Pelvic Organ Prolapse
Pelvic Organ Prolapse (POP) occurs when the tissue and muscles of the pelvic floor no longer support the pelvic organs resulting in the drop (prolapse) of the pelvic organs from their normal position. The pelvic organs include the vagina, cervix, uterus, bladder, urethra and rectum. The bladder is the most commonly involved organ in pelvic organ prolapse.
Many women have some degree of POP, although not all women have symptoms. Symptoms may include abdominal, back, or pelvic discomfort or pain; bulge of tissue or organs that protrudes to or past the vaginal opening; leakage of urine (urinary incontinence); constipation, flatulence, difficulty holding bowel movements and sexual difficulty (dyspareunia).
Pregnancy and childbirth, genetic predisposition, connective tissue disorders (such as Ehlers-Danlos or Marfan’s syndromes), denervation or weakness of the pelvic floor, aging and menopause, chronically raised intra-abdominal pressure due to frequent constipation, increased body mass index and/or chronic cough, previous pelvic floor surgery.
As many as 50% of child-bearing women demonstrate POP on examination and it is estimated that 11% of women have a lifetime risk of surgery for POP and almost 1/3 of women require reoperation. Successful treatment of POP continues to be one of the most challenging surgical procedures in gynecology. This is mainly because of the high recurrence rate.