As women age, go through pregnancy and childbirth, and menopause, they may experience relaxation of the pelvic floor muscles and develop pelvic organ prolapse. The pelvic organs include the uterus, vagina, bladder and rectum and are normally supported by the pelvic muscles and ligaments. When support is weakened, these organs cannot remain intact within the pelvis and will fall from their normal position, resulting in prolapse of the pelvic organs.

Risk factors for pelvic organ prolapse

Pregnancy

Pregnant women have relatively weak pelvic muscles. The pelvic cavity may become loose due to the number of births, inappropriate force during labour, heavy births and lack of postnatal pelvic exercises. There is also a greater risk of injury to the pelvic nerves and muscles.

Rapid weight gain or loss

The abnormal weight gain during pregnancy (about 12-13 kg during normal pregnancy) increases the strain on the muscles of the lower body, including the pelvic floor. If you do not rest and exercise after pregnancy, you can easily remain overstretched or even flaccid.

Aging of the body

The supporting tissues of the pelvis atrophy with age, resulting in a natural relaxation of the pelvic muscles or a reduction in their strength.

Chronic cough or constipation

Chronic coughing or constipation increases intra-abdominal pressure. When the abdominal pressure is high, the muscle groups that hold the body together will release the pressure where it is less strong. In girls, the pelvic floor muscles (including the vaginal wall) and the inguinal triangle on both sides of the lower abdomen are the weaker muscles. This can lead to inguinal hernia or prolapse of the pelvic organs from the vagina.

Long-term heavy load-bearing

Prolonged heavy lifting can also increase intra-abdominal pressure and put a strain on the muscles of the pelvic floor, leading to the prolapse of the pelvic organs.

Symptoms

Severe sense of falling

Patients usually feel a lump protruding from the vagina, a feeling of heaviness and discomfort, and a feeling that the uterus is falling down at the vaginal opening or even protruding outside the vaginal opening. Pain is also felt during intercourse. These symptoms are usually relieved when lying down or in the morning and are more pronounced when standing or at night.

2.  Difficulty in urination

If the anterior wall of the vagina or the ligaments and fascia supporting the bladder are loose, the bladder may prolapse towards the lower back of the vagina, known as bladder prolapse. Bladder prolapse alters the structure of the urethra in front of the anterior vaginal wall, causing frequent urination, urge incontinence, stress incontinence and, in severe cases, retention of urine and the risk of difficulty in urination.

3. Irregular bowel movements

If the posterior vaginal wall is flaccid, the rectum over the anal opening will bulge out towards the vaginal wall in front of it, resulting in a prolapsed rectum. The condition usually occurs in older women who have had multiple children. A common symptom is the accumulation of faeces in the rectal prolapse and the protrusion of the vaginal opening every time you defecate, making it difficult to get rid of the faeces and causing residue.

Pelvic organ prolapse affects the quality of life of patients. Women suffering from this condition are encouraged to address the problem and seek early treatment.