PELVIC ORGAN PROLAPSE

What is organ prolapse?

The bladder, uterus, cervix, vagina and rectum are all supported like a hammock by the pelvic muscles. When these muscles and tissues in the pelvis become weak or damaged, they begin to drop into the vagina, which is what is known as pelvic organ prolapse. Depending on the pelvic organs that are involved there are three types of pelvic organ prolapse:

• The uterus drops into the vagina it is known as uterine prolapse.
• The bladder protruding the vagina is known as cystocele prolapse.
• The rectum bulging into the back of the vagina is called rectocele prolapse.

What are the causes?

Pelvic organ prolapse is usually caused by pressure on the abdomen such as obesity, long-lasting cough or frequent constipation. It can also be due to vaginal childbirth, ageing, hormonal changes that occur during menopause or genetics.

What are the symptoms?

Women will experience one or more of the following symptoms:

• The sensation of pressure on the vagina
• The sensation that something is falling from the vagina
• Pain or stretch in the abdominal area
• A frequent urge to urinate
• Leaking urine
• Vaginal bleeding or spotting
• Back ache
• Constipation
• Discomfort or pain during intercourse

What are the treatment options?

Treatment of organ prolapse and the uncomfortable symptoms it brings may include behavioural therapy using Kegels may be used to strengthen the pelvic floor. The insertion of a pessary device may be another option in which a device is inserted into the vagina to support the drooping pelvic organs. For older women a hysterectomy may be a fitting solution, otherwise, for severe cases, surgery may be considered to repair the pelvic dropping, for which Dr Makhubo will refer you to a specialist surgeon.