At first, she assumed it was a normal postpartum symptom. However, after several months of persistent discomfort, Aina decided to seek medical advice.
Upon examination, doctors informed her that she was experiencing a condition known as pelvic organ prolapse.
According to consultant obstetrician, gynaecologist and urogynaecologist Dr Ixora Kamisan Atan, pelvic organ prolapse occurs in women who have given birth vaginally, especially at an older age, and is caused by weakened or damaged pelvic-floor muscles and supporting ligaments.
Other contributing factors include frequent childbirth, menopause, and conditions that add pressure to the pelvic floor, including chronic coughing, prolonged constipation, and obesity.
Pelvic organ prolapse is classified in four stages and can involve the uterus, bladder, bowel, or a combination of these organs descending from their original positions in the pelvis. While it is not life-threatening, prolapse can significantly affect a woman’s quality of life, Ixora said.
“In addition to the sensation of something falling out of the vagina, symptoms can include lower back pain, as well as heaviness or pulling sensations in the lower abdomen, pelvic area, and vagina.
“If the prolapse involves the bladder, it can cause difficulty urinating, straining during urination, an interrupted urine flow, and a sensation of incomplete bladder emptying.
“If the bowel is affected, it could lead to constipation and difficulty passing stool,” she told Bernama.
Globally, an estimated 30-50% of women experience pelvic organ prolapse. In the Southeast Asian region, the figure is around 20%.
“Mild prolapse (stage one) can be treated with pelvic-floor or Kegel exercises,” Ixora said. “For more severe prolapse, a support device called a vaginal pessary can be inserted, or the patient can opt for surgery.
“The duration of treatment varies. If a pessary is used, follow-up is required every three to four months. If surgery is performed, follow-up is typically every six to 12 months.”
She noted that prolapse can recur after surgery, with about a 30% risk of recurrence, but this does not always mean additional surgery is needed.
Ixora also highlighted that lifestyle changes can help prevent prolapse, including regular pelvic-floor exercises, maintaining a healthy diet and weight, and avoiding alcohol and smoking, as these can contribute to lung, liver and abdominal conditions that increase pressure on the pelvic floor.
“To reduce strain on the pelvic muscles, women should also avoid lifting heavy objects. If heavy lifting is unavoidable, there are specific techniques to minimise pelvic-floor stress,” Ixora advised.