Pelvic Prolapse
The muscles and connective tissues of the pelvic floor typically hold the pelvic organs in place. However, sometimes due to weakening of those muscles and tissues, pelvic organs can drop from their position. This results in a bulge in the vagina, called a prolapse.
The good news is, pelvic organ prolapse can be treated. Sometimes surgery might be needed to put the pelvic organs back in place; however, there are many nonsurgical options as well.
Symptoms of Pelvic Prolapse
These symptoms are common:
- Recurrent urinary tract infections
- Urinary urgency and frequency
- Feeling or seeing a bulge coming from your vagina
- Painful intercourse (dyspareunia)
- Difficulty emptying the bowel and/or bladder
- Constipation
- Increased pressure in the pelvis
- Lower back or pelvic pain
Causes of Pelvic Prolapse
Women who have had children, especially with vaginal deliveries, are at higher risk of developing pelvic prolapse. Advancing age is also a factor.
Other risk factors include:
- Family history of the condition
- Obesity
- Hysterectomy,
- Other conditions that increase intra-abdominal pressure, such as asthma or constipation
Diagnosing Pelvic Prolapse
When you visit Colorado Springs Urological Associates, your doctor will ask about your medical history and perform an exam focused on the abdomen and genitalia.
Your provider may also recommend these tests:
- Urinalysis: This test looks for any blood in the urine or infection.
- Post-void residual: You’ll be asked to urinate, then checked to make sure you are emptying your bladder.
- Cystoscopy: LINK to Treatments/Cystoscopy Your physician inserts a small scope into the urethra/bladder.
- Urodynamic testing:LINK to Treatments/Urodynamics In cases where there is urine retention or severe urgency, this test is used to measure your bladder function. A small catheter is inserted into your bladder to monitor bladder pressure and activity.
Treating Pelvic Prolapse
Depending on the cause and severity, there are both non-surgical and surgical treatments available.
Non-surgical Treatments
- Pelvic floor muscle exercises (i.e., Kegel exercises) to strengthen these muscles.
- Pessaries: A medical device inserted into the vagina used to provide structural support.
- Activity modification: Your physician may recommend activity modification such as avoiding heavy lifting or straining.
Surgical Treatments
- For sexually active women a vaginal surgery can be performed using their own vaginal tissue to rebuild pelvic floor support. Often, a more robust operation performed robotically through the abdomen is offered to support the vagina to the sacrum (tail bone) using synthetic mesh. Vaginal mesh procedures are less commonly performed due to safety concerns.
- For women who are not sexually active or who are at high surgical risk (due to age or medical history) a simple surgery to close the vaginal opening can be performed.
