Pelvic Support Problems

It's not unusual for a woman’s pelvic organs to change as you age.

You may have a feeling of pelvic pressure or heaviness. It might feel like something is falling out of your vagina.”

These symptoms may be caused by pelvic support problems. These problems may begin with childbirth, and may become more noticeable as you age.

The Pelvic Organs

The parts of the body affected by pelvic support problems include the urethra, bladder, small intestine, rectum, uterus and vagina.

The pelvic organs are held in place by three types of support:

• Layers of connecting tissue called endopelvic fascia
• Thickened parts of the fascia called ligaments
• A paired group of muscles that lies on either side and around the openings of the urethra, vagina and rectum

Causes of Pelvic Support Problems

The main causes of pelvic support problems are childbirth and aging. Occasionally pelvic support problems do affect women who have never gone through childbirth.

Symptoms

The symptoms of pelvic support problems depend on the organs involved. Symptoms may include:

• A feeling of pelvic heaviness or fullness
• A feeling that something is “falling out of the vagina”
• A pulling or aching feeling in the lower abdomen, groin or lower back
• Leakage of urine or problems having a bowel movement
• Cystocele (SIS-tow-seel) - bladder
• Enterocele (en-TARE-oh-seel) - small intestines
• Rectocele (REK-tow-seel) - rectum
• Uterine Prolapse - uterus
• Vaginal Prolapse - vagina

Types of Pelvic Support Problems

Cystocele occurs when the bladder drops from its normal place into the vagina. Some cystoceles cause urine to leak when you cough, sneeze, lift objects or walk.

Enterocele forms when the intestine bulges into the upper vagina.

Rectocele happens when the rectum bulges into or out of the vagina.

Uterine prolapse happens when the uterus drops down into the vagina.

Vaginal prolapse can happen after a hysterectomy (the removal of the uterus), when the top of the vagina loses its support and drops.

Diagnosis

Proper diagnosis is key to treating pelvic support problems, but diagnosis is not always simple.

The symptoms of pelvic support problems often mimic those other conditions. You can have these symptoms and know that you have a problem, but the cause may be unclear

Treatment

Treatment of pelvic support problems may involve special exercises or insertion of a device called a pessary. These treatments may improve support.

Your physician may suggest a high-fiber diet or medications to soften the stool and make bowel movements easier.

Keeping your weight under control, eating right, not smoking and not doing activities that stress the pelvic support muscles may also help.

No form of treatment, even surgery, is certain to solve the problem

Special Exercises

Kegel exercises, or pelvic muscle exercises, are used to strengthen the muscles that surround the openings of the urethra, vagina and rectum.

Diet

Your physician may suggest that you drink cranberry juice to help reduce the risk of infection.

Medication

A medication that softens stools may be prescribed along with a special diet to help control intestinal symptoms.

Surgical Repair

Pelvic support problems may be corrected by surgery. The type of support problem you have will decide whether surgery is done through the vagina or abdomen.

Special Devices

Sometimes surgery is too risky because of your general health. In such cases, a pessary may be inserted into the vagina to support the pelvic organs. When a pessary is used, it must be removed, cleaned and reinserted on a regular basis.