When Is it Time to Consider Pelvic Organ Prolapse Surgery?

Worldwide, pelvic organ prolapse (POP) affects 40% of women. Closer to home, these already surprising numbers become more concerning. First, women in the United States have a 13% lifetime risk of undergoing pelvic organ prolapse surgery. Second, the rate of POP in our country is expected to increase 50% by 2050, which means surgery rates will also likely increase.

Given this outlook, Dr. Ulas Bozdogan and our team at Advanced Endometriosis Center think it would be timely to discuss pelvic organ prolapse and when surgery makes sense. Let’s take a look.

Pelvic organ prolapse at a glance

Your pelvic region houses a number of different organs that are part of different systems. For example, your pelvis houses your reproductive organs, as well as your lower urinary tract and digestive system.

To keep all these organs in their places and functioning well, they rely on a strong pelvic floor — a group of muscles and connective tissues that form a sort of hammock at the base of your pelvis.

If your floor weakens, which can occur due to childbirth, aging, and obesity, your pelvic organs can lose this support and start to shift downward. This can occur with several different organs, including your:

• Bladder 
• Urethra 
• Rectum 
• Small intestine 
• Uterus 
• Vaginal vault — the top part of your vagina

This shift downward can force your organs to press against one another and affect their function. Not to mention, some organs can descend far enough that they protrude out of your vagina.

Early treatment for pelvic organ prolapse

During its early stages, most women are unaware of their POP as the shift is minor. When symptoms do develop, they depend on which organs are affected and can include:

• Pressure in your lower abdomen
• Pressure or pain during sexual intercourse
• Urinary or fecal incontinence
• Constipation

At the first signs of trouble, the best way to address POP is through pelvic floor strengthening exercises to re-establish support. Called Kegels, these exercises isolate and strengthen your muscles through squeezing and holding.

If Kegels don’t help, we can try a pessary, a silicone support ring you insert into your vagina to keep organs from sliding down into your vaginal canal.

Pelvic organ prolapse surgery

If your prolapse is severe and organs are bulging out of your vagina, or you’re running into serious functional issues, it may be time to explore POP surgery. This is especially true if pelvic floor exercises aren’t making a difference and a pessary is no longer sufficient for supporting your prolapsed organ(s).

Dr. Bozdogan is a leading expert in minimally invasive gynecologic surgeries and has extensive experience helping women with POP. While the exact steps he takes for each surgery can differ depending on your degree of prolapse and the organs involved, the overarching goal is the same — to reinforce your pelvic floor with a mesh and restore your organs to their normal positions.

Next steps

This blog isn’t designed to help you decide whether to have surgery but to guide you in the right direction. The best way to determine next steps for your POP is to sit down with Dr. Bozdogan for a consultation.

To get that ball rolling, we invite you to schedule a consultation at Advanced Endometriosis Center today online or over the phone. We have offices in New York City and Paramus, New Jersey.