Q&A Topic: Pelvic Organ Prolapse
with Elisa Burns, MD, FACOG
Q. Do I have pelvic organ prolapse?
A. This non-life-threatening condition occurs in a woman when damage to the connective tissue and muscles holding up the vagina, uterus, and cervix causes these organs to prolapse, or drop, from their normal positions. It takes three forms: the combined prolapse of the uterus and cervix, prolapse of the vagina and bladder, and prolapse of the back wall of the vagina and rectum. The most common symptom is bulging tissue at the opening of the vagina. Some women suffer pelvic or back pain.
Q. Why does it occur?
A. Pelvic organ prolapse is mainly caused by vaginal delivery, during which connective tissue and muscles are stretched or torn. That’s why a large baby increases your risk, as do multiple births. Other risk factors include older age and genetic tendency, with white women at greater risk. Anything that causes you to continually put pressure on the pelvic region, such as obesity or a chronic cough, can elevate your risk. While nearly every woman who has delivered vaginally has some degree of pelvic organ prolapse, most women aren’t symptomatic. Typically detected through a routine manual gynecological exam, the condition can become merely intermittent, though it usually worsens over time. While bulging tissue can usually be pushed back into the vagina, it can be uncomfortable and interfere with normal activities.
Q. What are my treatment options?
A. Non-surgical remedies include Kegel exercises for strengthening the pelvic muscles. These are easy to do, and you’ll find instructions online. In addition, a pessary—a firmer diaphragm—can be used to hold up the dropped organ. A pessary must be regularly taken out and cleaned, and many women see a gynecologist every few months to have this done. Surgery for the condition restores the position of the prolapsed organs. It can be performed vaginally or abdominally, with the vaginal approach more common. Following surgery, there is a 20 percent chance of recurrence, though most women enjoy some symptomatic relief. Surgery involves an overnight hospital stay, and you’ll likely be back to your normal routine in two weeks. In choosing a surgeon, look for a board-certified gynecologist or urogynecologist, or a pelvic surgeon with experience in vaginal surgery.
Q. Can I prevent pelvic organ prolapse?
A. Maintaining a healthy weight reduces your risk, as does not smoking. The good news for women regarding this non-dangerous condition: You have time and you have many options. So you can calmly research the best option for you.
Northern Westchester Hospital
Director, Quality & Outcomes
Institute for Robotic & Minimally Invasive Surgery
Learn More About Dr. Burns
Learn more about treatment for pelvic prolapse
More from Dr. Burns: Robot-Assisted Gynecologic Surgery
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