Pelvic Organ Prolapse

Types of Prolapse

Anterior vaginal wall or cystocele,
Posterior vaginal wall or rectocele,
Apical prolapse either uterine prolapse or post-hysterectomy,
Bowel prolapse or enterocele.
It leads to a sensation of a bulge, pressure, heaviness, feeling of a balloon or sitting on a ball, difficulty and incomplete bowel or bladder emptying, urinary frequency, urgency, incontinence, and lower back and abdominal discomfort. POP is linked to childbirth, obesity, genetic factor, advancing age/ menopause, the lifestyle of repetitive heavy lifting, chronic cough, or constipation

Treatment options

Depends on the degree of bother and the degree/severity of the prolapse, including:

Observation, lifestyle/behavioral modification, and physical therapy

Vaginal device (Pessary)
Surgery:
- Apical suspension like sacrocolpopexy that can be done robotically, or via vaginal route like uterosacral and sacrospinous fixation,
- Colporraphy or repair of the cystocele/anterior wall, rectocele/posterior wall, enterocele, perineorraphy
- Obliterative procedure: colpocleisis for women who do not desire to maintain sexual function
These surgeries are outpatient, meaning the patient will go home the same day with oral pain medications for 3-5 days. Return to work varies from 1-4 weeks depend on the type of the physical activity and baseline health of the patient.