Pelvic Organ Prolapse refers to a drop of one or more of the organs in the pelvis from its original position into the vaginal canal. This happens because the muscles and ligaments, which normally hold the pelvic organs in place are weakened or are damaged. This organ drop, thereby causing a bulge in the vagina.

What are the organs involved in Pelvic Organ Prolapse?

Some of the organs found in the pelvic area include:

The Bladder: This is where urine is stored.

The vagina: This is the pathway for menstruation and birth.

The Urethra: It acts to transport urine from the bladder to the external urethral orifice.

The small intestine: the main function of the small intestine is the absorption of food.

The Uterus: This is where fetus development occurs.

The Rectum:  This is where fecal matter is stored before excretion.

Each of these organs presents a different type of prolapse, which will be discussed below.

Types of Pelvic Organ Prolapse 

Cystocele 

In this condition, the support structures around the bladder, i.e., the ligaments, and muscles, are weakened or stretched. The bladder slips out of place and bulges into the anterior wall of the vagina. It is also known as anterior vaginal wall prolapse. It is usually accompanied by ureterocele the drooping of the Urethra.

Vagina Vault Prolapse 

Due to weakness of the muscles of the pelvis, it results in a drop of the top of the vagina into the vaginal canal.

Enterocele 

This is the prolapse of the small intestine. When there is a weakness of the muscles around the small intestine, it can lead to a drop of the small intestine into the vagina or the top of the vagina.

Uterine prolapse 

This is the dropping of the uterus from its original position down into the vagina Canal.

Rectocele 

This prolapse is also known as posterior vaginal wall prolapse.  It occurs due to the weakening of the supportive wall of tissue between the rectum and the vaginal wall. The rectum drops and bulges on the posterior wall of the vagina.

Causes of Pelvic organ prolapse.

Pelvic Organ Prolapse arises due to pressure on the pelvic floor. Some of the things that can cause this pressure include:

--Pregnancy and childbirth, especially vaginal delivery.

--Chronic constipation.

--Chronic coughing.

--Obesity.

--Aging.

--Hysterectomy.

--Genetic predisposition (Connective tissue disorders)

--Conditions that cause repeated increased pressure in the abdomen

Signs and symptoms of Pelvic Organ Prolapse 

-A feeling of pressure or fullness in the pelvic area.

-A bulge or lump in the vagina or rectum.

-Difficulty with urination or bowel movements.

-Feeling like something is "falling out" of the vagina.

-Pelvic pain or discomfort.

-Discomfort during sexual intercourse.

-Low back pain

-Bleeding from the eroded vaginal mucosa

-In the case of rectal prolapse:

-Leakage of stool.

-Rectal pain, itching, and bleeding 

Risk factors of Pelvic organ prolapse 

1. Pregnancy and labour
2. Obesity/BMI
3. Respiratory problems involving a chronic, long-term cough 
4. Cancer of the pelvic organs 
5. Hysterectomy (surgical removal of the uterus) 
6. Genetics (possibly) due to weaker connective tissues
7. History of vaginal delivery (increases the risk 5.56 times )
8. Hypertension and Diabetes Mellitus ( combined increase the risk by 1.9 times) 
9. Increased birth weight
10. Age 
11. Parity(i.e. the number of times a woman has given birth to a fetus with a gestational age of greater than or equal to 24 weeks, alive or stillborn) 

Who is at more risk of having pelvic organ prolapse?

POP is more common in older women, especially those who have had multiple vaginal births. However, it can occur at any age. Rectal prolapse is also more common in older adults because they are more prone to weakened muscles.

Treatment of Pelvic Organ Prolapse

The treatment of pelvic organ prolapse involves different approaches as the main aim of treatment is strengthening the muscles and getting the organs back to their respective positions.

Some of these treatment options include:

Lifestyle change 

Affected individuals would be required to take up some habits that would help eliminate the risk factor(s) that might have caused the prolapse.

Some of these lifestyle modifications include:

1. Weight loss
2. Pelvic floor exercises 
3. Dietary changes to prevent constipation.

Use of a Pessary

A Pessary is a device placed into the vagina to support prolapsed organs. It acts to alleviate some of the prolapse symptoms felt by the individual.

It reinforces the weak pelvic floor and prevents further descent of the prolapsed organs.

Avoid heavy lifting 

Lifting of heavy things would further put pressure on the pelvis and cause further descent.

Maintaining good posture.

It is important to maintain good posture as this helps in retraining the muscles of the pelvic floor 

Surgery 

In extreme cases, corrective surgery to the pelvis is conducted to correct the deformities.

Conclusion 

Pelvic Organ Prolapse is not a life sentencing condition. With early diagnosis and treatment, you can be assured of a reversal to your normal standard of life. Remember to consult a healthcare professional as soon as you notice any signs of pelvic organ prolapse.