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 is a very common condition, particularly among older women. It's estimated that 50% of all women have mild prolapse and 10% of them have moderate to severe prolapse.The total number of women undergoing prolapse surgeries was 92,503 in 1998 versus 113,646 in 2007. The incidence rate of surgery increased slightly, from 90.8 to 100.9 per 100,000 women, respectively. The most common procedure was hysterectomy, representing approximately half of prolapse surgeries in 1998 and 2007. Suspension procedures accounted for 18.8% of procedures in 2007, an increase from 6.1% in 1998. Surgeries performed via a minimally invasive route increased from 4.8% in 1998 to 9.4% in 2007. However, it was difficult to determine the route for many procedures based on current ICD-9 codes. There were also no codes that specifically designated mesh kit procedures or minimally invasive sacrocolpopexies.
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.
The Clinic doctors contribute to the understanding and treatment of pelvic organ prolapse through research and clinical practice. Researchers at Clinic focus on improving the diagnostic procedures and treatments used for all types of pelvic organ prolapse.