Pelvic Organ Prolapse

Uterine Prolapse, Vaginal Vault Prolapse, Cystocele, Urethrocele, Rectocele, Enterocele

The pelvic floor is composed of a group of muscles, ligaments and supporting tissues that form a sling, which holds the pelvic organs in place. The pelvic organs include the vagina, cervix, uterus, bladder, bowel and rectum. Pelvic Floor disorders are a group of disorders causing abnormal bowel and urinary function, as well as pelvic pain. These disorders are common among women and are strongly linked to pregnancy, childbirth and aging. These disorders include urinary and anal incontinence, overactive bladder, stress incontinence, constipation, pelvic organ prolapse, sexual dysfunction, and complications from previous surgeries. Pelvic Organ Prolapse (POP) is among these pelvic floor disorders and may be associated with some forms of incontinence. UT Urology operates a comprehensive clinic dedicated to the evaluation and management of all pelvic floor disorders, and specifically overactive bladder. These conditions affect millions of women who suffer from the physical and emotional effects in silence.

What Is Pelvic Organ Prolapse?

When the pelvic floor supporting tissues and muscles become weak, torn or stretched, the lack of support can cause the pelvic organs to drop (prolapse) from their normal position. Many women have some degree of prolapse, but not all women have symptoms. There is often discomfort or pain, pressure, urine leakage, constipation and sexual dysfunction, which often impact a woman’s quality of life. One in three women will experience a pelvic floor disorder in her lifetime. 

What Causes Pelvic Floor Disorders Including Prolapse?

Weakness or injury to the pelvic floor muscles and nerves due to pregnancy, labor, childbirth, aging, hormonal problems, injury, surgery, pelvic fractures and some muscle and nerve diseases. Prolapse can also result from menopause, obesity, chronic straining, chronic constipation or heredity. Pelvic floor prolapse runs in families. Some diseases that affect the connective tissue may lead to pelvic floor dysfunction and prolapse. Diseases that affect the nerves that control the pelvic floor include diabetes, Parkinson’s disease, stroke, back surgery, and spinal stenosis. The risk increases after bearing children and as we age. 

What Are the Symptoms of Pelvic Organ Prolapse?

• A sense of pulling or dragging feeling in the vagina or lower back
• Feeling a lump or bulge in the vagina
• Pressure in your pelvis or vagina
• Urinary symptoms include urgency of urination, frequency of urination, incomplete urination and stress incontinence
• Bowel symptoms include difficulty moving the bowel, incomplete bowel emptying and leaking stool
• Discomfort during sexual intercourse
• Being unable to use a tampon
• Lower back discomfort
• Urinary leaking during intercourse

How Is Pelvic Floor Dysfunction Diagnosed?

Your urologist will evaluate your symptoms and medical and obstetric history, conduct a physical exam, and perform various tests based on your symptoms and the physician’s suspicions of what may be causing your symptoms.

Types of Pelvic Floor Prolapse

There are four main types:

• When the wall between the bladder and vagina weakens, the bladder can fall in to the vaginal canal. (Cystocele or Urethrocele)
• When part of the rectal wall protrudes into the vagina (Rectocele)
• Small bowel may herniate into the vaginal wall (Enterocele)
• Uterine Prolapse

Treatment Options for Pelvic Organ Prolapse

Treatment depends on the type of prolapse. The goal is to restore quality of life. If the prolapse is not severe, lifestyle changes can help. Your urologist will advise you on steps to take to support pelvic health. Pelvic floor exercises (Kegel exercises), biofeedback, and hormone replacement therapy may help. Pessaries are devices that can be inserted into the vagina to support the pelvic organs to help reduce symptoms. If pessary use is uncomfortable, there are several surgical techniques available.

Pelvic Floor Dysfunction and Pelvic Reconstruction Surgery

Our urologists are experts in pelvic flood dysfunction and pelvic reconstructive surgery. We offer access to the most current diagnostic and therapeutic approaches for Overactive Bladder.

For prolapse, minimally invasive surgeries through the vagina, or abdominal wall using laparoscopy are available. Our goal is to restore healthy normal pelvic floor anatomy and function. The urologists at Erlanger Urology are specialists in addressing all facets of prolapse including incontinence and voiding dysfunction that may coexist with prolapse. We have experts in this area with advanced fellowship training to provide you with all options available for pelvic floor disorders.

Erlanger Resources

Erlanger is on the forefront of urological and urogynecological therapies for women. The following resources are available for patients with these concerns.

Erlanger Urology

Erlanger Gynecological Services