Some women will have pelvic organ prolapse and not notice it. For others it can be painful.
Although pelvic organ prolapse is not a lethal condition -- in other words, you will not die sooner if you have the condition -- it does affect quality of life for many women. It can be pervasive and distressing.
Women with mild prolapse discovered during a routine pelvic exam may have no symptoms. But others can experience a range of symptoms, depending on which organ is drooping. The symptoms of pelvic organ prolapse may include:
- Pelvic pressure and pain, leg fatigue and lower back pain
- Urinary problems, such as urinary incontinence or difficulty in starting to urinate
- Bowel problems, such as fecal incontinence or trapped stool, which can cause pain and constipation
- Painful intercourse
Women can have a combination of several organs being prolapsed, and the symptoms depend on the organ that is prolapsed and the degree of prolapse.
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The risk of pelvic organ prolapse increases with age, and it's more common in women who've given birth vaginally. Other contributing factors may include family history, excess weight, weak connective tissue, chronic constipation, and an occupation that requires heavy lifting.
Pelvic organ prolapse (POP) may cause the vagina, uterus, urethra, small intestine, and rectum to drop below their normal position, possibly causing stress incontinence. The prolapsed organs are covered with vaginal skin, so they just look like big bulges in any of the five areas mentioned below. If you have POP, you may feel as though you are “sitting on an egg.”
There are five main areas/types of prolapse, and you may have one or a combination of them:
• Cystocele - The bladder drops down into the vagina, resulting in
incomplete emptying of the bladder and a possible urinary tract
infection. A cystocele may become worse with time.
• Cystourethrocele - The lower part of the urethra drops down into the
vagina. This is also usually associated with a cystocoele.
• Uterine prolapse - The uterus and cervix drop down into the vagina,
resulting in urinary urgency and frequency. If you have had a
hysterectomy, your vagina may prolapse, since it is located in the mid
compartment of your pelvic area above the (now removed) uterus.
• Enterocele - The small intestine drops from the vagina.
• Retrocele - The rectum protrudes into the vagina, resulting in
incomplete rectal emptying.
There are four different grades of pelvic organ prolapse, depending upon its severity:
Grade 1: The sagging organ bulges toward the opening of the vagina.
Grade 2: The sagging organ is halfway down the vaginal canal.
Grade 3: The sagging organ is at the opening of the vagina.
Grade 4: The sagging organ drops out of the vagina.
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Pelvic organ prolapse (POP) is the condition in which any organs in the pelvis/vagina are "falling". When a patient has bladder prolapse, uterine, or vaginal prolapse, or rectal prolapse it can be considered POP. The downward descent of the pelvic or vaginal organs can cause a significant amount of problems with pelvic pressure, pelvic pain, problems with bladder or bowel emptying, pain with intercourse, and a noted bulging or protrusion of the organs into the vagina. The most common cause of pelvic organ prolapse (POP) is child birth. The delivery of a baby through the vagina can cause tearing of the connective tissue surrounding the pelvic organs which would subsequently cause a hernia of the bladder, the bowels, or the rectum into the vagina. These hernias and/or tears in the connective tissue is what causes pelvic organ prolapse. Other causes of pelvic organ prolapse (POP) are obesity, chronic straining, weak connective tissue disorders, smoking, or some types of vaginal or gynecologic surgeries. A hysterectomy can increase a patient's risk of pelvic organ prolapse (POP) because the connective tissue is disrupted at the apex of the vagina and if not properly repaired or reapproximated then there can be a weakness of the apex of the vagina causing future pelvic organ prolapse (POP).
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