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Pelvic Organ Prolapse Diagnosis & Treatment

Diagnosing pelvic organ prolapse

Your health care provider may take several steps to diagnose pelvic organ prolapse. They will start by taking your medical history, asking about your symptoms, pregnancies, childbirth and other risk factors.

They will examine you to determine the position of your pelvic organs and identify signs of prolapse. They may ask you to bear down or strain to evaluate how severe prolapse is and how strong your pelvic floor muscles are.

Your provider may perform the pelvic organ prolapse quantification exam (POP-Q). This test is a specific way to measure how severe POP is. It involves measuring points along the wall of the vagina and the pelvic organs with instruments. 

Results are on a scale of 0 (the organs haven’t moved) to 4 (an organ bulges outside your body). The results help guide treatment decisions and monitor how your condition is changing over time.

Your provider may also recommend bladder function tests and imaging tests such as ultrasound or MRI to better visualize the position of the pelvic organs.

Treating pelvic organ prolapse

To treat POP, your provider may recommend exercises, lifestyle changes, medical devices or surgery depending on the type of prolapse you have, how severe it is, your overall health and your preferences. You may want to see a provider who specializes in pelvic floor disorders.

Exercises

Pelvic floor exercises can strengthen the muscles that support the pelvic organs. If you do them regularly, they can help reduce symptoms such as pressure and urinary incontinence. Consult a pelvic health specialist or physical therapist to learn how to perform these exercises properly.

Lifestyle changes

Lifestyle changes that may help include staying at a healthy body weight, quitting smoking, avoiding heavy lifting and practicing good bowel habits to help prevent constipation.

  • When you’re lifting heavy objects, bend at the knees and hips rather than the waist and engage the core muscles to support the lower back and pelvis. If something is too heavy for you to lift, ask for help.
  • Choose a healthy, balanced diet high in fiber and drink plenty of water to help promote regular bowel movements and prevent constipation.
  • Avoid straining during bowel movements, which can put pressure on the pelvic floor muscles. If you need to have a bowel movement, don’t delay.

Medication and medical devices

Vaginal estrogen may be an option if menopause is contributing to POP.

A pessary is a removable device you can insert into the vagina that helps support your pelvic organs and reduce symptoms. Pessaries come in various shapes and sizes, and a health care provider can find one that fits best for you. Pessaries can be effective if you prefer not to have surgery or you’re not a candidate for surgery.

Surgery

Several different surgeries can help treat POP:

  • Anterior and posterior repair (colporrhaphy): This surgery involves tightening and reinforcing the front (anterior) and back (posterior) vaginal walls to repair weak tissue and support the pelvic floor. It may be useful for bladder or rectum prolapse.
  • Uterine suspension (hysteropexy): In this procedure, the uterus is lifted and secured to its normal position within the pelvis. It’s usually performed with minimally invasive techniques, and it may be a good choice for women who want to maintain their fertility.
  • Sacrocolpopexy: This procedure uses synthetic mesh or tissue grafts to attach the top of the vagina to the tailbone (sacrum). It’s an effective treatment option for moderate to severe pelvic organ prolapse.

Surgery recovery depends on the procedure you had and your overall health. In general, you can expect some discomfort, swelling and limited mobility in your pelvic region after surgery.

Your health care provider can explain how to care for your incision, how to treat pain and when you can return to your normal activities. It may take several weeks or months to recover fully. 

Pregnancy and pelvic organ prolapse

If the pelvic floor muscles and ligaments are weak, it could affect pregnancy and childbirth. Hormonal changes and increased pressure in your abdomen during pregnancy could also make pelvic organ prolapse worse.

Vaginal childbirth, especially if it involves a lot of pushing or a traumatic delivery, can weaken the pelvic floor. But with good care and pelvic floor exercises, many women can manage POP during and after pregnancy.

Emotional support and coping strategies

Dealing with POP can be difficult. You may want to join a support group or online community to connect with others who understand your experiences and challenges. In a support group, you can share concerns, ask questions and get encouragement and support. Hearing other people’s stories can help you feel less alone.

You may also want to see a mental health provider to help you process your emotions, develop coping strategies and navigate the challenges that can come with pelvic floor disorders.

It’s important that you communicate openly and honestly with your health care providers, so you get the support and guidance you need. Discuss your concerns, questions and treatment options and ask for clarification and more information whenever you need to.

Final thoughts

Pelvic organ prolapse is when the pelvic floor muscles are weak or damaged, so the organs shift out of place. It’s a common condition in women, but many don’t seek treatment. Getting care can relieve your symptoms and improve your quality of life.