Pelvic Organ Prolapse

A common issue in our ageing population

Pelvic Organ Prolapse (POP) happens when the muscles and tissues supporting the pelvic organs become weak or loose.

Imagine the pelvic muscles and tissues holding up the pelvic organs like a hammock; when these muscles and tissues degenerate, they are unable to support these organs and prolapse (droop) occurs. This causes one or more pelvic organs to drop beyond its normal position into the vaginal opening.

The type of pelvic organ prolapse depends on the organ in question:

Cystocele
(Dropped bladder)
This occurs when the bladder drops into or out of the vagina. It is the most common type of POP.

Rectocele
(Dropped rectum)
This happens when the rectum protrudes into or out of the vagina.

Uterine prolapse
(Dropped uterus)
This happens when the uterus bulges into or out of the vagina.

Common Causes of Pelvic Organ Prolapse

Natural childbirth
Multiple vaginal deliveries stretch and strain the pelvic floor, in turn causing pregnancy-related prolapse.

Ageing
The prevalence of pelvic floor disorder increases with age due to the weakened pelvic muscles and tissues.

Constant abdomen pressure
Chronic coughing, asthma, constipation or obesity put pressure on and worsen the damaging of the pelvic floor.

Signs of Pelvic Organ Prolapse

  • Feeling a bulge or lump in the vaginal canal
  • A dragging heaviness or fullness in the vagina
  • Experiencing pain during sexual activity
  • Urinary or bowel difficulties
  • Pelvic pain and discomfort
  • Lower backache and abnormal vaginal discharge or bleeding

Diagnosis and Treating Pelvic Organ Prolapse

In our rapidly ageing population, POP is becoming increasingly common. If your symptoms interfere with your daily activities and affect your quality of life, it is best to seek treatment. Your doctor may ask about your symptoms and conduct a physical examination including a pelvic examination.

The treatment given will depend on your age, type and severity of prolapse, any other underlying health problems, and whether you are sexually active. Your treatment may include one or more of the following:

Lifestyle & diet
Adjusting your diet and doing frequent exercise to encourage weight loss can help to reduce pressure on your pelvic floor and thus reduce your symptoms and improve overall health.

Pelvic floor exercises
Designed to help strengthen the pelvic floor muscles, pelvic floor exercises a.k.a Kegel exercises, are ​home based exercises that can reduce or stop prolapse symptoms.

Pessary
For patients who do not prefer surgery or are found to be medically unfit for surgery, a vaginal ring called ‘pessary’ can be inserted into the vagina to relieve bladder and bowel pressure. Made of either plastic or silicone, pessaries are small devices that provide support to the prolapsed pelvic organs. These rings would have to be changed every 3-4 months to prevent infections.

Fotona Erbium Laser
This non-invasive treatment uses a Fotona Erbium laser to treat pelvic organ prolapse and/or urinary leakage.

Pelvic Floor Repair
Surgery involves reconstruction of the pelvic floor together with a return or removal of the prolapsed organ.

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