Pelvic organ prolapse (POP) – types of POP and symptoms and treatment options of POP
Pelvic organ prolapse (POP) is a condition where one or more pelvic organs (such as the uterus, bladder, or rectum) bulge or descend into the vaginal canal due to weakened pelvic muscles and ligaments. There are different types of pelvic organ prolapse, depending on which organ is affected.
The types of pelvic organ prolapse include:
-Cystocele: This occurs when the bladder bulges into the vaginal wall. The anterior wall of the vagina is affected.
Symptoms of Cystocele: Symptoms of Cystocele may include a feeling of pressure in the pelvis, difficulty emptying the bladder, and urine leakage.
-Rectocele: This occurs when the rectum bulges into the back wall of the vagina. The posterior wall if the vagina is affected.
Symptoms of Rectocele: Symptoms of Rectocele may include constipation, difficulty passing stool, and pain during sexual intercourse.
-Uterine prolapse: This occurs when the uterus falls down into the vaginal canal.
Symptoms of Uterine prolapse: Symptoms of Uterine Prolapse may include a feeling of pressure in the pelvis, lower back pain, and difficulty with sexual intercourse.
-Enterocele: This occurs when the small bowel bulges into the vagina. The posterior wall if the vagina is affected.
Symptoms of Uterine prolapse: Symptoms of Uterine prolapse can include a feeling of pressure in the pelvis and pain during sexual intercourse.
Treatment options for pelvic organ prolapse (POP)
Treatment options for pelvic organ prolapse depend on the severity of the condition, the woman’s overall health, and her desire to have children in the future if she hasn’t already.
Non-surgical treatment options may include:
- Pelvic floor exercises to strengthen the muscles and ligaments that support the pelvic organs
- Vaginal pessaries: A medical device inserted into the vagina to provide support to the pelvic organs and prevent them from falling further
- Oestrogen replacement therapy: This may help to strengthen vaginal tissues, reducing prolapse symptoms.
Surgical options for pelvic organ prolapse may include:
- Uterine suspension: Surgery to restore the uterus to its proper position within the pelvis and hold it in place.
- Hysterectomy: Surgery to remove the uterus if the woman is past childbearing age or if she does not wish to have any more children or any children.
- Obliterative procedures: Procedures that narrow or close the vaginal canal, reducing prolapse symptoms, but will make vaginal delivery impossible in the future, so must be considered carefully.
- Reconstruction procedures: Procedures that use grafts or sutures to provide support to the pelvic organs.
Diagnosing Pelvic Organ Prolapse
Diagnosis of pelvic organ prolapse usually begins with a physical examination by a healthcare professional, such as a gynaecologist or urogynaecologist. During the examination, the specialist will assess the degree of prolapse and the extent of the descent of the pelvic organs.
The physical examination may include:
- Visual inspection of the external genitalia and vagina
- Digital pelvic examination: The healthcare professional inserts one or two fingers into the vagina and may ask the patient to perform a “bearing down” manoeuvre to assess the degree of prolapse
- Pelvic ultrasound: An imaging test that uses sound waves to create an image of the pelvic organs
- Urodynamics: A test to measure the function of the bladder and urethra
- In some cases, additional imaging tests may be recommended, such as magnetic resonance imaging (MRI) or computed tomography (CT) scans.
It is important for women to report any symptoms of pelvic organ prolapse, such as a feeling of pressure or discomfort in the pelvic area, urinary or faecal incontinence, and pain during sexual intercourse, to the specialist during the consultation. Early diagnosis and treatment can help prevent further progression of the condition and improve quality of life.
Following a consultation with a specialist, they would then determine the best option of treatment with dependant on your symptoms, lifestyle, life plans, health, specialist’s recommendations and personal preferences.
If you are experiencing any symptoms discussed above and would like to seek advice from a specialist, we offer appointments with a specialist Gynaecologist and Uro-gynaecologist Mr Philip Rahmanou in Cheltenham and Gloucester. Call us on 07805 354110 or email info@practiceforwomen.co.uk
