Pelvic support problems occur when the tissues that support the pelvic organs are stretched and damaged. This damage causes the organ(s) that are supported to drop down and press against the wall of the vagina. This causes a bulge (prolapse). Sometimes the organ will drop down so much that the bulge sticks out through the vaginal opening. The pelvic organs include the vagina, cervix, uterus, bladder, urethra, small intestines and rectum.
Risk factors for pelvic prolapse include difficult childbirth, multiple childbirths, obesity, abdominal or pelvic tumors, increased intra-abdominal pressure from coughing, or constipation. Heavy lifting, aging and inherited weakness of the tissue can also increase risk of pelvic prolapse.
Types of prolapse include uterine prolapse, vaginal vault prolapse (especially after a hysterectomy), cystocele (bladder), urethrocele (urethra), enterocele (small intestine), rectocele (rectum).
Symptoms of pelvic organ prolapse may include: feeling pelvic heaviness or fullness, bulge in vagina, pulling or aching feeling or pressure in the lower abdomen or pelvis, low back pain, urinary incontinence (leakage of urine), constipation, sexual difficulties, trouble inserting tampons or vaginal applicators for medication. Often pelvic pressure symptoms worsen with standing, lifting, coughing or as the day progresses.
Diagnosis of pelvic organs prolapse includes a pelvic examination to determine the organs involved and the extent of the prolapse.
Treatment of pelvic organ prolapse depends on the type of prolapse, the severity of symptoms, a woman’s age, other medical conditions, the desire for future pregnancy, and sexual activity. No treatment may be needed in asymptomatic women. In mild cases, pelvic floor (Kegel) exercises may be performed to strengthen the muscles of the pelvic floor. A pessary (such as a rubber ring or cube) may be chosen to be placed in the vagina to support the pelvic organs. Surgical procedures may be necessary in more severe cases of prolapse. Lifestyle changes such as weight loss or high fiber diet may also be recommended. Medications may be prescribed to treat constipation, control overactive bladder complaints, or hormone therapy to improve the quality of vaginal and pelvic tissue. Finally, many women suffer from pelvic support problems. If you are having symptoms, seek evaluation and treatment from your healthcare provider.