Pelvic Organ Prolapse

Pelvic organ prolapse (POP) is a common type of pelvic floor condition that occurs when the muscles and tissues supporting the pelvic organs become weak or stretched. 

As a result, one or more organs – such as the uterus, bladder, rectum, or small bowel – can drop down into or bulge out of the vagina. Normally, the pelvic muscles and connective tissues (called fascia) support the pelvic organs like a hammock. When these muscles and tissues are weak or damaged, they can no longer support the pelvic organs and lead to POP.

Pelvic organ prolapse is quite common in women, especially as they get older.

A subspecialty called urogynecology (sometimes called reconstructive pelvic surgery) addresses pelvic floor disorders in women. Cooper’s highly trained urogynecologists are skilled and compassionate in talking to women about pelvic organ prolapse, and they tailor an array of effective treatment options to your individual situation.

Types of Pelvic Organ Prolapse

The most common types of POP include:

• Cystocele: the bladder drops into or out of the vagina (most common type)
• Rectocele: the rectum bulges into or out of the vagina
• Uterine prolapse: the uterus drops into or out of the vagina
• Enterocele: part of the small intestine bulges into the vagina
• Urethrocele: the female urethra (the tube that carries urine from the bladder to outside the body) protrudes into the vagina (often happens with cystoceles)
• Vaginal vault prolapse: the upper part of the vagina sags or drops into the vaginal canal or outside the vagina (sometime occurs with prolapse of other pelvic organs)

Causes and Risk Factors 

The most common risk factors for developing POP include:

• Vaginal childbirth, especially multiple of large babies (greater than 8 ½ lbs.)
• Family history
• Menopause, due to estrogen loss
• Pelvic floor injury from falls, motor vehicle accidents, pelvic radiation, or surgery
• Hysterectomy
• Nerve and muscle diseases like multiple sclerosis, Parkinson’s disease or stroke
• Ethnicity/race, as Caucasian women are at higher risk
• Obesity
• Chronic coughing
• Chronic constipation and straining
• Age, with older women at greater risk
• Repetitive heavy lifting

Symptoms 
 

• The symptoms of POP vary depending on the type and severity of the prolapse. Common signs include:
• A feeling of pressure, aching, or fullness in the pelvis
• Bulging tissue in or outside the vagina
• Discomfort during physical activity or sexual intercourse
• Pelvic pressure that gets worse with standing, coughing, or as the day goes on
• Leaking urine (urinary incontinence) or problems having a bowel movement
• Difficulty inserting tampons

In severe cases, the prolapsed organs can protrude out of the vagina.

Treatment Options

There are several effective treatments for POP. Your specific treatment plan will depend on the type of prolapse you have, how severe your symptoms are, your age and general health, and whether you are sexually active. Treatment options may include: 

• Pessary: a removable plastic or silicone device placed into the vagina to support the pelvic organs; this treatment approach may also help with urinary incontinence
• Dietary changes: such as adding more fluid and fiber to your diet, which can help prevent constipation and straining during bowel movements
• Pelvic floor muscle therapy: targeted exercises or rehabilitation from a specially trained physical therapist to strengthen supporting  muscles
• Surgery:there are two main types for treating POP:
  • Pelvic reconstructive surgery – using your own body tissue or synthetic mesh to repair the prolapsed organ and build a “sling” to support your pelvic floor. This type of surgery is recommended for sexually active women who have severe prolapse of the uterus or vagina.
  • Colpocleisis – closing the vaginal opening to support structures; an option for women who no longer have vaginal intercourse.

There are several preventive steps you can take to reduce your risk of POP:

• Maintain a healthy weight, or lose weight if you are overweight
• Eat a diet that includes the right amount of high-fiber foods and drink plenty of fluids
• Don’t smoke

Why Choose Cooper for Pelvic Organ Prolapse Care

At Cooper University Health Care, our  urogynecology team is on the forefront of diagnosing and treating pelvic organ prolapse. Women choose Cooper because of our:

• Compassionate, expert care: Our fellowship-trained urogynecologists offer a full range of today’s most advanced diagnostic and treatment options, delivered in a caring, sensitive manner
• The only pelvic floor physical therapy (PT) program in the region: this specialized form of rehabilitation focuses on strengthening the pelvic floor to help control overactive bladder
• Minimally invasive surgical expertise: Cooper is the only health system in the region to offer robotic surgery for pelvic floor disorders and overactive bladder, resulting in faster recovery, reduced pain and minimal scarring
• Academic excellence: Our urogynecologists are faculty at Cooper Medical School of Rowan University, training the next generation of specialists