Pelvic Organ Prolapse is a condition in which the muscles and tissues that support the pelvic organs become stretched, damaged, or weakened, causing the organs they support to drop downward or sag the pelvic organs include the vagina, uterus, bladder and rectum.

Types:

·         Uterine Prolapse

·         Vaginal vault Prolapse

·         Cystocele-bladder drops down into the front (anterior wall) of the vagina

·         Rectocele-rectum drops down and bulges into the vagina

Causes:

·         Aging

·         Hysterectomy or prior pelvic surgery

·         Menopause

·         Intense physical activity

·         Obesity

·         Family history

·         Chronic straining due to constipation

·         Chronic coughing

·         Pelvic floor trauma during delivery

Symptoms:

·         Heaviness in the pelvic area that worsen standing, lifting & coughing or as the day passes

·         Bulge in the vagina

·         Lower back pain

·         Leakage of urine (urinary incontinence) during cough, laugh, exercise

·         Constipation

·         Low sexual activity or painful sexual act

Diagnosis:

·         Clinical; per rectal &per vaginal examination

·         MRI defecography & MRI pelvis

Treatment:

·         Early: Cured with physiotherapy (kegel exercises)-to strengthen pelvic floor muscle for better support

·         Late: Needs Pelvic Organ Prolapse suspension (P.O.P.S) +STARR surgery (hospitalization for 2-3 days &rest for 1 week)

·         In P.O.P.S a “Y” shaped mesh is used to lift the vagina & is fixed to ASIS. (Anterior bony prominence over waist)