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Pelvic Prolapse:
The Facts Every Woman Should Know
By Louisa A. Appiah
There are many things women naturally keep to themselves, and that certainly does not exclude body disorders. Pelvic prolapse, a topic many women will shy away from or even be embarrassed to discuss has been a hot topic in the Health Information industry lately. Millions of women have been diagnosed with this urogynecologic disorder and others are advised to get themselves examined.
What is it?
A Pelvic Organ Prolapse is a ‘prolapse' or a displacement of the pelvic organs such as vagina, rectum, bladder, and uterus. This is due to a weakening of muscles of the pelvic floor. The arrangement of the pelvic floor muscles can be likened to a hammock, and a weakening of the ‘floor' causes organs to ‘fall through' the floor. The biggest opening to the pelvis in women is the vagina, which is where most of the effects of Pelvic Organ Prolapse are observed.
Are there different types?
Yes, there are. Different terms refer to the displacement of the
different organs.
Cystocele: A prolapsed bladder resulting from a weakening in the pelvic muscles in front of the vagina causing the bladder to bulge into the vagina.
Rectocele and Enterocele: When the muscles behind the vagina weaken the rectum (Rectocele) and the small bowel (Enterocele) bulges into the vagina.
Uterine Prolapse: The uterus (womb) and the cervix (the ‘mouth' of the uterus above the vagina) can prolapse down into the vagina.
Vaginal Prolapse: This is more common in women who have had
hysterectomies, when the upper part of the vagina displaces downwards.
Who does it affect?
Women of all ages can be affected to some degree by pelvic organ prolapse. Risk factors include:
> Over 50 years old
> Menopause
> Having more than 3 pregnancies in more than 24 weeks.
> More than 3 vaginal deliveries
> History of operative delivery
> History of vaginal delivery without episiotomy
> Home delivery
> Lower abdominal surgeries
> Pelvic masses e.g. uterine fibroid
Other risk factors which could worsen an already existing problem include heavy lifting, obesity, chronic constipation, poor nutrition, chronic coughing and others.
How do I identify it?
Some of the symptoms of a Pelvic Organ Prolapse are:
> pain during sexual intercourse
> difficulty emptying your bladder
> increased urinary infections
> chronic constipation or difficulty finishing a bowel movement
> back pain
> tissue bulging through the vagina
> sensation that you are sitting on something
Are there any complications?
Pelvic Organ Prolapse can affect a women's self image, her sexual life and her quality of life. Kidney failure and increases urinary infections are other complications.
Will I need vaginal examination for detection?
Yes, a doctor will need to examine you to confirm his diagnosis and the extent of the organ prolapse. This may be your own doctor or you may be referred to a specialist. A complete vaginal examination will include the doctor inserting a speculum into your vagina and asking you to bear down on your pelvis. If one is uncomfortable with being examined alone, a chaperone can be provided on
request.
What can be done about it?
Treatment for pelvic prolapse depends on the type and severity of the each disorder. Pelvic floor (such as Kegel) exercises strengthen the pelvic floor. It should be considered in mild cases of organ prolapse. This involves squeezing your pelvic muscles as if you wanted to stop passing urine. Many women have acknowledged an improvement in sexual response once these muscles are strengthened. Pessaries can be used for moderate organ prolapses when surgery is not wanted. They are like diaphragms inserted into the vagina- an easy practice to learn. A number of surgical options are also available. Like most surgeries, these are not 100% effective but can be life transforming. These options should be discussed in details with a recommended Specialist.
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* All health information is intended to educate and must not be substituted for professional advice. Read Obaasema Terms of Use.
Resources:
• Garshasbi, A et al; The status of pelvic supporting organs in a population of iranian women 18 - 68 years of age and possible related factors . PMID: 16649354
• Women's Health Matters: Pelvic Prolapse Health Centre; accessed on 2006 May 8 on URL: Epigee Women's Health: Pelvic Prolapse.
Articles accessed:
• http://www.ncbi.nlm.nih.gov /entrez/query.fcgi?cmd=Retrieve&db=pubmed
&dopt=Abstract&list_uids=16649354&query_hl=3&itool=pubmed_docsum
• http://www.womenshealthmatters.ca/centres/pelvic_health/
pelvic_prolapse/program/index.html
• http://www.epigee.org/health/pelvic_prolapse.html
• Image from: http://www.merck.com/media/mmhe2/figures/fg249_1.gif and http://www.mentorcorp.com/pelvic-organ-prolapse/gyn_stages.htm
• http://www.pennhealth.com/obgyn/news/04fall/bladder.html
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