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Weekend Doctor Column: Pelvic Organ Prolapse

By Aubrey Marcum, PA and Lorie Thomas-Schultz, DO, Blanchard Valley Obstetrics & Gynecology

Have you started to notice something bulging at the opening of your vagina? Have you noticed changes with how your bladder functions or difficulty with intercourse? If you answered yes to either of these questions, then you may be experiencing a very common problem called pelvic organ prolapse. Pelvic organ prolapse is basically a hernia of the pelvic organs to or beyond the vaginal walls. 

There are a number of things that can contribute to this type of prolapse. Pregnancy and childbirth can cause stretching and weakness of the vaginal tissue and muscles that support the bladder. Menopause can contribute due to a decrease in the hormone estrogen that helps to maintain tissue and muscle support of the vagina. Frequent straining, such as heavy lifting, chronic constipation or chronic cough can cause weakness in the tissues of the vagina that support the bladder. 

Symptoms of prolapse may include a bulge of tissue at the opening of the vagina, difficulty or pain with intercourse, urinary symptoms (such as leaking, frequency, urgency, difficulty emptying or more frequent urinary tract infections), low back pain or pelvic pain or pressure. 

Treatment of the prolapse depends on how much it is bothering you. Patients that have no symptoms may not require any treatment. 

For patients who are symptomatic, there are nonsurgical and surgical options for treatment. Nonsurgical options include Kegel exercises, pelvic floor physical therapy, vaginal estrogen treatment or placement of a pessary. If conservative options fail or symptoms are more severe, then surgery may be recommended. There are different surgical options that are individualized to the specific patient’s needs. 

If you are wondering if you might have pelvic organ prolapse, we would encourage you to discuss your symptoms with your gynecologist as they will be able to diagnose and treat your symptoms.

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