Finding Security with your Pelvic Organ Prolapse
“Do I have pelvic organ prolapse?”
“Is my uterus falling out of my body?”
“I feel a bulge and heaviness … what do I do?”
“I’ve been told I have a prolapse ... Do I have to have surgery?”
Despite approximately 50% of women over 50 having some degree of prolapse, pelvic organ prolapse (POP for short) is surrounded by misinformation and misconceptions. This can make the experience of living with pelvic organ prolapse scary, isolating, and confusing. As such, women often do not seek out the medical care they need or even know the appropriate healthcare professionals to assess their prolapse and treat their symptoms.
Types of Pelvic Organ Prolapse
Originally, when I thought of pelvic organ prolapse, I imagined the uterus “falling out” of the vagina. In reality, a pelvic organ prolapse can look and be very different depending on the type of prolapse it is and its’ grade. Pelvic organ prolapse happens when your muscles and ligaments that support your pelvic organs are weakened, allowing your bladder, rectum, uterus, and/or urethra move out of place and slip into the vagina.
Here is a list of the different types of pelvic organ prolapse:
Cystocele:
Occurs when the bladder descends into your vagina
Most common type of prolapse (3x more common than a uterine prolapse)
Also known as an anterior vaginal wall prolapse
Urethrocele:
The urethra presses against the front wall of the vagina
Also known as an anterior vaginal wall prolapse
Rectocele:
The wall between the rectum and the vagina weakens, allowing your rectum to bulge into your vagina
Also known as a posterior vaginal wall
Uterine Prolapse:
The uterus drops down into the vagina due to pelvic floor muscle and tissue weakness
Vaginal Vault Prolapse
Can occur after having a hysterectomy
The top of the vagina drops down into the lower part of the vagina
Grades of Pelvic Organ Prolapse
Many terms, like bulge, lump, or heaviness, associated with pelvic organ prolapse are non-specific. This can make it hard for people with pelvic organ prolapse to know exactly what is going on in their body. For this reason, being familiar with not only the types or pelvic organ prolapse but also the grade or stages of prolapse is important for you to be your best advocate.
The gold standard of pelvic organ prolapse measurement is the Pelvic Organ Prolapse Quantification System (POP-Q).
Image from https://imuathena.wordpress.com/2021/02/08/pelvic-organ-prolapse/
I feel a bulge and heaviness down there … What do I do?
If you think you have a prolapse … do not panic! A pelvic organ prolapse is not dangerous or an emergency. However, it is good to be aware of, so you can receive the proper support and treatment. Healthcare professionals you can talk to include a general practitioner, ob-gyn, urogynecologist, and a pelvic floor therapist. When you are assessed for a pelvic organ prolapse, make sure they perform an examination laying down, standing up, and without a speculum to ensure there are no obstructions or barriers to performing a proper assessment.
IMPORTANT NOTE: While a pelvic floor therapist cannot diagnose a prolapse, they are the experts in treating the pelvic floor! If you suspect you have a pelvic organ prolapse, a pelvic floor therapist can provide you with exercises, education, and strategies to treat your prolapse and it’s symptoms. It is also common for your ob/gyn to miss the extent of your prolapse because they assess in supine. At The Perinatal Pelvis we look at what your prolapse does during functional mobility.
Contact Kyrsten Spurrier, OTR/L at The Perinatal Pelvis if you have any questions about pelvic organ prolapse and what options are available to you!
Resources:
https://imuathena.wordpress.com/2021/02/08/pelvic-organ-prolapse/
https://theflowerempowered.com/knowledge-portal/pelvic-organ-prolapse/pop-q-measurement/
