Pelvic Organ Prolapse – Prevention and Management

What is it?

POP is the descent of the pelvic organs from their normal position into the vaginal canal. This happens when the supporting tissues (pelvic floor muscles and connective tissues) weaken, and one or more organs then drop into the vagina. These are the different types:

• Cystocele – when the bladder bulges into the front wall of the vagina (most common type)
• Urethrocele – when the urethra (the tube for draining urine) bulges into the front wall of the vagina
• Uterine Prolapse – when the uterus drops down into the vaginal canal
• Vaginal Vault Prolapse – when the top of the vagina loses its support and drops
• Enterocele – when the small intestine bulges into the vagina
• Rectocele – when the rectum bulges into the back wall of the vagina

How can it be prevented?

As POP can be caused by multiple factors, there is no single strategy to prevent the development of this condition. We cannot change the genetic risk of POP (which impacts the strength of the connective tissue); however, we can modify several lifestyle choices to help reduce the risk of developing POP.

• Pelvic Floor Exercises – daily exercise of the pelvic floor will improve the strength and endurance of this important muscle group. This muscle group acts as a hammock to support the pelvic organs. Regular exercise may also decrease the symptoms of POP and limit the worsening of this condition.
• Regular Bowel Movements – a high fiber diet with plenty of water and other fluids will help to keep you regular. Chronic straining and constipation can increase the risk of developing POP.
• Maintain a Healthy Body Weight – being overweight can increase the risk of developing POP.
• Quit Smoking – smoking can increase the risk of developing POP.
• Get a Health Check-Up – seek help if you have a chronic cough or chronic constipation. These conditions will increase your intra-abdominal pressure and may lead to developing POP. There may be multiple treatment options that can help you.

How can it be treated?

If you think you may have a POP, check in with your doctor and book an assessment with a pelvic floor physiotherapist. Pelvic floor exercises can significantly improve the management of your symptoms and prevent this condition from worsening. Your doctor may also recommend seeing a gynecologist for a pessary. A pessary is a silicone medical device that is placed inside the vagina to support the pelvic organs. It is fitted specifically to you and is removable. In severe cases, surgery may be recommended and would be determined after a consult with a specialist.

References:

https://www.health.harvard.edu/womens-health/what-to-do-about-pelvic-organ-prolapse

https://my.clevelandclinic.org/health/diseases/24046-pelvic-organ-prolapse

https://www.acog.org/womens-health/experts-and-stories/the-latest/5-things-i-wish-all-women-knew-about-pelvic-organ-prolapse