How Pelvic Organ Prolapse (POP) is Treated
Giving birth can be exhilarating, intense, extreme and myriad other things. Post delivery can bring a series of interesting and sometimes scary physiological events as well. About 50% of women who deliver babies will have one or more prolapsed organs, and most will also have prolapsed hemorrhoids at the same time.
What is Pelvic Organ Prolapse?
Pelvic organ prolapse (POP) can happen to almost any woman after giving birth. Even though age and obesity are risk factors, young and healthy women can also be subjected to this uncomfortable situation. The most common prolapse involves the bladder; however, the rectum can also fall, putting pressure on the back wall of the vagina. This is called a rectocele. The most severe problems accompany the prolapses that externally protrude. If the entire anorectal canal falls, it will often protrude through the anal sphincter. This is known as an ano-rectal prolapse. The uterus, which is supposed to be at the top of the vaginal canal, deep inside of the body, can fall to the entrance of the vagina. A uterine prolapse is a very serious problem and, as with any prolapse, requires the immediate care of a physician.
How Can It Be Treated?
Treatment is based upon the condition itself as well as what a woman's plans for the future entail. A woman who wants to continue bearing children will have a treatment that is different from one who is finished childbearing.
When the prolapse is not very severe, it can often be addressed with Kegel pelvic floor exercises. Consciously contracting and releasing the muscles in the pelvis, Kegel exercises are usually prescribed for women post-delivery to help them regain their inner muscle strength and train the pelvic floor muscles to do their job properly. A more problematic situation may require Kegel exercises initially and the suggestion that childbearing involve the consultation of a medical professional. A pregnancy when a prolapse is more severe can mean serious restrictions during the pregnancy, including bed rest and a device (pessary) inserted into the vagina to hold the organs in their correct places.
Surgical Procedures in Extreme Cases
A ligament fixation is a surgical procedure that is used in cases of severe bladder or rectal prolapse, and in some cases for a uterine prolapse. This procedure is done through the vagina or through the abdominal wall if the woman wants to have more children. Fixing the ligaments through the vagina weakens the vaginal wall so much so that natural childbirth becomes impossible.
The most extreme treatment for a prolapse is the complete removal of the organ. Severe bladder and rectal prolapses have been treated by removing the organs; however, the end result is the need for the attachment of a bag to contain waste that has to be emptied regularly. This can sometimes lead to serious problems. While only done in extreme cases, the removal of the bladder or rectum may be the only treatment that is viable.
Before You Go Under the Knife...
Removal of the uterus, known as a hysterectomy, is the most extreme form of treatment for a uterine prolapse. The end result is, of course, sterility and the end to childbearing. Although it does not carry the same impact as bladder or rectum surgeries do, a hysterectomy has a lot of its own issues that include psychological loss, surgically-induced menopause, and damage to other organs and in some cases, infection. A hysterectomy is more accepted than the other major surgeries and is more commonly performed. Before undergoing the knife, a second opinion may be a wise decision. Even though a prolapsed organ is a frightening situation, it does not necessarily mean it can't be treated effectively.
Recovery from Surgery
Recovery after prolapse surgery can take several weeks, during which time lifting and prolonged standing is not recommended. The first two or three weeks can be very painful and uncomfortable. It can also take some time for the organs to regain their function and retraining the bladder and bowel may be necessary.
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