What is Total Organ Prolapse (TOP)? What are the Symptoms and Treatment?

Pelvic organ prolapse (Total Organ Prolapse, POP) is the prolapse of one or more of the bladder (bladder), uterus or intestines out of the vagina in women.

It can be roughly classified as mild, intermediate and advanced. Slight sagging occurs in the form of organs to bulge in the vagina and does not require treatment. Moderate sagging can be defined as the organs coming into the vaginal opening and becoming prominent but not going out of the vagina.

Treatment can be done by talking to the patient. In advanced prolapse, one or more of these organs have come out of the vagina and can be seen from the outside. It requires treatment.

There are symptoms such as the feeling of swelling out of the vagina, the feeling of pulling towards the lower part of the vagina and waist, inability to discharge urine comfortably, incontinence with cough sneezing, inability to fully empty the intestines and the need to push the swelling in the vagina to empty it, difficulty in sexual intercourse.

POP prolapse affects one in three women who have more than one delivery. The effects may be immediate or may spread over the years due to the weakening of the connective tissue holding the organs.

The menopause period further increases the severity of the event. One out of every 9 women is therefore a candidate for surgery.

If you suspect that there is a pelvic organ prolapse, you should consult a physician who is interested in this job to find out the degree.

After taking a detailed history and doing a physical examination, he will tell you his grade. Approximately 40% of them show little or no symptoms.

The degree of pelvic organ prolapse is important in treatment. In addition, since it is not a life-threatening situation, it is also important whether the patient complains about it.

In mild cases without serious complaints, no treatment may be required. However, if there is a cough, it should be relieved, avoiding situations that increase intra-abdominal pressure, and exercising should be recommended.

 If the sagging is more serious, especially if there is sagging, placing a pessary ring can be applied to elderly patients who cannot afford the surgery or those who want to have children.

If the patient’s organ prolapse is serious and requires treatment, surgical treatment is the most successful method. Surgical treatment is performed in two ways: vaginal and abdominal approach.

In the vaginal approach, the organs that come out are pushed into place and separated from the surrounding tissues and placed in their original places by strengthening. Abdominal approach open, laparoscopic or total

organ prolapse degree is important in treatment. In addition, since it is not a life-threatening situation, it is also important whether the patient complains about it or not. In mild cases without serious complaints, no treatment may be required. However, if there is a cough, it should be relieved, avoiding situations that increase intra-abdominal pressure, and exercising should be recommended.

If the sagging is more serious, especially if there is sagging, placing a pessary ring can be applied to elderly patients who cannot afford the surgery or those who want to have a child.

If the patient’s organ prolapse is serious and requires treatment, surgical treatment is the most successful method. Surgical treatment is done in two ways: vaginal and abdominal approach.

In the vaginal approach, the organs that come out are pushed into place and separated from the surrounding tissues and placed in their original places by strengthening. The abdominal approach is performed using open, laparoscopic or robot-assisted laparoscopic methods. In all, hanging organs are hung on the bone called sacrum with the help of mesh and fixed with stitches.

This operation, which we call Sacro colpopexy, is 90-95% successful.

It is done by laparoscopic methods. In all, hanging organs are hung on the bone called sacrum with the help of mesh and fixed with stitches. This operation, which we call sacrocolpopexy, is 90-95% successful.

The treatment decision should be made by mutual discussion after the communication between the patient and the physician. If you want to have a child in the next period, the choice of follow-up or pessary ring will be more appropriate.

The type of surgical approach varies from patient to patient. Laparoscopic or robotic approach can be preferred for those who have aesthetic concerns. With open surgery, it can be successfully treated without any contamination of the abdominal organs (retroperitoneal approach).