Pelvic Organ Prolapse Incidence

"You have prolapse."

For some people, this is one of the scariest things a medical provider could say to them.

But should it be?

Prolapse Incidence, or 'Pelvic Organ Prolapse (POP)' Incidence (the number of people with prolapse in a group at any time) has been found to be upwards of 75% in asymptomatic people.

That's 75% of people who have NO SYMPTOMS, who will have a prolapse upon physical examination.

Oh, Snap!

So...if the thing is there...but we don't feel it...is it a problem?
I'm going to gracefully defer from answering that for 2 hot minutes.

First, Let's Review Stages of POP

Pelvic Prolapse Stages

STAGE 0: no prolapse. Everything is 'up atop' the vagina. While we imagine that this would be a person with a vagina who has never had children...the fact is that we seldom see Stage 0 in any person with a vagina. But in theory, they exist. Like unicorns, I suppose.

STAGE 1: The pelvic organs are present in the 'upper half' of the vagina.

STAGE 2: The pelvic organs are beginning to fall, but are still totally within the vagina. So you open the labia and you see a little pink balloon, or a donut, peeping at you, but it's not outside.

STAGE 3: The pelvic organs are 'at the vain gal opening' or 'a bit' outside the vagina.

STAGE 4: Stuff is OUTSIDE the vagina or rectum. Like you look down there and "there's a pear sticking outside my va-jay-jay."

Here's a pretty good page from the National Associate for Continence, for another reference.

Whoa. Surely a person would feel that.

Nope. That study I mentioned...it found that upon physical exam in non-symptomatic people.

For those of you in the back, this is likely college kids, or pelvic health pros who HAVE NO SYMPTOMS of prolapse, and are donating their vaginas for trained medical pro looking at, to check specifically for prolapse, to see how many of us have them and don't know.

And they found that up to 75% of people DID HAVE THEM!! OMG.

So they are now 'diagnosed' as having prolapse?

No! This is where it gets fun. To be 'diagnosed' with prolapse, a person not only needs to have the physical findings of a prolapse upon medical examination (by a trained professional)...the person ALSO needs to complain of a prolapse related complaint.

What are possible prolapse related complaints?

Pelvic Pressure at rest or with activity
Pelvic Pain
Feeling of fullness in vagina or rectum
Constipation
Leakage of Urine or Poop
And More...

The point is, that MORE than just the physical presence of a prolapse is required for 'Diagnosis'

This is similar to when we (the medical community) MRI 100 people who DO NOT have low back pain...and over half of them have herniated discs. Just because the herniated discs are there...doesn't mean they are the 'bad guy' and causing the complaints. Yes, they are warning sign, perhaps of underlying body mechanic deficits that can be addressed and improved, but it doesn't mean the end of your life.

Pelvic Organ Prolapse Incidence may be high, but it doesn't mean your life is over

Your life is not over. You can resume normal physical activities, including exercise and seggsy-time. You just need the right guidance. Pelvic PT can help. Here's a blog that tells you how to find a Pelvic PT near you.

Remember, the success rate of Pelvic PT is the SAME as surgery, so try PT first. If you have, and surgery is in your future, check out this post for questions to ask before and after a hysterectomy or bladder lift.

And most importantly, don't loose hope.

If you've received that diagnosis and have NO SYMPTOMS, please don't freak out. Go to a trained Pelvic PT to work on your pelvic pressure basics, to protect your vagina, so that you don't develop symptoms in the future. If your PT diagnosed you and you are not having symptoms, talk to them about this study. If they diagnosed you, then didn't address it in their plan of care, talk to them about it! You deserve up-to-date evidence-based care!!

Thanks for reading!

XOXO

Dr. Kelly 

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