Pelvic Organ Prolapse

Understanding Pelvic Organ Prolapse

Pelvic organ prolapse (POP) is a condition in which one or more of the pelvic organs, such as the uterus, bladder, or rectum, protrude or “fall” into the vagina due to weakened or damaged pelvic floor muscles and ligaments.

Pelvic organ prolapse can cause a variety of symptoms, including a feeling of heaviness or pressure in the pelvis, urinary incontinence or difficulty emptying the bladder, fecal incontinence or difficulty with bowel movements, pain or discomfort during sex, and vaginal bulging or protrusion.

There are different types of pelvic organ prolapse depending on which organ or organs are involved. Treatment for pelvic organ prolapse depends on the severity of the condition and the individual’s symptoms, but may include pelvic floor exercises, lifestyle changes, pessaries (devices inserted into the vagina to support the pelvic organs), or surgery.

Types of Pelvic Organ Prolapse

There are several types of pelvic organ prolapse, which are classified based on which organ or organs are involved:

Cystocele: This type of prolapse occurs when the bladder bulges into the front (anterior) vaginal wall.
Rectocele: This type of prolapse occurs when the rectum bulges into the back (posterior) vaginal wall.
Uterine prolapse: This type of prolapse occurs when the uterus falls into the vaginal canal.
Vaginal vault prolapse: This type of prolapse occurs when the top of the vagina prolapses into the vaginal canal after the uterus has been removed.
Enterocele: This type of prolapse occurs when a portion of the small intestine bulges into the vaginal canal.
Pelvic floor dysfunction: This type of prolapse is a general term used to describe a weakness or dysfunction in the muscles, ligaments, and connective tissue that support the pelvic organs.

It’s worth noting that many women with pelvic organ prolapse have a combination of these types of prolapse. Treatment for pelvic organ prolapse will depend on the specific type and severity of the prolapse, as well as the individual’s symptoms and medical history.

What are the Symptoms of Pelvic Organ Prolapse?

Symptoms of pelvic organ prolapse can vary depending on the severity of the prolapse and which organs are affected, but some common symptoms include:

A sensation of pressure or fullness in the pelvic region, as if something is falling out or dropping down
A feeling of heaviness in the lower abdomen or pelvis
Discomfort or pain during sexual intercourse
Urinary problems, such as difficulty emptying the bladder completely, frequent urination, or urinary incontinence (leakage of urine)
Bowel problems, such as constipation or fecal incontinence (leakage of stool)
Lower back pain
Vaginal bleeding or discharge

If you experience any of these symptoms, it is important to schedule an appointment with NYGSE, who can help diagnose and treat pelvic organ prolapse.

How is Pelvic Organ Prolapse Diagnosed?

Pelvic organ prolapse (POP) is typically diagnosed through a combination of medical history, physical examination, and additional testing as needed.

During a physical examination, a healthcare provider may ask you to bear down (as if having a bowel movement) or cough, which can help reveal any bulging of the pelvic organs through the vaginal opening. They may also perform a pelvic exam to assess the degree of prolapse, check for any abnormalities or changes in the vaginal walls or cervix, and evaluate the strength of the pelvic floor muscles.

Additional testing may include:

Imaging tests, such as a pelvic ultrasound or MRI, which can help visualize the prolapsed organs and any associated abnormalities or damage.
Urodynamic testing, which assesses how well the bladder and urethra are functioning and can help diagnose any associated urinary problems.
Colposcopy, which involves using a special instrument to examine the cervix and vaginal walls in more detail.

It is important to note that pelvic organ prolapse can often be diagnosed through a physical examination alone, and additional testing is only necessary if there are concerns about other potential underlying conditions or associated symptoms. It is always best to consult with a healthcare provider if you are experiencing symptoms or concerns about pelvic organ prolapse.

What is Prolapse Repair Procedure?

Prolapse repair procedure refers to the surgical procedures used to correct pelvic organ prolapse (POP), which is the condition in which one or more of the pelvic organs (such as the bladder, uterus, or rectum) bulge or descend into the vaginal wall or outside the body.

The specific prolapse repair procedure recommended will depend on the severity and type of prolapse, as well as the individual’s medical history and other factors. Common procedures include:

Vaginal mesh surgery: In this procedure, a synthetic mesh is used to support the prolapsed organ and hold it in place. This surgery may be recommended for severe cases of POP or for women who have experienced a recurrence of POP after previous surgery.
Sacrocolpopexy: This procedure involves using a mesh to attach the prolapsed organ to the sacrum (lower spine), providing support and preventing further descent.
Hysterectomy: In some cases, a hysterectomy (surgical removal of the uterus) may be recommended as a treatment for POP, particularly if the prolapse involves the uterus.
Colporrhaphy: This procedure involves repairing the vaginal wall and supporting tissues to correct the prolapse. In some cases, additional materials such as a synthetic mesh or the patient’s own tissue may be used to reinforce the repair.

It is important to note that prolapse repair procedures are generally considered safe and effective, but all surgical procedures carry some risk.

How Much is the Treatment of Pelvic Organ Prolapse ?

The cost of treatment for pelvic organ prolapse in the United States can vary widely depending on several factors such as the severity of the condition, the type of treatment needed, the location, and the healthcare provider.

For mild cases, conservative treatments such as pelvic floor exercises or pessaries may be recommended. The cost of pessaries ranges from $50-$500, and pelvic floor therapy can cost between $150-$350 per session.
For moderate to severe cases, surgical intervention may be required. The cost of surgery for pelvic organ prolapse can range from $5,000-$20,000 or more, depending on the type of surgery, the length of hospital stay, and other factors. The cost of surgical treatment also includes pre-operative and post-operative care, diagnostic tests, and any medications or medical supplies required.
According to a 2021 report by the Healthcare Bluebook, the fair price range for laparoscopic pelvic organ prolapse repair surgery in the United States is between $11,958 and $27,427. This estimate includes the cost of the surgery, anesthesia, and facility fees, but does not include pre- or post-operative care or any additional charges that may be incurred.

It is important to note that health insurance may cover some or all of the cost of treatment, depending on the individual policy and the specific treatment recommended. It is always a good idea to check with your insurance provider to understand your coverage and potential out-of-pocket costs.

Pelvic Organ Prolapse

Understanding Pelvic Organ Prolapse

Restoring Strength, Comfort, and Confidence

COMMON QUESTIONS ABOUT Pelvic Organ Prolapse

Pankaj Singhal, MD, MS, MHCM

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