasing the risk of pelvic organ prolapse. If you are someone that is frequently lifting heavy objects and you don’t use proper lifting techniques you can weaken even damage the pelvic muscles which in turn can lead to pelvic organ prolapse.
The bladder is the pelvic organ most commonly affected in pelvic organ prolapse. However, there are several other organs that can be affected including the uterus and vagina as well as the small bowel, rectum and urethra. More than one organ can be involved at the same time. There are a variety of different types of pelvic organ prolapse depending on the location of the weakness and the organ involved. However, the 3 main types include; an anterior prolapse, also known as a cystocele, which occurs when the bladder pushes into the anterior or front wall of the vagina is the most common. The second involves the prolapse of the cervix or top of the vagina. this occurs because the cervix and/or the uterus droops pushing into the vagina. This type usually occurs after a hysterectomy. The third is called a posterior wall prolapse also known as a rectocele. This type occurs when the bowel pushes into the back wall of the vagina.
Although pelvic organ prolapse is not a life threatening condition it can significantly impact a woman’s quality of life. Many women describe their symptoms as feeling like they’re sitting on a ball or have trouble going to the bathroom while others complain of persistent low back pain. Frequently women also complain of stress incontinence.
For many women making certain lifestyle changes like losing weight and doing exercises that strengthen the muscles of the pelvic floor. However, if the symptoms are more severe there is a small device known as a vaginal pessary that can be inserted to help keep the organs in place. Vaginal pessaries are removable devices that are made of either plastic, rubber, or a silicone based material. Each pessary is fitted to the individual woman by her doctor. Pessaries need to be removed and cleaned regularly, your dctor will provide the information and instruct you on the correct procedure.
Of the millions of women affected by pelvic organ prolapse many will opt for surgery to resolve their symptoms. In most cases that involves placement of a ‘mesh’. However, in recent months there have been numerous complaints and lawsuits filed against the manufacturer of trans vaginal mesh. According to Dr. Benjamin Dillon of the Kelsey Seybold Clinic “the biggest problem with mesh is erosion or extrusion. Extrusion is when the mesh comes through the walls of the vagina, erosion is when the mesh erodes into the surrounding tissue.” So if you’re one of the millions of women suffering from pelvic organ prolapse talk with your doctor and do your own research before making a decision about treatment.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at firstname.lastname@example.org.