Pelvic Organ Prolapse

Pelvic organ prolapse is a condition that affects many females.

When Might You Notice Pelvic Organ Prolapse?

There can be many different signs of pelvic organ prolapse depending on the type of prolapse you have. Signs can include:

  • Feeling like you have to hold things in place when pooping
  • Having tampons fall out when menstruating
  • Differences when engaging in intimacy
  • Uncomfortable sensations near the vaginal area, or feeling bulging or fullness

Types of Pelvic Organ Prolapse Include:

  • Cystocele or dropped bladder prolapse, where the bladder drops out of or into the vagina. This is the most common type of prolapse. There are many surgical options available to treat this, including reconstructive surgery, which uses synthetic mesh to repair the prolapse. Anterior vaginal repair, or anterior colporrhaphy, is the most common type of procedure. This is when an incision is made in the vagina and extra supportive tissue is folded over and sewn between the vagina and bladder.
  • Rectoceles prolapse, where the rectum is pushed into the vagina. This bulge of tissue into the vagina occurs when the tissue between the vagina and rectum is torn or weakened. Symptoms may include a soft bulge that might come through the vagina, trouble with bowel movement and a sensation of fullness or pressure in the rectum.
  • Uterine prolapse, where the uterus drops down into the vagina. The uterus slips down because of stretched or weakened pelvic floor muscles. This mostly affects people after they have gone through menopause, typically women around 50-80 years old. Mild uterine prolapse usually does not need treatment, but in cases where there is extreme discomfort, treatment is recommended.

Treatment Options for Pelvic Organ Prolapse Include:

  • Mesh surgery, which is when the vaginal tissue is tied up by mesh. The mesh is then attached to a ligament. Mesh used to be inserted into the body vaginally, which was intimidating to many patients, but the FDA removed these kits from the medical market in 2019. Now, mesh is only inserted abdominally, which is a much safer way to insert the mesh into the body. This procedure is riskier for smokers, but safe overall.
  • A pessary, which is a removable device made to be kept in the vagina for support in a prolapse. The devices are made of silicone and sometimes vinyl. They are easy to remove and insert. Patients can remove them as they please and can keep them in for up to three months. They are typically used for women who want to avoid surgery or want to manage the pain while waiting for surgery.
  • A hysterectomy, which is removal of the uterus. This is a treatment option for uterine prolapse. Some patients instead get a sacral hysteropexy, which suspends the uterus from the front of the tail bone using body tissue or a created graft to support the vagina and uterus.
  • Obliterative surgery, which closes the vagina to treat pelvic organ prolapse. It is important to note that after this type of surgery, vaginal sex is not possible due to the closed vaginal opening.

Diagnosing Pelvic Prolapse

To diagnose pelvic organ prolapse, your provider will typically ask about your medical history and perform a physical exam of your pelvic organs.

If you feel you could have pelvic organ prolapse, call one of our UofL Physicians – Urogynecology offices to schedule an appointment:

UofL Physicians – Urogynecology
Springs Medical Center
6240 Dutchmans Parkway, Suite 190
Louisville, KY 40205
502-588-7660
Sean Francis, M.D. and Stacy Lenger, M.D.

UofL Physicians – Urogynecology Associates
UofL Health – Center for Women’s Health at UofL Health – Mary & Elizabeth Hospital
Plaza 4
4331 Churchman Avenue
Louisville, KY 40215
502-977-5907
Ankita Gupta, M.D., M.P.H.

To learn more about pelvic organ prolapse, watch this interview of Dr. Lenger from KET.

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Article by: Stacy Lenger, M.D.

Dr. Lenger is a urogynecologist with UofL Physicians – Urogynecology at the Springs Medical Center. She specializes in pelvic floor disorders, prolapse, incontinence and birth-related injuries. She went to medical school at the University of Missouri, completed an internship and residency at the University of Tennessee and a fellowship in Female Pelvic Medicine and Reconstructive Surgery at Washington University in St. Louis. Dr. Lenger provides patient-centered, compassionate care with both the highest quality surgical care and medical management. She aims to improve the quality of life for all patients.

All posts by Stacy Lenger, M.D.
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