Pelvic organ prolapse (POP) occurs when one or more pelvic organs, such as the bladder or uterus, descend from their normal position, often creating a bulge in the vagina. These organs are typically held in place by a supportive network of muscles and tissues known as the pelvic floor. Urinary tract infections (UTIs) are common infections affecting any part of the urinary system, most often caused by bacteria. This article will explore the connection between POP and an increased risk of developing frequent UTIs.
Understanding Pelvic Organ Prolapse
Pelvic organ prolapse occurs when the muscles and connective tissues forming the pelvic floor, which act like a supportive hammock for organs, weaken or become damaged. This weakening allows one or more pelvic organs, such as the bladder, uterus, or rectum, to drop from their usual positions and bulge into the vagina. This condition can result from factors like childbirth, aging, or prolonged pressure on the abdomen.
Several types of pelvic organ prolapse exist, often named after the specific organ that has descended. A common type directly impacting the urinary system is a cystocele, where the bladder bulges into the front wall of the vagina. Another relevant type is uterine prolapse, which involves the uterus descending into the vaginal canal. These two types are particularly significant due to their proximity and potential influence on bladder and urinary tract function.
How Prolapse Contributes to UTIs
Pelvic organ prolapse can increase the risk of urinary tract infections by altering the anatomy and function of the urinary system. A primary mechanism involves incomplete bladder emptying, also known as urinary retention. When the bladder or other pelvic organs descend, they can change the bladder’s position or cause the urethra—the tube that carries urine out of the body—to kink or compress. This physical obstruction makes it difficult to completely empty the bladder.
The inability to fully empty the bladder leads to a build-up of residual urine. This stagnant urine provides an ideal environment for bacteria to multiply. Normally, the act of completely emptying the bladder helps to flush out these bacteria, serving as a natural defense mechanism against infection. When this cleansing action is compromised, bacteria can thrive and ascend into the bladder, initiating a UTI.
For instance, a cystocele, or prolapsed bladder, can pinch off the urethra, hindering urine flow and preventing thorough emptying. Even a posterior vaginal wall prolapse, like a rectocele, can indirectly press on the urethra, causing similar obstructive voiding symptoms. A post-void residual volume of 180 ml or more increases the risk of bacterial growth, highlighting the importance of complete bladder emptying in preventing recurrent UTIs.
Recognizing Symptoms and Seeking Help
Recognizing the symptoms of both pelvic organ prolapse and urinary tract infections is important for timely intervention. Pelvic organ prolapse can manifest as heaviness, pressure, or a bulging sensation within the vagina. Individuals might also notice a visible lump at or beyond the vaginal opening, experience lower back pain, or have discomfort during sexual activity. Urinary changes such as frequent urination, incomplete bladder emptying, or a weak urine stream are also common with prolapse.
Concurrently, urinary tract infections present with distinct symptoms that can include a frequent and urgent need to urinate, a burning sensation during urination, and cloudy or strong-smelling urine. Lower abdominal pressure or pain may also be present. If the infection spreads to the kidneys, symptoms can become more severe, including fever, chills, and flank pain.
Given the overlap in some urinary symptoms and the increased risk of UTIs with prolapse, consult a healthcare professional if any of these signs are consistently present. Early diagnosis allows for appropriate management, which can prevent complications and improve quality of life.
Managing Prolapse and Preventing UTIs
Managing pelvic organ prolapse involves approaches aimed at improving organ support and reducing UTI risk. Non-surgical options include pelvic floor muscle training, like Kegel exercises, which strengthen supportive tissues. Vaginal pessaries, removable devices, mechanically support prolapsed organs, improving their position and aiding bladder emptying. For more severe cases, surgical repair aims to lift and secure organs, directly addressing urinary retention.
Beyond prolapse treatment, several practices help prevent UTIs. Maintaining good hydration by drinking plenty of water is crucial, as it flushes bacteria and dilutes urine, hindering bacterial growth. Practicing complete bladder emptying, through techniques like double voiding or leaning forward, minimizes residual urine. Proper hygiene, such as wiping front to back after using the toilet and urinating after sexual activity, further reduces bacterial entry into the urinary tract.