4 Types of Pelvic Organ Prolapse and How They Are Treated

When an organ or tissue slips from its normal position, it’s called pelvic organ prolapse, and it occurs mostly in women. Your pelvic floor acts as a basket, holding pelvic organs in place. When it’s compromised, damaged or tears, you have pelvic prolapse.

Types of Pelvic Organ Prolapse

• Cystocele is a weakening around the bladder, often with the bladder bulging into the vaginal wall.
• Uterine prolapse occurs when your uterus descends into the vaginal area.
• Vaginal vault prolapse occurs when the top of the vagina falls, typically because of a hysterectomy.
• Rectocele happens when the rectum pushes into the bladder or vaginal wall.

Which Prolapse Do You Have?

With vaginal vault prolapse, cystocele and rectocele, you may feel a bulge extruding from the vagina. Some women have described the sensation as feeling like a baby crowning during childbirth. In some cases, the tissue coming out may be smaller, more like a protruding tampon. Additionally, you may have urinary complaints and trouble fully emptying your bladder.

If you are suffering from rectocele, it will feel like something is stuck in your rectum. You may need to shift your body to completely evacuate your stool. You might also experience stool accidents. Rectocele also tends to disrupt intercourse.

With any type of prolapse, your partner might complain that they feel something in the way.

Could It Happen to You?

There are risk factors, including:

• Being a woman.
• Having been pregnant.
• Having had a baby.
• Aging. Starting at about 50, most women begin menopause. That’s when their bodies produce less estrogen, which is responsible for the strength and elasticity of pelvic tissues.
• Having a hysterectomy.
• Doing extreme heavy weightlifting.
• If family members have suffered from prolapse, you have a greater risk.

How You Are Diagnosed

Your medical provider will examine and assess the prolapse. If you have prolapse, you can choose between nonsurgical and surgical options.

Your first option is to observe and check that it’s not worsening -- as long as it doesn’t affect your ability to evacuate your bladder and bowel.

You can perform pelvic floor exercises to strengthen the pelvic area. If you choose this option, you may want guidance from a pelvic floor physical therapist.

There’s also a small device called a pessary that inserts into the vagina to support the pelvic organs and alleviate symptoms.

During your assessment exam, your doctor will explain the surgical options, which depend on your age and how bad the prolapse is.

Surgical Options

A sacrocolpopexy is one of the most successful surgical options. It helps reconnect the top of the vagina (aka the vaginal vault) after it has dropped downward because of childbirth, hysterectomy or aging-related tissue weakening. This surgery can typically be performed robotically, and even laparoscopically, through abdominal entry. It repairs all compartments of the vagina by attaching an upside-down, Y-shaped mesh from both sides of the vagina to a higher ligament in the body to help anchor and pull up the lower portions. This is a great option for younger, active patients, and the success rate for the sacrocolpopexy surgery is between 80 percent and 90 percent.

Two additional surgical options are both vaginal approaches that rely upon different anchoring techniques and different anchoring points, attaching to a ligament in the pelvic area. Like the sacrocolpopexy, the top of the vagina is anchored as a means of lifting it. The success rate of this surgery is about 70 percent.

Another Option

Copal Colpocleisis is a procedure in which the vaginal walls are sewed together, partially or fully closing the vagina and preventing vaginal intercourse. It’s typically recommended for older patients who aren’t candidates for other surgical options. This procedure is quicker than the others, requiring a shorter period of anesthesia, and a faster recovery time. The success rate is 100%.

This content is not AI generated.