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What is Pelvic Organ Prolapse?

Why does Pelvic Organ Prolapse cause Incontinence?


Pelvic organ prolapse occurs when a pelvic organ (ex. bladder or rectum) drops from its normal place and pushes against the walls of your vagina. This happens when your pelvic floor muscles become to weak or stretched to hold your pelvic organs in place. Pelvic organ prolapse is generally caused by childbirth, or surgery. Other risk factors include pregnancy, menopause, obesity, aging and genetics. Prolapse can worsen with any sort of pressure on your belly like constant coughing, excess weight, frequent constipation, and pelvic organ tumors.


Because your bladder pushes against the walls of your vagina and or anal cavity, your urinary and bowel functions may be hampered.


Causes and Statistics


The most common pelvic organ prolapse is the bladder prolapse (cystocele). According to US National Library of MedicineNational Institutes of Health, “Up to 60% of women presenting with pelvic organ prolapse are also diagnosed with urinary incontinence, and close to 40% of women presenting with urinary incontinence, in turn, are found to have some degree of pelvic organ prolapse.”


With bladder prolapse, the risk acquiring Urinary Incontinence increases, especially stress urinary incontinence. The bladder prolapse prevents pelvic floor muscles from functioning correctly. The sphincter, for example, may have trouble contracting. As a result you may experience leakage during moments of stress on the abdomen, like laughing, coughing or sneezing. The bladder prolapse may also place to much pressure on the urethra. This can cause urge incontinence.


The second most common type of pelvic organ prolapse is rectal prolapse (rectal descent). According to the US National Library of MedicineNational Institutes of Health, “Fecal incontinence is associated with 20 to 40% of the patients with pelvic floor prolapse.”


Rectal prolapse often causes fecal incontinence. During childbirth, damaged nerves, or other types of pelvic floor injuries, the front of the rectum can fall into the top of the anal canal and block the anal opening. Medical University of South Carolina explains how the loss of anatomical support of the rectum may result in obstructed defecation and may present as symptoms of fecal seepage and fecal incontinence. The obstructed defecation (constipation) can stretch and weaken the pelvic floor and rectal muscles. If a mass of dry, hard stool stays too long in the rectum, watery stool to move around the mass and leak out. Rectal prolapse may also prevent the anal sphincter and other pelvic floor muscles from contracting. Without the ability to contract the anal sphincter, anal leakage occurs.


Common Symptoms of pelvic organ prolapse:


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  • Feeling pressure against the vaginal wall
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  • Feeling very full in your lower abdomen.
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  • Feeling like something is falling out of your vagina
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  • Feeling a pull or stretch in your groin area or pain in your lower back.
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  • Urinary incontinence
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  • Urge incontinence and nighttime urinary incontinence
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  • Frequent urination
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  • Having pain in your vagina during sex
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  • Having problems with your bowels, such as constipation.
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  • Fecal Incontinence
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  • Delayed or slow urinary stream
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Pelvic organ prolapse and incontinence are incredibly common in women. About half of women who have damaged pelvic organ tissue with experience pelvic organ prolapse.


Treatments for pelvic organ prolapse depend on the severity of the condition. If your prolapse is less severe you may find treatments like dietary changes, pelvic floor training, kegels, or physical therapy will help your condition. If your prolapse is more severe you may have to choose more invasive treatment options like surgery, or other non-surgical treatments.


It’s important to seek help if you experience pelvic organ prolapse. You may feel embarrassed about your incontinence and condition, but the faster you seek treatment the faster you can return to a happy life.

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