Pelvic organ prolapse and urinary incontinence are common disorders that affect millions of people. They can occur at any age, but become more common with increasing age, especially after menopause.
Pelvic organ prolapse and urinary incontinence are common disorders that affect millions of people. These conditions can significantly impact a person’s quality of life, causing discomfort, embarrassment, and limiting daily activities.
“An estimated one-third of all U.S. women are affected by some type of pelvic floor disorder,” said Sarah Sears, MD, member of the Division of Urogynecology at MetroHealth. “A lot of women think their problems are a normal part of aging and are embarrassed to talk to their doctors about them, but there are plenty of treatment options available that can improve the quality of life for those affected by these disorders.”
Pelvic Floor Disorders
- Prolapse occurs when the pelvic organs, such as the vagina, uterus, bladder, or rectum start to sag due to weakening muscles and tissues in the pelvic area.
- Urinary incontinence is the loss of bladder control.
- Stress incontinence is leaking of urine with certain activities such as coughing, laughing, or sneezing.
- Urge incontinence is leaking urine when you have a sudden urge to urinate and can’t make it to the bathroom in time.
These conditions can occur at any age, but become more common with increasing age, especially after menopause. These different conditions are often seen together and share common risk factors.
- Pregnancy and childbirth: The physical stress and trauma experienced during pregnancy and vaginal delivery can weaken the pelvic floor muscles, leading to pelvic organ prolapse and urinary incontinence. Multiple pregnancies, long labor, and delivering large babies increase the risk.
- Age: As we age, the tissues supporting the pelvic organs weaken. Hormonal changes, especially during menopause, contribute to the loss of elasticity.
- Genetics: Women who have family history of these disorders have a higher likelihood of developing them. The genetic make-up of connective tissue also plays a role.
- Obesity: Excess weight puts additional pressure on the pelvic floor muscles.
- Heavy Lifting/Straining: Heavy lifting or straining, especially in jobs that involve repetitive heavy lifting, can strain the pelvic floor.
- Lifestyle: Certain lifestyle choices, such as smoking, can lead to an increase in developing these conditions.
Treatment options include pelvic floor exercises, lifestyle modifications (such as weight management), and in some cases, surgery.
Here are the more specific treatment options:
For urinary incontinence:
- Lifestyle changes including fluid and food management and changing toileting behaviors
- Physical therapy for the pelvic floor
- Surgical procedures
For Pelvic Prolapse:
- Do nothing if it is not bothersome and does not affect bladder emptying
- Insert a pessary, a rubber ring that can be placed in the vagina in the clinic to support the vagina and pelvic organs
- Surgery – most are performed through minimally invasive techniques