How Is POP Diagnosed?
Most of the time, a prolapse that is not causing symptoms is found during a routine exam. If you’re experiencing symptoms, your doctor will take your medical history, perform a pelvic exam, and, depending on your specific symptoms, may order the following the tests:
- Cystoscopy: Helps doctor see the interior lining of the bladder and urethra.
- Urodynamic tests: Shows how your body stores and expels urine.
- Computed tomography (CT) scan: Uses x-rays to take detailed pictures of pelvic organs.
- Intravenous pyelogram (IVP): X-ray test that shows the position, size, and shape of certain pelvic organs.
Once your doctor has ordered these tests, he or she will use this information, along with a physical exam, pelvic exam, and family history, to make a diagnosis. Pelvic organ prolapse is usually categorized in stages, from 0 to 4, as follows:
- Stage 0: No prolapse
- Stage 1: Almost no prolapse; pelvic organs are well supported
- Stage 2: Pelvic organ(s) have begun to fall, but organs are still inside the vagina
- Stage 3: Pelvic organ(s) are beginning to bulge to or beyond the opening of the vagina
- Stage 4: Pelvic organ(s) are completely outside the vagina
Before we get into treatments for POP, let’s come back to Anne’s story. Remember that her doctor advised Anne to have a simple hysterectomy as the first line of treatment, but Anne wants to avoid this.
Anne confided in her friend who happens to be a physiotherapist. Her friend suggested trying Kegel exercises to see if this could help alleviate Anne’s symptoms. Her friend recommended using a pelvic floor biofeedback device to ensure she contracts the right muscles properly.
To Anne’s delight, once she started doing pelvic floor exercises with the assistance of a Kegel exerciser, she noticed improvements over time. She no longer has pain or bleeding with intercourse, and her constipation has improved greatly. Anne sought out another doctor who says that Anne has sufficiently strengthened her pelvic floor muscles to the point surgery isn’t necessary.
Anne’s story illustrates how some women may be able to sufficiently relieve the symptoms of prolapse without invasive treatments like surgery. Yet, pelvic floor exercises, alone, may not work for all women. What are the other treatment options?