Glossary · Conditions

Pelvic organ prolapse

Also called: POP, Cystocele, Rectocele, Uterine prolapse.

Definition: Pelvic organ prolapse is descent of the bladder, uterus, rectum, or vaginal apex from their normal positions through a weakened pelvic floor. It is more common after vaginal childbirth and in postmenopausal women. Treatment ranges from pelvic floor PT and pessaries to surgical repair, depending on severity and patient preference.

Detailed definition

Pelvic organ prolapse (POP) refers to descent of one or more pelvic structures: cystocele (anterior wall, bladder), rectocele (posterior wall, rectum), uterine prolapse, or vaginal vault prolapse (after hysterectomy). Severity is graded by the Pelvic Organ Prolapse Quantification (POP-Q) system from stage 0 (no prolapse) to stage IV (complete eversion). Risk factors include vaginal childbirth, advancing age, chronic increases in intra-abdominal pressure (chronic cough, constipation, obesity, heavy lifting), connective tissue disorders, and postmenopausal estrogen deprivation. Many women with mild prolapse are asymptomatic. Symptoms include vaginal pressure or "something falling out," urinary or defecatory dysfunction, and dyspareunia. Treatment options: observation for asymptomatic; pelvic floor PT for mild; pessary fitting (a device worn vaginally to support the prolapse); and surgical repair for severe or refractory cases. Vaginal estrogen is often used adjunctively to improve tissue quality before pessary use or surgery.

Why it matters in menopause

Pessaries are an underused option — a fitted pessary can resolve symptoms entirely without surgery in many women. Vaginal estrogen alongside a pessary improves tolerance and reduces erosion. ClearedRx can prescribe vaginal estrogen as part of conservative prolapse management; pessary fitting is typically done in person.

Sources

External references: Wikipedia.

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