Pelvic organ prolapse, or the invasion of nearby organs into the vaginal canal, is the most frequent side effect of natural childbirth.

But could pelvic organ prolapse be a sign of cancer? We checked in. Dr. O. Lenaine Westney, a reconstructive urologist who sometimes treats this condition. She specializes in the management of urinary incontinence and structural genitourinary problems that occur during or after treatment for pelvic cancer. Here’s what she told us:

What is escape?

A prolapse is a type of hernia in which an organ protrudes through an opening where it would not normally come out (in this case, the vagina). Hernias are usually associated with the intestines, but prolapses are specific to the vagina. This means that structures adjacent to it may be involved, such as:

  • bladder: Known as “cystocele”
  • rectum: Known as “rectal aneurysm”
  • small intestine: Known as “enterocele”
  • uterus: Also called “descendant” or “descendant.”

However, the term “prolapse” itself is not very specific, as it does not indicate which organs are involved. And it depends on what’s on the other side of the weakened tissue. Still, prolapse can only occur if the vaginal canal is present. This is because, by definition, the organs involved in the vaginal canal enter the vaginal cavity.

What is the most common cause of pelvic organ prolapse?

Although it is less common, it most commonly occurs in women who have had a vaginal birth. It can also be a side effect of a hysterectomy or surgical removal of the uterus.

Once the cervix is ​​removed, the top of the vagina must be reattached to the ligaments and other structures that normally hold the vagina in place. Otherwise, it may become unstable within the abdominal cavity, causing the vagina to collapse and the top of the vagina to protrude and become visible outside the body.

Is pelvic organ prolapse a symptom of cancer?

No, pelvic organ prolapse is not associated with the development of certain types of cancer.

However, that can It occurs because a large mass in the abdomen is creating abdominal pressure, or because a large amount of fluid has accumulated in the pelvis. It can also occur after surgery for some cancers because it involves the removal of other structures.

For example, when the bladder is removed, some of the supporting tissue that gives thickness and muscle to the vaginal walls is also removed. The same thing happens with rectal and cervical surgery. Changes to the structures that normally support the vagina can weaken or destabilize its walls. And that can lead to secondary prolapse.

Can pelvic organ prolapse be treated?

yes. However, how it is treated depends entirely on the severity of the person’s condition. Pelvic organ prolapse is rated on a scale of 1 to 4, with 1 being very mild and 4 being the entire vagina everting.

One of the easiest and least invasive ways to treat mild pelvic organ prolapse is physical therapy. Patients are given a variety of exercises to perform to increase pelvic floor strength. Stool softeners and other medications may also be prescribed to reduce constipation, and weight lifting may be restricted to reduce tension and pressure in the abdomen.

Another relatively non-invasive treatment is a pessary, which is a silicone or plastic object placed inside the vagina to prevent prolapse from bulging out of the vagina. Pessaries come in different shapes depending on the type of prolapse, but the most common one is shaped like a donut.

Surgery is usually recommended for more advanced cases of pelvic organ prolapse. Doctors use biological mesh to strengthen weak areas and hold everything in place. Sacral colpopexy may also be performed. This is where the top of the vaginal canal connects to the sacrum or coccyx, and the mesh is used as a bridge to stabilize it.

Are there other factors that make you more likely to develop pelvic organ prolapse?

Again, this is not a very common occurrence, but the risk increases slightly with each additional vaginal delivery. Older age is also a risk factor because ligaments and other supporting structures naturally weaken over time.

There are some very rare vascular disorders that can also prevent good connective tissue development and cause prolapse, but they are very rare.

When should I see a doctor if I think I may have a pelvic organ prolapse?

If you see or feel any unusual protrusions coming from your vagina when you bend over to urinate or defecate, call your doctor right away. However, symptoms are not always so dramatic, so if you have trouble emptying your bladder or having a bowel movement, especially if they don’t seem to improve on their own after a week or two, seek medical attention. Please take it.

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