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Pelvic Organ Prolapse

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  • Pelvic organ prolapse

    Pathophysiology

    Pelvic organ prolapse is the abnormal descent or herniation of the pelvic organs from their normal attachment sites or their normal position in the pelvis. The pelvic structures that may be involved include the uterus (uterine prolapse) or vaginal apex (apical vaginal prolapse), anterior vagina (cystocele), or posterior vagina (rectocele). Many parous women may have some degree of prolapse when examined; however, most prolapses are not clinically bothersome without specific pelvic symptoms, and they may not require an intervention.

  • Pelvic organ prolapse

    Disease statistics

    Several previous studies have demonstrated an association between age, vaginal parity, body weight, hormone replacement therapy and severity of the index of prolapse with recurrent POP.In the present study a statistically significant difference existed in both the ages and the menopausal status of women who had experienced and had not experienced objective recurrences. No significant difference was demonstrable between the parity or body weight of the two groups.In the second phase of this study results indicated that the incidence of subjective recurrence (16%) was half that of objective recurrence (32.76%). Symptoms of POP are not always related to the severity of the condition and, as demonstrated in this study, many patients are asymptomatic. The incidence of symptomatic prolapse has been reported to be as low as 7.4% when the anatomical recurrence rate was 31.3%. Miedel et al.confirmed this, reporting an anatomical recurrence rate of 41.1%, with less than one half of cases symptomatic.

  • Pelvic organ prolapse

    Treatment

    If you do not have any symptoms or if your symptoms are mild, you do not need any special follow-up or treatment beyond having regular checkups. If you have symptoms, prolapse may be treated with or without surgery. Often the first nonsurgical option tried is a pessary. This device is inserted into the vagina to support the pelvic organs. Targeting specific symptoms may be another option. Kegel exercises may be recommended in addition to symptom-related treatment to help strengthen the pelvic floor. Weight loss can decrease pressure in the abdomen and help improve overall health. If your symptoms are severe and disrupt your life, and if nonsurgical treatment options have not helped, you may want to consider surgery.

  • Pelvic organ prolapse

    Research

    Research conducted by the Pelvic Floor Disorders Network, an initiative funded by the National Institutes of Health, has revealed that the long-term success rates of a surgery to treat pelvic organ prolapse are lower than expected. Nearly one-third of women develop anatomic or symptomatic treatment failure within five years of undergoing sacrocolpopexy for pelvic organ prolapse.

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