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Pelvic Organ Prolapse – What Women Need to Know

Pelvic Organ Prolapse (POP) occurs when there is a weakening or tear in the pelvic floor muscles or connective tissues. This causes pelvic organs to fall downward into the vagina. This is similar to a hernia in the vaginal space.

Pelvic Organ Prolapse is More Common Than You’d Think

POP is a common problem.

One in three women who have given birth have POP.

Many women with POP may not experience symptoms. On the other hand, other women may:

  • Feel pressure from a bulge in the vagina
  • See or feel tissue coming out of the opening of the vagina
  • Have vaginal dryness or irritation from rubbing on undergarments
  • Have trouble urinating or having a bowel movement until the bulge is pushed out of the way
  • Have urinary frequency, loss of bladder control, or reoccurring urinary tract infections

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Causes of POP

Pelvic floor damage may come from a number of things. Some of these causes include:

  • Pregnancy and childbirth
  • Aging
  • Menopause
  • Certain health conditions that involve repetitive straining or weakening of the muscles
  • Genetics
  • Heavy lifting

How Pelvic Organ Prolapse is Diagnosed

Several pelvic organs – whether it is the bladder, uterus, bowel, or rectum – may be involved in prolapse. To evaluate whether POP is present, a specialist provider reviews the medical history and completes a physical exam in order to evaluate the degree of pelvic support.

Treatment for Pelvic Organ Prolapse

The ideal treatment for POP depends on how severe as well as how bothersome the symptoms are.

There are conservative treatments, such as lifestyle changes, pelvic floor muscle exercises, or the use of a vaginal pessary. There are also surgical options to lift up the pelvic organs and correct the pelvic anatomy.

Pelvic Floor Muscle Exercises (PFME)

Pelvic floor muscle exercises (PFME), commonly known as “Kegel” exercises, can help strengthen the pelvic floor and improve symptoms. These are most helpful in mild to moderate POP symptoms.

PMFE need to be done regularly, and it may take 3 to 6 months to fully see results. For the best effect, work with a specialized physical therapist.

Vaginal Pessary

A ‘pessary’ is a silicone device that is inserted to the vagina. it is designed to lift up the bladder or vaginal walls and prevent the bulge from coming out. This can relieve the vaginal pressure some women have. Some women wear a pessary only when they do strenuous activities, while others leave it in all the time.

POP Surgery

Surgical options are based on the compartment that is involved and which pelvic organs have prolapsed. Surgery may involve the use of stitches to restore the support or it may be with the use of a mesh material or graft. The degree of prolapse and the individual’s lifestyle are important factors in selecting the most appropriate surgery.

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4 Lifestyle Changes to Prevent Prolapse from Worsening

There are some modifications to one’s lifestyle that can reduce POP Symptoms. Some of these include:

  1. Eliminate constipation, and avoid straining with bowel movements.
  2. Avoid extreme weight lifting and repetitive heavy lifting.
  3. Maintain a weight that is in normal range, and lose weight if you are overweight.
  4. Quit smoking. Tobacco use doubles the risk for pelvic floor disorders.

Don’t Suffer in Silence – You Have Options!

If you suffer from pelvic organ prolapse, there are options for you! A urogynecologist will be able to discuss each of these options with you and help tailor the best treatment for your condition.


About Andrea Crane, MD

Dr. Andrea Crane is a board certified OB/GYN and urogynecologist at WakeMed with interests in comprehensive pelvic reconstruction, da Vinci® robot-assisted sacrocolpopexy, and sacral neuromodulation. Her training includes evaluation and treatment of childbirth trauma, advanced pelvic organ prolapse, urinary and fecal incontinence, vesicovaginal and rectovaginal fistulae, and mesh complications. Learn more about urogynecology in Raleigh, NC, and schedule an appointment today.

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