Pelvic Organ Prolapse (POP) occurs when the female pelvic organs fall from their normal position, into the vagina. Occurring in women of all ages, it is more common as women age, particularly in those who have delivered large babies or had exceedingly long pushing phases of labor. Smoking, obesity, connective tissue disorders and repetitive strain injuries can all increase prolapse risk. Minor prolapse can be treated with exercises to strengthen the pelvic floor muscles; more serious prolapse, requires pessary use or reconstructive surgical treatment. Reconstructive pelvic prolapse surgery may be done without resorting to complete hysterectomy by hysteropexy, the resuspension of the prolapsed uterus.
Traditional gynecologic practice favors removal of the uterus or ovaries (or both) at the time of prolapse surgery, and one estimate states that of the 600,000 hysterectomies performed in the United States every year, 13 percent are for prolapse. However, there is concern that many of these hysterectomies may be unnecessary and that hysteropexy would suffice as a treatment instead.
The rectum or urinary bladder may also prolapse due to changes in the integrity of connective tissue in the posterior or anterior vaginal walls, respectively. Symptoms may include a feeling of pressure in the pelvis or the visible protrusion of organs from the vagina. Prolapse is rarely painful, but the change in organs' position may cause urinary or bowel symptoms.
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