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Pelvic Organ Prolapse Symptoms & Treatment
“Pelvic relaxation may sound like something pleasant but that is definitely not the case,” says McLeod Gynecologist, Dr. John Browning. “The phrase is another way of describing pelvic organ prolapse – or the failure of a woman’s body to support the uterus. At its worst, the condition can result in a woman’s uterus, bladder, small bowel, and even the rectum protruding from her vagina and cervix. Thank goodness there are a number of ways to solve this problem.”
Causes. Multiple vaginal births, obesity, aging and high impact activities or chronic straining due to constipation are among the risk factors and causes for pelvic relaxation. Women as young as 20 can experience some of these conditions.
Pelvic organ prolapse develops in three different ways.
Uterine Prolapse. The uterus drops down in the vagina.
Anterior (front) Wall Prolapse. In these cases the bladder or urethra (the tube carrying urine) pushes into the vaginal wall from the front.
Posterior (back) Wall Prolapse. The rectum or intestines can detach and fall into the vagina from the back.
Symptoms. Most women with prolapse will feel discomfort. It may be difficulty urinating or loss of control of bowel movement. Pressure in your pelvis is also a sign. Women describe this as “a feeling of fullness” or “sitting on a small ball.” Pain during intercourse or low back pain and difficulty walking are also signs of the problem.
Pelvic organ prolapse may develop very slowly. Your doctor may discover the prolapse before you even feel any symptoms. However, if the condition has gone untreated, the uterus may be clearly visible outside the vagina. And the person may experience a lot of discomfort or pain.
Treatments. If the problem is caught early enough – often during an annual GYN exam – the physician might suggest exercises to strengthen the pelvic muscles. “Kegels” are one of the commonly recommended exercises. You can ask your gynecologist for instructions. For postmenopausal women, estrogen hormone cream may be prescribed.
Women, who are poor surgery candidates or who may not want immediate surgery, can be fitted with a pessary – a device that supports the organs. Similar in appearance to a diaphragm or cervical cap, a pessary can be inserted during a doctor’s office visit but should be cleaned and checked at regular intervals by your physician.
About 1 in 10 women experiencing pelvic organ prolapse requires surgery to correct her problem. The surgeon will reconstruct the pelvic region. Today, most surgery is performed through the vagina, although some surgeries are performed laparoscopically through a small incision in the abdomen.
Organs will be repositioned and secured to ligaments and tissues with a few surgical stitches. Post-menopausal women may have their uterus removed (a hysterectomy) as part of the corrective surgery.
Final Thought. Although the “pelvic relaxation” may not – in the end – be a comfortable situation, you can rest assured that there are a number of very effective ways to treat and correct the condition. The first step is reporting these signs and symptoms to your physician and seeking answers to improve quality of life.
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Sources include: McLeod Health, American Urogynecologic Society, Harvard Family Health Guide, Nurse Midwifery, Landsforeningen for Kvinner med Bekkenlosningsplager, Reproductive Medicine, Christine Gerber MD, Journal of Incontinence & Pelvic Floor Dysfunction