Pelvic Organ Prolapse Postpartum

Pelvic organ prolapse is downward descent of female pelvic organs. These organs include the bladder, uterus or post-hysterectomy vaginal cuff, and the small or large bowel, resulting in protrusion of the vagina, uterus, or both.

Your pelvic floor muscles play a role in holding up your pelvic organs from below. If your pelvic floor muscles are weak, then your pelvic organs might not be held in their right place. And as a result, they may bulge or sag down into the vagina.

The most consistent risk factors include:

1. Vaginal child birth
2. Advancing age
3. Increasing body-mass index

Patients generally present with several complaints, including bladder, bowel, and pelvic symptoms. However, with the exception of vaginal bulging, none is specific to prolapse.

If you are experiencing any symptoms please seek medical advice as you will likely need a pelvic examination and medical history check.

Factors for a Higher Risk of Prolapse

There is a strong genetic component so prolapse tends to run in families. It is more likely after menopause or if you are overweight.

Prolapse can also happen in young women right after childbirth.

About 50% all women who have had a child have some level of prolapse. Of this, only one in five women need to seek medical help.

Prolapse can also happen in women who haven't had a baby, mainly if they cough, strain on the toilet or lift heavy loads.

Did you know that even after surgery to repair prolapse, one in three women will prolapse again?

Types of Prolapse

Pelvic organs may bulge:

1. into the front wall of the vagina (cystocele)

2. through the back vaginal wall (rectocele or enterocele) or;

3. the uterus may drop down into the vagina (uterine prolapse). More than one of the pelvic organs may bulge into the vagina.

During the early stages you may not notice the signs of prolapse. This is where it is important to have your routine pap smear test as your doctor will be able to see it when you have this test.

Signs of a Prolapse You May Notice

If the prolapse bulges right outside your body, you may feel sore and bleed as the prolapse rubs on your underwear.

1. your bladder is not emptying completely
2. you have a weak urine stream
3. a heavy sensation in the vagina
4. something coming down' or a lump in the vagina
5. sexual problems
6. a lump bulging out of your vagina
7. recurring urinary tract infections
8. difficulty emptying your bowel.

Causes

By now, you will probably know that 'childbirth' is the main cause of a prolapse. This occurs because as the baby passes through the vagina, it can stretch and tear the supporting tissues and your pelvic floor muscles. The more vaginal births you have, the more likely you are to have a prolapse.

1. constipation
2. persistent coughing
3. lifting heavy weights

Prevention of Prolapse

Because a prolapse is due to weak pelvic tissues and pelvic floor muscles, you should keep your pelvic floor muscles strong. Now you know why I include a pelvic floor exercises in your workouts every week of your pregnancy!

Treatment of Prolapse

1. Surgery for Prolapse

Surgery can be done to repair torn or stretched support tissues and ligaments. There are different surgical options including:

1. vaginal approach
2. abdominal approach
3. laparoscopic (keyhole)
4. robotic

2. Non-surgical Options

1.Strengthening your pelvic floor muscles.

2. Making necessary lifestyle changes - diet, fluid intake, exercising, losing weight.

3. Avoid straining on the toilet.

Takeaway

Prolapse is common for mamas. The key is for you to do your pelvic floor exercises throughout your pregnancy and continue doing them after childbirth.