Pelvic Organ Prolapse or POP is a common condition in women where the bladder (cystocele/anterior wall prolapse), uterus and/or bowel (rectocele/posterior vaginal wall) protrudes into the vagina. It can often be accompanied by symptoms such as heaviness in the vagina or the sensation of a vaginal lump, bowel and bladder problems, low back or pelvic ache and issues with sexual intercourse.
POP is most common after pregnancy and labour with almost 1 in 2 women who have been pregnant having some form of prolapse. Pregnancy and labour weaken the pelvic floor and can damage the connective tissue, particularly in those with big babies or prolonged pushing phases during delivery. Other factors that can make someone more susceptible to prolapse include family history, menopause (low levels of oestrogen), obesity, chronic coughing or constipation, frequent heavy lifting, and previous vaginal surgeries.
Treatment of POP depends on the location and severity of the prolapse. Lifestyle changes such as weight loss, quitting smoking and reducing heavy lifting can help with symptoms. A physiotherapist trained in pelvic health can assist with exercises to improve the pelvic floor as well as advice on managing bladder and bowel symptoms. Sometimes a pessary, a small plastic/silicon support inserted into the vagina, can help to reduce the symptoms. If the symptoms are severe or conservative treatment options are unsuccessful then surgery is considered.
If you are concerned about POP it is important to speak to your local GP or pelvic health trained physiotherapist for an assessment. It is also highly recommended that all women have a postnatal review regardless of symptoms to ensure there are no early signs of prolapse developing and to rehabilitate the pelvic floor.