If you have just given birth to a child or if you are entering into menopause, you may have noticed slight changes in your pelvic organs. In particular, you may notice that you are having trouble urinating properly or, you may be finding that sexual intercourse is quite uncomfortable, possibly even painful. If you are plagued by any of these symptoms, you may be suffering from a common pelvic problem, known as pelvic prolapse. Affecting up to one-third of all women, pelvic prolapse can be an embarrassing problem, however, there are now a number of effective treatment options available.
What is Pelvic Prolapse?
Pelvic prolapse occurs when the muscles inside of your pelvis begin to weaken. These muscles, often known as the "pelvic floor," provide support to various pelvic organs, including your vagina, uterus, bladder, and bowel. When these muscles weaken, they begin to lose their ability to support these organs, causing the organs to shift and press against one another.
Types of Pelvic Prolapse
There are actually a number of different types of pelvic organ prolapse.
- Cystocele: A cystocele occurs when the muscles in front of the vagina become weakened, allowing the bladder to push into the vagina.
- Rectocele and Enterocele: These prolapses occur when the muscles behind the vagina become weakened or damaged. When the rectum pushes into the vagina, it is known as a rectocele; when other areas of the bowel push into the vagina, it is known as an enterocele.
- Uterine Prolapse: A uterine prolapse occurs when the uterus and cervix descend from above and push down on the vagina.
- Vaginal Vault Prolapse: A vaginal vault prolapse occurs when the vagina begins to push on the pelvic muscles.
What Causes Pelvic Prolapse?
Pelvic prolapse is the direct result of weakened pelvic floor muscles. These muscles can become weakened for a number of reasons, including:
- hormonal fluctuations (such as those occurring during menopause)
- vaginal child birth
- hysterectomy and other types of pelvic surgery
Who's At Risk for Pelvic Prolapse?
Though any woman can develop pelvic prolapse, certain women are at increased risk for the condition. Risk factors include:
- being overweight (because excess weight adds stress to the pelvic floor muscles)
- smoking (smoking causes chronic coughing which can stress the pelvic muscles)
- having one or more vaginal deliveries
- entering into menopause (the hormonal changes of menopause weaken the pelvic floor muscles)
What are the Symptoms of Pelvic Prolapse?
Typically, pelvic prolapse is accompanied by a variety of symptoms. However, many women do experience mild prolapses without even being aware of it. Symptoms often include:
- pain during sexual intercourse
- difficulty emptying your bladder
- chronic constipation or difficulty finishing a bowel movement
- back pain
- tissue bulging through the vagina
- sensation that you are sitting on something
Complications of Pelvic Prolapse
If you are experiencing symptoms of pelvic prolapse, it is important to address the problem as soon as possible. If left untreated, pelvic prolapse can worsen, leading to several health complications, including:
- stretching of the bladder (due to failed emptying)
- kidney damage
- vaginal or uterine infection
Treating Pelvic Prolapse
There are a number of different ways to treat pelvic prolapse. Depending upon the type of prolapse you have and its severity, particular treatments may be more effective for you.
Kegel exercises are recommended for women with mild pelvic prolapse. These exercises can help to strengthen your pelvic floor muscles and prevent any further prolapse of your pelvic organs. Kegel exercises are simple to perform, requiring no equipment and little time and effort. All you have to do is squeeze your pelvic muscles, as if you were trying to stop your flow of urine. When performed daily for at least six months, kegel exercises have been shown to effectively reduce the severity of most types of pelvic prolapse.
Women who have mild to moderate pelvic prolapse may find pessaries helpful when it comes to managing their symptoms. Pessaries are an excellent treatment alternative when surgery is undesired. They work from within to support the uterus and other pelvic organs. They are made out of silicone and look much like a diaphragm. Pessaries need to be fitted by your health care provider, but you can insert and remove them in the comfort of you own home. Pessaries can last for up to five months, and help to relieve symptoms of pain and urinary incontinence. However, regular use of a pessary can increase your risk of infection
Surgery is often required to treat more serious types of pelvic prolapse. Surgery aims to return the shifted organ to its proper place as well as reinforce the pelvic floor. Surgery often involves anchoring the pelvic muscles by stitching them into place. It may also involve reinforcing stretched muscles with sutures or staples. Surgery can be performed abdominally, via laparoscopy (through small incisions in the pelvic region), or vaginally. When performed correctly, surgery can be up to 90% effective at curing pelvic prolapse.