Pelvic Organ Prolapse (POP)

By Dr. John F. McNamara Jr., MD, Randolph OB/GYN

Pelvic Organ Prolapse (POP) causes symptoms due to prolapse (falling down) of various pelvic organs and structures when a woman is in certain positions, usually when standing or exercising. This can include:
• Uterine prolapse
• Bladder prolapse
• Vaginal prolapse
• Rectal prolapse

Symptoms can include vaginal bulging, pelvic pressure, bleeding/discharge/ infection, low backache, splinting or digitation.

Vaginal bulging, pelvic pressure and backache are direct results of the prolapse. Bleeding, discharge or infection can come from the prolapsed organs being exposed to the outside environment, such as rubbing on undergarments. Splinting (stopping midway) with urination or defecation may require digitation (pushing in the bulge) in order to urinate or defecate completely.

One can also get symptoms of sexual dysfunction including painful intercourse (either superficial or deep), obstructed intercourse (vaginal penetration is not possible due to obstruction) or vaginal laxity (vagina is not firm).

One can also have urinary, fecal, or flatal (gas) incontinence (involuntary loss), incomplete emptying, constipation and pain.

Treatment

There are three choices of treatment.

1. No therapy - One can simply live with these symptoms. With rare exceptions there is no physical harm caused by pelvic prolapse, although it may be uncomfortable or at times embarrassing.

2. Pessary - These are devices (typically shaped like a plug or cup) that one is fitted for by the doctor, which is inserted into the vagina to mechanically “hold things up.” The style and type varies depending upon the type of prolapse. How often one removes it determines the chances of infection and erosion from its use.

3. Surgery - Surgical options vary. An experienced pelvic surgeon is important. In general I do not recommend use of mesh except in very specific circumstances (see related article here). Possible use of mesh includes when a prior operation has failed, when there is no tissue to repair, and certain defects which have a high risk of failure without the use of mesh (some as high as 40+%).

Learn More About Pelvic Organ Prolapse
If you have symptoms of pelvic organ prolapse or would like to learn more about your options, schedule an appointment with me or other skilled physicians at Randolph OB/GYN using our online contact form or calling 704-333-4104.