It's Time to Talk to Your Doctor about Pelvic Organ Prolapse

By Joseph Maccarone, MD, Urogynecologist—Virtua Female Pelvic Medicine 

Pelvic organ prolapse (POP) is a common condition affecting 1 in 3 women. It occurs when a woman’s pelvic organs drop downward due to a lack of support from the muscles and connective tissues in the pelvic floor. Although POP is rarely life threatening, it can cause discomfort, embarrassment and may even affect the way you go about your daily activities. 

Many women believe that POP is just a normal part of aging or childbearing and assume that they simply have to deal with the symptoms. But, in fact, POP can be treated successfully and safely—so there’s no reason to live with discomfort.

What causes POP?

The female pelvic floor is made up of muscles and connective tissues that hold up the vagina, cervix, uterus, bladder, urethra, intestines and rectum. When these tissues and muscles are weakened, stretched, torn or damaged, they can’t provide proper support to these organs. As a result, the organs can sometimes drop downward and out of their proper position. 

Who’s at risk for developing POP?

The risk of POP increases as women get older and after childbirth. Women who have had multiple vaginal deliveries or vaginal deliveries that required the use of instruments such as forceps or a vacuum have a higher risk for developing POP. Other risk factors include: 

• Family history: Your mother or other women in your family have a history of POP.
• Injury: You had a pelvic floor injury caused by a fall or other accident or had a pelvic surgery, such as a hysterectomy.
• Smoking: You’re a smoker, as this can contribute to chronic coughing and lead to weakened connective tissues in the pelvic floor.
• Lifting and overuse: You have stressed your pelvic floor with repeated, strenuous activities or heavy lifting.
• Chronic constipation/straining: You’ve experienced chronic constipation and straining with bowel movements.
• Weight: You’re overweight or obese. 

What are the symptoms of POP?

Many women who have POP have no noticeable symptoms. But, one of the most commonly reported symptoms is a bothersome feeling of pressure or fullness in the vagina. Vaginal dryness/irritation and pain with intercourse also are common. 

However, POP can affect women differently. For example, some women experience urinary symptoms, such as leakage (also called incontinence), frequent urinary tract infections, frequently urinating, difficulty urinating or difficulty emptying their bladder. Other women may experience bowel symptoms, such as straining or needing to push on the vagina to have a bowel movement. 

In severe cases of POP, you may be able to see or feel tissue coming out of your vagina. Although this may be frightening, it’s only dangerous if you also are unable to empty your bladder or bowels. Nonetheless, you should be sure to see a doctor as soon as possible if this happens to you. 

How is POP treated?

There’s a variety of safe, effective ways to treat POP—and talking to your doctor is the first step toward finding the right treatment for you. Although many women find it difficult or embarrassing to talk about POP, you can rest assured that your doctor will treat you with respect, care and compassion. 

If you have a mild case of POP, your doctor may recommend that you try conservative treatment first, such as physical therapy or pelvic floor exercises that you can do at home. 

Your doctor also may recommend a pessary, which is a plastic device that’s inserted into the vagina to support the pelvic organs. Pessary options include: 

• Removable pessaries that are fitted by your doctor
• Over-the-counter removable pessaries
• Pessaries that can only be fitted and removed by your doctor 

If more conservative treatments aren’t effective or don’t meet your needs, your doctor may recommend surgery. During POP surgery, your doctor will use your own tissue or synthetic or biologic surgical mesh to support the pelvic organs. 

In many cases, POP surgery can be performed vaginally and without an abdominal incision. This means that you will experience less pain, faster healing and a reduced risk for infection or other complications. 

For POP surgery, experience counts

Although some women are fearful of POP surgery, it’s a safe and effective treatment option. Virtua has experienced, board-certified female pelvic medicine specialists with specific expertise in pelvic support surgery. 

If POP is affecting your quality of life, you don’t have to live with it—your doctor can help. 

Get more information about female pelvic medicine at Virtua, or call 1-888-847-8823 to schedule a consultation with a Virtua female pelvic medicine specialist. 

For more information about POP, visit Voices for PFD.

Updated April 10, 2018