Pelvic Organ Prolapse

Question 1

pathophys of prolapse

Answer 1

• pelvic fascia, ligaments, and muscles may become attenuated from pregnancy, labor, delivery
• increased intra-abdominal pressure (chronic cough, habitual straining, or heavy lifting) may predispose
• atrophy may play role (from menopause)

Question 2

risk factors for prolapse

Answer 2

• age
• multiparity (esp if injuries 2/2 childbirth)
• smoking
• pulmonary disease (chronic cough)
• obesity
• genetics (Hispanics, AA women)
• connective tissue disorder
• ?prior surgery

Question 3

cystocele/apical sx (bladder prolapse)

Answer 3

• heaviness, sensation of bulge, or fullness in pelvis
• sensation of “something falling out”
• sx often worsen after prolonged standing; relieved by lying down
• may have associated sx of frequency, urgency, incontinence, or retention