Rising Pelvic Organ Prolapse Cases Among Younger Women: What You Need to Know

[medi K / HEALTH IN NEWS] Pelvic organ prolapse is a condition in which organs such as the bladder, uterus, or rectum descend downward, often due to weakened pelvic floor muscles and ligaments in women. Common symptoms include urinary difficulties, constipation, and lower abdominal discomfort, though early stages are frequently asymptomatic, making timely diagnosis challenging.

According to data from South Korea's Health Insurance Review & Assessment Service, the number of patients with pelvic organ prolapse rose from about 25,000 in 2020 to 29,000 in 2024, marking a 17.5% increase. Notably, cases among women in their 40s and 50s grew by nearly 10% over the same period, signaling that this is no longer a disorder confined primarily to older adults.

Shin Jeong-ho, a professor of obstetrics and gynecology at Korea University Guro Hospital, noted, "In the past, childbirth and aging were the main causes, but recent evidence points to habits like Pilates and abdominal exercises that elevate intra-abdominal pressure as contributing factors. This has heightened the risk for younger women as well."

Symptoms Often Overlooked: Seek Care if Discomfort Persists Beyond Two Weeks

Early symptoms typically manifest as a heaviness in the lower abdomen, vaginal pressure, a sensation of incomplete bladder emptying, or constipation—sensations easily dismissed as fatigue or stress. As the condition progresses, it can impair walking, leading individuals to avoid outings and potentially fostering depression over time.

A palpable foreign body or lump within the vagina signals advanced progression. Particularly if lower abdominal or pelvic discomfort lasts more than two weeks or intensifies, consulting an obstetrician-gynecologist for an accurate diagnosis is crucial.

Surgery Is Key, but Preventing Recurrence Demands Ongoing Management

Pelvic organ prolapse is classified into stages 1 through 4 based on severity. When an organ protrudes beyond the vaginal introitus, it qualifies as stage 3 or higher, often necessitating surgical intervention.

A leading procedure, sacrocolpopexy, involves anchoring the vagina to the sacrum to prevent further descent. This method offers lower recurrence rates and greater stability compared to traditional approaches. With the integration of robotic surgery, procedural precision has improved, and recovery times have shortened.

Even after successful surgery, however, recurrence remains a risk if underlying causes persist. Indeed, many patients experience relapse within several years, with some studies reporting rates as high as 40%.

Professor Shin advised, "The three to six months following surgery are especially critical; patients should avoid lifting heavy objects, engaging in exercises that strain the abdomen, or standing for prolonged periods. To prevent constipation, adequate hydration and dietary fiber intake are essential, alongside exercises to strengthen the pelvic floor muscles."

When Exercise Turns Harmful: Lifestyle Habits Are Central to Prevention

One factor behind the uptick in cases among younger women is excessive physical activity. Workouts that intensely engage the abdomen—such as gym routines, Pilates, or high-intensity strength training—can elevate intra-abdominal pressure, inadvertently pushing pelvic organs downward. What begins as a pursuit of health can thus backfire.

Prevention hinges on maintaining an appropriate body weight, avoiding constipation, and minimizing habits that increase abdominal pressure. Steering clear of heavy lifting or overzealous repetition of core-focused exercises is advisable. Modest adjustments to daily routines can significantly safeguard pelvic health.

Kim Kuk Ju / press@themedik.kr

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