Pelvic Organ Prolapse: Understanding Causes, Symptoms And Effective Repairs

Pelvic organ prolapse (POP) is a common condition affecting millions of women, particularly after childbirth, menopause, or certain pelvic surgeries. It occurs when the muscles and tissues supporting pelvic organs weaken, allowing organs like the bladder, uterus, or rectum to descend into (or "prolapse") the vagina.

If you're experiencing symptoms such as pelvic pressure, urinary difficulties, or a sensation of something bulging from your vaginal area, you might be dealing with POP. The good news is that effective treatments, including advanced pelvic organ prolapse repair surgery, can offer lasting relief.

What Exactly Is Pelvic Organ Prolapse (POP)?

Pelvic organ prolapse happens when the pelvic floor muscles and the connective tissues (fascia and ligaments) no longer provide adequate support for the organs within the pelvis. This lack of support can lead to various types of prolapse:

• Cystocele: When the bladder bulges into the front wall of the vagina. (Often called a "dropped bladder.")
• Rectocele: When the rectum pushes into the back wall of the vagina.
• Uterine Prolapse: When the uterus descends into the vaginal canal.
• Vaginal Vault Prolapse: Occurs when the top of the vagina (the "vault") collapses or sags, most commonly after a hysterectomy.
• Enterocele: When a portion of the small intestine bulges into the vaginal space.

Key Causes of Pelvic Organ Prolapse

Understanding the risk factors can help in both prevention and management. The most common causes and contributing factors for POP include:

• Vaginal Childbirth: This is especially impactful with large babies, prolonged labor, or multiple deliveries, which can strain pelvic floor muscles and connective tissues.
• Aging and Menopause: Decreased estrogen levels during menopause lead to a natural weakening of connective tissues, reducing pelvic floor support.
• Chronic Strain: Conditions like chronic constipation, persistent coughing, or frequent heavy lifting significantly increase abdominal pressure, stressing the pelvic floor.
• Obesity: Excess body weight adds continuous pressure to the pelvic floor.
• Genetic Predisposition: Some women may inherit naturally weaker connective tissues, making them more susceptible to prolapse.

Recognizing the Symptoms of Prolapse

Symptoms of POP can vary in severity, but commonly include:

• A sensation of fullness or pressure in the pelvic area.
• Feeling like something is "falling out" of the vagina.
• Urinary issues, such as incontinence (leaking urine) or difficulty starting urination.
• Bowel difficulties, like constipation or straining during bowel movements.
• Discomfort or pain during sexual activity.

Moderate to severe cases of prolapse often benefit significantly from surgical repair, particularly when symptoms negatively impact a woman's quality of life.

What Does Pelvic Organ Prolapse Repair Involve?

Pelvic organ prolapse repair is a reconstructive surgical procedure designed to restore the normal anatomical position of pelvic organs and strengthen the supportive pelvic floor structures. These procedures can be performed through different approaches:

• Vaginally
• Abdominally (open surgery)
• Minimally invasive techniques such as laparoscopy or robot-assisted surgery.

Common surgical approaches for POP repair include:

• Anterior and Posterior Colporrhaphy: These procedures tighten the vaginal walls to provide better support for the bladder (anterior repair for cystocele) or the rectum (posterior repair for rectocele).
• Sacrocolpopexy: Often considered the "gold standard" for vaginal vault prolapse, this laparoscopic or robotic procedure uses a surgical mesh to attach the top of the vagina (or uterus) to the sacrum (lower spine) for strong, long-lasting support.
• Hysteropexy or Sacrohysteropexy: A mesh-based procedure that supports the uterus, offering an alternative for women who wish to avoid a hysterectomy while still addressing prolapse.
• Vaginal Vault Suspension: Reattaches the top of the vagina to ligaments within the pelvis, typically performed after a hysterectomy.

What to Expect During Your Recovery

Most women experience a recovery period of 4 to 6 weeks, though the exact timeline can vary depending on the specific procedure performed and individual healing. Key aspects of post-surgery care include:

• Avoiding heavy lifting or strenuous activities as advised by your surgeon.
• Waiting 6–8 weeks before resuming sexual activity to allow for proper healing.
• Monitoring for signs of infection or other complications and reporting them promptly.

Minimally invasive surgical options (like laparoscopic or robotic approaches) often lead to benefits such as less post-operative pain, shorter hospital stays, and a quicker return to daily activities.

When Should You Consult an OBGYN?

If you are experiencing any symptoms of pelvic organ prolapse that interfere with your daily activities, comfort, or self-esteem, it is crucial to consult with a qualified OBGYN specializing in pelvic floor disorders. Early evaluation and proper treatment can prevent the condition from progressing and significantly improve your quality of life.

At OBGYN CARE, you’ll receive expert, compassionate care from a physician who is not only highly experienced in managing pelvic floor disorders but also specialized in advanced minimally invasive and robotic gynecologic surgery. Dr. Marinescu leads an AAGL-accredited Center of Excellence in Minimally Invasive Gynecology and holds the distinguished title of Surgeon of Excellence from the Surgical Review Corporation (SRC). From individualized pelvic floor assessments to the most advanced robotic prolapse repairs, our care is designed to help you heal with less downtime – and regain confidence in your body.