What is POP? Pelvic organ prolapse (POP) is a serious health condition where a pelvic organ, like the bladder, falls from its original spot and pushes against the walls of the vagina. Transvaginal mesh implants are intended to treat POP, but thousands of women have experienced serious health complications from the devices.
POP can occur when pelvic organs become weak or are stretched from a woman giving childbirth or undergoing a surgery. It also occurs when the muscles and ligaments supporting pelvic organs become weak and are unable to keep organs in place. Having a hysterectomy can also cause POP, according to the Mayo Clinic.
The most common organ effects by POP is the bladder, but the urethra, vagina, small bowel, rectum and uterus can also become weak, requiring women to seek treatment for POP. One or more organs can also be involved in POP at the same time, according to WebMD.
What organ is affected determines what type of POP a woman has. The Harvard Medical School explained the different types of POP:
Cystocele
Cystocele POP is when the bladder protrudes into the front wall of the vagina. This type of POP occurs in about 1 percent of cases. Some patients with cystocele POP may not experience any symptoms, especially when the condition is in its early stages. However, some may feel symptoms including pressure in the pelvis or vagina, lower back pain, vaginal bleeding or have a lump protruding from the vagina. Patients may also have problems emptying their bladder or experience difficulty with bowel movements.
Urethrocele
Urethrocele POP is when the urethra is pressing against the front vaginal wall. Patients with this type of POP face complications including urinary incontinence, urinary retention, painful intercourse and bladder injury, according to WebMD.
Rectocele
In Rectocele POP, the rectum protrudes into the back wall of the vagina. This can cause difficulty with defecation. This type of POP can develop when the lower pelvic muscles are damages in labor or in a previous pelvic surgery. It also can become more obvious during bowel movements.
Rectocele can be present at birth, though this is rare, WebMD reported. This POP is also similar to an enterocele, which is a small bowel prolapse that happens when the small bowel pushes against the vagina wall.
Uterine
With a uterine POP, the uterus drops down into the vagina. This kind of POP can happen when a woman has a hysterectomy or when the pelvic floor muscles and ligaments are stretched or weakened. A loss of estrogen can also cause this type of POP. Symptoms of uterine POP are a sensation of heaviness or pulling in your pelvis along with other feelings like lower back pain. Some women may experience tissue protruding out of their body and feel as if they are sitting on a small ball or as if something is falling out of their vagina, according to the Mayo Clinic.
In severe cases of uterine prolapse, some women may develop ulcers as part of the vaginal lining protrudes outside of the body and rubs on underwear.
Treatments
Though many women have used transvaginal mesh implants to treat their POP, the U.S. Food and Drug Administration has warned against these devices, saying that thousands of women have reported serious complications as a result of using them. In July 2011, the FDA said it received 2,874 reports from women with POP who had experienced adverse health events from their mesh devices.
Mesh erosion, organ perforation, urinary problems, pain, infection and bleeding were some of the most common complaints from POP patients using transvaginal mesh.