So, what is the culprit behind pelvic organ prolapse (POP)? Well, many factors can cause our organs to drop or press into or out of the vagina or anus. These include aging, childbirth (especially multiple childbirths), menopause, genetics, heavy lifting, and obesity.
Fortunately, there are ways to manage and even reverse pelvic organ prolapse through pelvic floor therapy. This type of therapy involves learning and performing exercises specifically tailored to strengthen the pelvic muscles, which can help prevent prolapse from worsening.
Anatomy
Let’s review the anatomy of the female pelvic floor (though prolapse can be found in males as well). In this region, we have four key structures: the anus located in the back of the pelvis, the vagina in the middle, in front the urethra, and three organs- rectum, uterus, and bladder. It is also important to note that within the vagina there are two walls – anterior and posterior. Recognizing the different areas of this region allows us to identify various types of prolapses which can occur.
What causes a prolapse?
Situations of chronic, high intra-abdominal pressure can lead to pelvic organ prolapse. This is when the pelvic floor muscles, ligaments, and other supportive structures that play a crucial role in regulating intra-abdominal pressure are no longer able to effectively do their job. This may be due to pregnancy or childbirth, obesity, chronic coughing, or a variety of other causes.
When this happens, the pelvic organs can start to bulge down into the vagina, urethra, or rectum. This can cause various symptoms such as pain, discomfort, and even incontinence. In order to prevent further decline of pelvic floor function and pelvic organ prolapse, it is important to engage in pelvic floor therapy.
Treatment
At times, surgical intervention may be needed for more severe cases of pelvic organ prolapse. However, there are many conservative treatments available that can help alleviate symptoms and manage pelvic organ prolapse. These include pelvic floor therapy and sometimes the use of a pessary, which is an ideal treatment option for those who don’t want to undergo surgery. With the proper training and guidance, most patients can be fitted with a pessary and taught how to manage it for both short-term and long-term relief. Patient satisfaction is typically high with this kind of treatment, so pessaries can be an effective tool when managing prolapse.