Do you feel back pain or pelvic pressure at the end of the day — or after you’ve been standing for a long time? Maybe you’re making frequent trips to the bathroom or dribbling urine. These could be signs of a condition called pelvic organ prolapse (POP).

What Is Pelvic Organ Prolapse?

POP is a pelvic floor disorder in women. It happens when the muscles and tissues that support the pelvic organs become weak and loose.

Normally, the muscles and tissues of the pelvic floor support the bladder, uterus, cervix, vagina, and rectum like a hammock. But when the pelvic floor becomes weak, the organs may slip down or press into the vagina. It’s not life-threatening, but POP can cause pain and discomfort.

According to the U.S. Department of Health and Human Services, almost 3% of American women suffer from POP.

Types of pelvic organ prolapse

There are three main types of POP. They are:

  • Cystocele — when the bladder drops into the vagina. (This is the most common type of POP.)
  • Uterine prolapse — when the uterus pushes into the vagina.
  • Rectocele — when the rectum bulges into the vagina.

What causes pelvic organ prolapse?

Some women are more likely to have POP. Risk factors include:

  • Genetics. Some people naturally have very loose, flexible connective tissue.
  • Childbirth. Multiple vaginal deliveries or large babies can stretch the muscles and tissues of the pelvic area.
  • Chronic pressure in the lower abdomen. Obesity, heavy lifting, chronic coughing, and constipation can weaken your pelvic floor.
  • Age. As you get older, the muscles in your pelvic floor tend to weaken.

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Pelvic Organ Prolapse Symptoms

POP typically has one or more symptoms. These include:

  • Pressure or a heavy feeling in your pelvis.
  • A feeling that something is falling out of your vagina.
  • Back pain.
  • Feeling a bulge inside or outside your vagina.
  • Feeling an increase in symptoms at the end of the day.
  • Feeling an increase in symptoms after standing for a long time.
  • An increase in urinary urgency (that “gotta go” feeling).
  • Needing to urinate more often.
  • Difficulty emptying your bladder completely.
  • Dribbling urine.

Pelvic Organ Prolapse Treatment

To diagnose POP, your doctor will ask you questions about your health, symptoms, and past pregnancies. They will also do a pelvic exam. They may order other tests, such as an ultrasound or MRI.

Options for pelvic organ prolapse treatment

You may not be able to completely reverse POP. But if your condition is mild to moderate, you can reduce your symptoms by lifestyle changes. Try to:

  • Maintain an ideal weight. Being overweight puts pressure on pelvic muscles.
  • Avoid constipation. Straining during bowel movements can weaken your pelvic floor. To prevent constipation, exercise, drink more water, eat high fiber foods, and talk to your doctor about medication to soften stool.
  • Treat chronic coughing. Long-term coughing puts pressure on pelvic muscles and weakens them. If you smoke, try to quit. If you have asthma or bronchitis, talk to your doctor about how to manage a chronic cough.
  • Limit high impact exercise. Reduce jumping, running, and heavy lifting. These pounding workouts put pressure on pelvic muscles and contribute to a weakened pelvic floor.
  • Learn pelvic floor therapy. A physical therapist can explain how to do pelvic floor exercises called Kegels. By contracting and releasing your pelvic floor muscles, you strengthen the muscles that support the pelvic organs.
  • Learn if Kegels are right for you. If you’re having pelvic pain (including pain during intercourse) along with urinary symptoms, they could make things worse. Check with your doctor before beginning pelvic floor exercises.
  • Use proper technique when lifting. Lifting, pushing, or pulling heavy things puts excessive pressure on your pelvic floor. To avoid this, contract your abdominal muscles when lifting, pushing, or pulling.

If your condition is more severe, you might need medical treatment. Options include:

  • Pessary. This is a medical device that a doctor initially inserts into your vagina. You can then remove and reinsert the pessary to clean it or to have sex. It supports and keeps the bladder, uterus, or rectum in its proper position.
  • Surgery. Your doctor may use your own body tissue or synthetic mesh to repair the prolapse and build pelvic floor support. If you have a severe uterine prolapse, your doctor may suggest a hysterectomy (removal of the uterus).
Sources

U.S. Department of Health and Human Services, Office on Women's Health, Pelvic Organ Prolapse, Link

U.S. Food and Drug Administration, Pelvic Organ Prolapse (POP), Link

NHS, Pelvic Organ Prolapse, Link

National Association for Continence, What Is Pelvic Organ Prolapse? Link

About UPMC Magee-Womens Hospital

For more than a century, UPMC Magee-Womens Hospital has provided high-quality medical care to women at all stages of life. UPMC Magee is long-renowned for its services to women and babies but also offers a wide range of care to men as well. Our patient-first approach ensures you and your loved ones get the care you need. Nearly 10,000 babies are born each year at Magee, and our NICU is one of the largest in the country. Our network of care – from imaging centers to hospital services – provides care throughout Pennsylvania and Maryland, giving you a chance to get the expert care you need close to home. The U.S. Department of Health and Human Services recognizes UPMC Magee as a National Center of Excellence in Women’s Health, and the Magee-Womens Research Institute is the largest research institute in the U.S. devoted exclusively to women’s health and reproductive biology.