Have you ever had the feeling that something is “falling out” – in
places where it should not feel that way? If so, you may have a pelvic
organ prolapse (POP). When the muscles of the pelvic floor and the
connective tissue that surround it are weak and cannot give support to
the organs that lie above them, they will drop down. This is referred to
as a pelvic organ prolapse.

Which organs fall out of place with a pelvic organ prolapse?

The pelvic organs include the uterus, bladder and rectum. Without support, any one of these can start to drop down.

What causes a pelvic organ prolapse?

The main causes
of a pelvic organ prolapse are pregnancy and vaginal childbirth, which
can weaken muscles of the pelvic floor. Other causes include menopause,
aging and repeated heavy lifting. There are also physical conditions
that can create pressure on the abdomen which can cause a pelvic organ
prolapse, such as obesity, constipation, physical straining during bowel
movements and chronic coughing, which can be brought on by smoking,
asthma or other medical conditions. A pelvic organ prolapse can occur at
any age, but most women who develop symptoms do so after menopause.

What are the symptoms of a pelvic organ prolapse?

When
a pelvic organ prolapse is mild, you may not notice anything at all.
Sometimes, a bulge can be felt inside the vagina. For severe cases of a
pelvic organ prolapse, organs may push out of the vaginal opening. Here
are some of the specific symptoms of a pelvic organ prolapse:

• Feeling of pelvic pressure or fullness in the pelvic area
• Organs bulging out of the vagina
• Leakage of urine (urinary incontinence)
• Difficulty emptying the bladder
• Difficulty having bowel movements
• Lower back pain
• Problems with inserting tampons or applicators
• Is surgery required to fix a pelvic organ prolapse?

Surgery is not usually the first course of treatment for a
pelvic organ prolapse. Here are some things that can be tried before
surgery:

• Changes in diet and lifestyle may be helpful in relieving some
  symptoms. If urinary incontinence is a problem, limiting excessive fluid
  intake and altering the types of fluid consumed may be helpful. For
  example, decreasing alcohol and drinks that contain caffeine may provide
  some relief.
• If bowel problems are an issue, increasing the amount of fiber in
  your diet can prevent constipation and straining during bowel movements.
• If you are overweight or obese, weight loss can help improve overall health and reduce prolapse symptoms.
• Does exercise help a pelvic organ prolapse?
• Pelvic floor exercises performed regularly may improve incontinence
  and may slow the progression of a pelvic organ prolapse. A health care
  professional or physical therapist can help ensure that these exercises
  are being performed correctly.

Is there anything else that can help with a pelvic organ prolapse?

Some
physicians recommend a pessary, which is a device that is inserted into
the vagina to support the pelvic organs. Many women find immediate
relief from their symptoms with pessary use. Pessaries are available in
many shapes and sizes. They can be used for short-term or long-term
treatment. Pessary choice is based on a woman’s symptoms and the type of
prolapse.

Can surgery correct pelvic support problems?

If all
else fails, surgery may relieve some symptoms. In general, there are two
types of surgery: surgery to repair the pelvic floor; and surgery to
shorten, narrow or close off the vagina.

It is always recommended
that you meet with your primary care physician, urologist or
gynecologist, whenever you have any questions or concerns regarding any
health-related issues.