Women who have experienced the discomfort, inconvenience and embarrassment of pelvic organ prolapse or urinary incontinence want to resolve the problem as soon as possible.
Pelvic organ prolapse is a condition characterized by the dropping of the pelvic organs such as the bladder, uterus and vaginal walls and is caused by the loss of normal support of the vagina. Up to 50 percent of women who have given birth will be diagnosed with some degree of pelvic organ prolapse.
While pelvic organ prolapse occurs with varying levels of severity, common symptoms include a feeling of pressure or fullness in the vaginal or pelvic area, urinary and fecal incontinence, vaginal bleeding, difficulty with bowel movements and painful sex.
The exact cause of pelvic organ prolapse is often unclear, but common risk factors include pregnancy and subsequent vaginal delivery, genetic predispositions, previous injury to the pelvic floor such as surgery, and a number of behavioral and lifestyle factors. Obesity, constipation, smoking and a history of heavy lifting are also associated with an increased risk of pelvic prolapse.
Women of childbearing age can reduce their risk of developing pelvic organ prolapse, or the severity of prolapse symptoms, by improving many aspects of their health. Less severe cases of pelvic organ prolapse can be treated through behavioral modification and physical therapy.
To reduce the risk of prolapse and maintain overall reproductive wellness, women should consider the following actions:
▪ Quit smoking. Studies have shown smoking increases the chances of prolapse as well as recurrence after surgical repair.
▪ Maintain a healthy weight. Women with obesity are 40 to 75 percent more likely to experience pelvic prolapse.
▪ Seek treatment for conditions that strain the pelvic floor, such as chronic cough.
▪ Consider physical therapy or exercises to strengthen your core and the vaginal floor. Talk to your doctor about specific recommendations.
▪ Avoid heavy lifting and repetitive strenuous activity, such as intense weight lifting. If lifting is part of your exercise regimen or job, consult with a doctor to discuss ways to reduce the risk of straining your internal organs.
Many non-surgical treatments and behavioral modifications have been proven effective in treating pelvic prolapse and should be the first-line therapies. Robotic surgery has many effective applications, including minimally invasive management of pelvic organ prolapse. However, the surgery only partially treats the problem and a more comprehensive, evidence-based approach is needed for optimal results.
Any woman experiencing symptoms of pelvic prolapse should consult her gynecologist about preventative measures and a comprehensive approach to treatment.
Dr. Rudy Tovar is board certified by the American Board of Obstetrics and Gynecology in General Obstetrics and Gynecology and in Female Medicine and Reconstructive Pelvic Surgery. He is an urogynecology specialist at UK HealthCare Women's Health.