'Bits That Shouldn't Stick Out': Could You Be Suffering From Pelvic Organ Prolapse?

Pelvic organ prolapse may not be a medical emergency, but it can most certainly make your life very uncomfortable, and even painful. Want to garden? Ride a bike? Have sexual intercourse? Whatever you do, you are liable to be reminded that something isn't quite right with your body at any time at all — and the symptoms are not, unfortunately, limited to the vaginal area either. 

If you've had weird sensations around the pelvis, and suspect that you may be looking at a prolapse, read on to find out more about this tricky problem from someone who has been there, done that. 

What Is Pelvic Organ Prolapse?

Your pelvic muscles, connective tissue called fascia, and portions of fascia that perform the role of ligaments, all serve to keep your pelvic organs in place under normal circumstances. Pelvic organ prolapse can occur when this support structure fails. 

Pelvic organ prolapse starts with "pelvic relaxation", but with continued weakening of muscles and other supporting structures within the pelvic region, this relaxation can then cause pelvic organs to bulge into the vagina. The bladder, uterus, urethra and rectum can all be involved in a pelvic organ prolapse.

Women who are obese, have pelvic organ tumors, or suffer from long-term constipation or cough are also at a higher risk of developing this uncomfortable condition. Indeed, anything that weakens the pelvic floor or puts extra weight on it can contribute. Pelvic organ prolapse is — for an issue that is talked about so little — surprisingly common. In the United States alone, 200,000 women will undergo inpatient surgery for pelvic prolapse each year, with between 11 and 19 percent of women having gone under the knife for this very reason by age 85. 

READ Pelvic Pain: Home Remedies for Pelvic Inflammatory Disease

How Do You Find Out That You Have Pelvic Organ Prolapse?

Some women with mild pelvic organ prolapse will be completely asymptomatic. They will either find out about their condition during a routine gynecological exam, or not know they have pelvic prolapse at all. Many women are diagnosed with pelvic organ prolapse because they experience very uncomfortable symptoms that lead them to seek medical attention, however. The symptoms of pelvic organ prolapse can include:

• A feeling of pressure against the vaginal wall
• Feeling "bits sticking out"
• A sensation of fullness within the lower abdomen
• Urinary urgency and even incontinence
• Lower back and thigh pain
• Pain during sexual intercourse
• Constipation or other gastrointestinal issues
• Physically feeling a bulge in the vagina upon manual inspection

I Think I Have Pelvic Organ Prolapse: What Now?

Should the symptoms of pelvic organ prolapse sound familiar to you, it's time to seek medical attention. Depending on where you live, you can see a gynecologist or your family doctor for initial diagnosis — but know that, if you choose to turn to your primary care physician, they will most probably refer you to a gynecologist once the initial exam is over, for further consultation and treatment. 

Many women find the thought of seeking medical attention for a pelvic organ prolapse embarrassing and wait longer to see their doctor than they ideally should. Personally, I put going to my family doctor off for rather a while because I'm always busy working. Don't do as I did; you do benefit from a timely diagnosis.

Should you be experiencing "leakage" (AKA urinary incontinence) as well, you need to be assessed for this separately. 

Pelvic Organ Prolapse: The Diagnosis 

Pelvic organ prolapse is categorized in stages of severity, ranging from one to four. It can occur in any part of the vaginal canal, and will be labeled according to which organs are protruding:

• Cystocele: When the bladder protrudes
• Urethrocele: When the urethra protrudes
• Rectocele: When a portion of the rectum protrudes
• Uterine prolapse: When the uterus protrudes
• Vaginal vault prolapse: When, in women who have undergone a hysterectomy, a portion of the vagina bulges into another

Pelvic Organ Prolapse: Your Treatment Options

Your first line of treatment are those infamous Kegel (pelvic floor) exercises that everyone always told you you should have been doing anyway. Kegels are especially likely to be effective in women who suffer from pelvic organ prolapse without having any symptoms. For these patients, doing something to the tune of 50 pelvic floor exercise repetitions a day can help prevent the progression of this condition. 

Should your prolapse be more severe, your doctor will most likely recommend the placement of a pessary. A pessary is a good option for women who are either not suitable candidates for surgical treatment (because they'd like to have more children, for instance), or who would simply like to avoid or delay surgery for as long as possible. This is the option I chose — I don't have time for surgery! A pessary is a device inserted into the vagina for up to several months at a time that helps support the muscles and can relieve the symptoms of your pelvic organ prolapse.

READ Epidurals During Childbirth May Protect Pelvic Muscles

Previously, such operations were either carried out by making incisions into the vagina or abdomen, but these days, it is very likely that your surgery will be performed laparoscopically. During the surgery, your prolapsed organs will be "put back in their place" with the help of stitches, and your vaginal-wall weakness repaired. In some cases, grafts are used to repair the vaginal wall. 

You can expect to remain in hospital for around three days, which is then followed by a recovery period at home. Once the surgery is complete, there is a risk of recurrence — being diligent about performing Kegel exercises after the operation helps reduce that risk.