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 vgina, uterus, bladder and rectum.

Types:

• Uterine Prolapse

• Vaginal vault Prolapse

• Cystocele-bladder drops down into the front (anterior wall) of the vgina

• Rectocele-rectum drops down and bulges into the vgina

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 vgina

• 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 vginal 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 vgina & is fixed to ASIS. (Anterior bony prominence over waist)