Pelvic organ prolapse: Diagnosis, treatment, and avoiding complications

Abstract

Pelvic organ prolapse (POP) is defined as the descent of one or more of the anterior vaginal wall, posterior vaginal wall, the uterus (cervix), or the apex of the vagina (vaginal vault or cuff scar after hysterectomy). Prolapse is extremely common and is one of the leading reasons for surgery in the United States. The main symptom of prolapse is the sensation of bulge or pressure in the vagina. Severe prolapse may interfere with successful urination, defecation, or sexual function. Prolapse diagnosis is usually based on physical exam, though several formal staging systems exist. Asymptomatic or minimally symptomatic prolapse may not require any intervention. Patients with significant bother may elect to use a plastic device (pessary) to hold their prolapsed organs in place, or they may elect for surgery. There are a variety of surgical procedures for prolapse, depending on the patient's health, preferences, degree, and location of prolapse.