Pelvic Organ Prolapse

The organs within a woman’s pelvis (uterus, bladder and rectum) are normally held in place by ligaments and muscles known as the pelvic floor. The pelvic organs can bulge (prolapse) from their natural position into the vagina. When this happens it is known as pelvic organ prolapse. Sometimes a prolapse may be large enough to protrude outside the vagina.

Key Points

    • Prolapse is very common. Mild prolapse often causes no symptoms and treatment is not always necessary.
    • Prolapse can affect the quality of life by causing symptoms such as discomfort or a feeling of heaviness. It can cause bladder and bowel problems, and sexual activity may also be affected.
    • How severe your symptoms are and whether you choose to have surgery will depend on how your prolapse affects your daily life.
    • Surgery for prolapse aims to support the pelvic organs and to help ease your symptoms.

Different Types of Vaginal Prolapse

There are several types of prolapse that have different names depending on the part of the body that has dropped.

    • Cystocele. The bladder drops into the vagina.
    • Enterocele. The small intestine bulges into the vagina.
    • Rectocele. The rectum bulges into the vagina.
    • Uterine Prolapse. The uterus drops into the vagina.
    • Vaginal Vault Prolapse. The top of the vagina loses its support and drops.

Symptoms

Symptoms of POP can come on gradually and may not be noticed at first. A health care professional may discover a prolapse during a physical exam. Women with symptoms may experience the following:

    • Feeling of pelvic pressure or fullness
    • Bulge in the vagina
    • Organs bulging out of the vagina
    • Leakage of urine (urinary incontinence)
    • Difficulty completely emptying the bladder
    • Problems having a bowel movement
    • Lower back pain
    • Problems with inserting tampons or applicators

Surgical Options for Management of Prolapse

    • Fixation or suspension using your own tissues. It is performed through the vagina. The prolapsed part is attached with stitches to a ligament or to a muscle in the pelvis. A procedure to prevent urinary incontinence may be done at the same time.
    • Colporrhaphy—Used to treat prolapse of the anterior (front) wall of the vagina and prolapse of the posterior (back) wall of the vagina. This type of surgery is performed through the vagina. Stitches are used to strengthen the vagina so that it once again supports the bladder or the rectum.
    • Sacrocolpopexy—Used to treat vaginal vault prolapse and enterocele. Dr. Byrne performs this procedure with small incisions using the Da Vinci Robot. Surgical mesh is attached to the front and back walls of the vagina and then to the sacrum (tail bone). This lifts the vagina back into place.
    • Obliterative surgery narrows or closes off the vagina to provide support for prolapsed organs. Sexual intercourse is not possible after this procedure.

Evaluation with Dr. Byrne

Dr. Byrne offers offers comprehensive evaluation, management, and treatment options for female urinary and pelvic floor dysfunction.

About 50% of women will develop some form of pelvic floor dysfunction in their lives. This bulge often worsens over time.

Dr. Byrne focuses on improving patient quality of life with complete evaluation leading to the treatment plan that is right for each individual patient.

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