Causes of Pelvic Organ Prolapse (POP)
Prolapse development can be attributed to the damage, stretching, and weakening of the support muscles and ligaments in the female pelvis. These support structures keep the bladder, rectum, small bowel, and uterus oriented in the appropriate position. Any event that results in damage to these structures can result in POP.
Types of POP
- Cystocele: Also known as "dropped or fallen bladder." It is the protrusion of the bladder through the front wall of the vagina.
- Rectocele: When the rectum protrudeds through the back wall of the vagina.
- Enterocele: When the small bowel protrudes through the upper portion of the vaginal wall.
- Uterine Prolapse: When the uterus protrudes downward into or out of the vagina.
- Vaginal Vault Prolapse: Where the upper part of the vagina turns itself inside out and protrudes into or out of the vagina. This occurs if the uterus is absent.
Diagnosis of POP
The diagnosis of POP does not require special diagnostic tests or procedures. A thorough history from the patient as to symptoms and what activities exacerbate the condition and what maneuvers help relieve it is the first step in the evaluation. A physical exam with the emphasis on the pelvis will be conducted. It is very difficult for the patient to distinguish one form of prolapse from another they simply notice they have developed a bulge in the vaginal area associated with some discomfort.
Symptoms of POP
- Bulge in the vagina or protruding out of the vagina
- Pelvic Pressure
- Low back pain
- Urinary problems (slow stream, Urinary Incontinence, Urinary frequency)
- Bowel problems (constipation, fecal incontinence)
- Painful intercourse
- Child Birth
- Pelvic Trauma
- Straining (Heavy Lifting, Defecation, Chronic Coughing)
- Prior surgery for POP