Pelvic Organ Prolapse

Pelvic Organ Prolapse (POP) is a result of weakening of muscles of the pelvic floor.  The pelvic floor is a complex network of muscles and ligaments that support the surrounding organs, including the vagina, uterus, bladder, and rectum.   As the pelvic muscles weaken, the structures of the pelvis begin to descend into the vagina.

Pelvic prolapse may occur after vaginal delivery (childbirth), menopause, or hysterectomy.   Symptoms indicating pelvic prolapse include vaginal fullness, vaginal bulge, urinary incontinence, voiding difficulty, or some combination of these symptoms.   However, many patients do not experience any symptoms, and are only diagnosed by their physician when addressing other concerns.

When the prolapse involves the anterior wall of the vaginal canal (bladder), it is called Cystocele.   When it involves the posterior wall of the vaginal canal (rectum), it is called Rectocele.   The prolapse may also involve the Uterus (Uterine prolapse), the intestine (Enterocele) and the apex of the vaginal canal after hysterectomy (Vault prolapse).  These forms of prolapse may coexist in different combinations with or without urinary incontinence.

Treatment options For Pelvic Organ Prolapse

Treatment options for the prolapse depend on the type of the prolapse, the degree of the prolapse and the associated symptoms. The treatment options may include:

  • Pelvic muscle exercises (also known as KEGEL Exercises)
  • BIOFEEDBACK (pelvic muscle training)
  • A vaginal pessary (a removable device placed in the vagina similar to a diaphragm designed to hold up the pelvic structures in position)
  • Minimally invasive surgical repair of the prolapse using human tissue or synthetic mesh grafts.

Pelvic muscle exercises (KEGEL Exercises)

First published in 1948 by Dr. Arnold Kegel, Kegel exercises are designed to strenthen the pelvic floor and reduce symptoms of urinary incontinence.  Kegel exercises consists of repeatedly contracting and relaxing the muscles that form part of the pelvic floor.   Just as a personal trainer improves the results of your exercise regimen, it is important to learn the right way to contract the pelvic muscles in order to make these exercise effective.   At Genesis we offer tools such as Biofeedback to teach you to perform Kegal exercises correctly.

BIOFEEDBACK (pelvic muscle training)

The challenge with Pelvic muscle exercises (KEGEL Exercises) is that it can be difficult to know for sure if you are doing them correctly and that you are actually exercising the right muscle.   Many women who try Kegel exercises don’t achieve the results they want and often give up too soon.  Biofeedback helps you perform these exercises in a manner that is truly engaging the muscles of the pelvic floor.  In addition, you will be able to measure your progress and determine the strength of your Kegel contractions over time.  Biofeedback is an excellent tool that helps many women achieve positive results and is available through your Genesis Female Urology Specialist.

Vaginal Pessary

A vaginal pessary is a removable device placed in the vagina, similar to a diaphragm, to provide support to the pelvic structures and relieve pressure on the bowel and bladder. Pessaries do not cure pelvic organ prolapse but may help manage the progression of prolapse by adding support to the vagina.  If you are not candidate for surgery or other therapies, a vaginal pessary may offer an alternative.   A Genesis Female Urologist can help determine if a pessary will work for you.

Pelvic Organ Prolapse (POP) Repair

A variety of surgical approaches are used to repair and correct pelvic organ prolapse when other less invasive therapies are not effective.  Today, many surgical techniques are minimally invasive with procedures performed vaginally or occasionally via a small incision in the abdomen.  Native tissue, human tissue graft, xenograft and mesh graft are used to reinforce pelvic support structures. As with all surgeries – each technique has risks and benefits associated with the procedure.  

A Genesis Female Urology Specialist can help you evaluate the alternatives and determine what treatment option is best for you.

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