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.

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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.