Pelvic organ prolapse is where one of the pelvic organs—the bladder, uterus, rectum, small intestine, or vagina—drops down from its usual position and pushes against the walls of the vagina. Up to one-third of women experience pelvic organ prolapse or a similar pelvic disorder at some point in their lives. The experience can be embarrassing, uncomfortable, and painful.
Causes and Risk Factors
The pelvic floor muscles should hold the pelvic organs in place. In some cases, these muscles weaken and fail to do their job. With prolapse, the pelvic floor allows the organs to drop and bulge into the vagina. Primary causes and risk factors include:
- Childbirth
- Aging
- Obesity
- Family history
- Constipation
- A chronic cough
- Pelvic organ cancer
- A past hysterectomy
- Excessive pressure on the abdomen
Types of Pelvic Organ Prolapse
Each type corresponds to a different organ involved:
- Cystocele: A bulge of the bladder into the vagina.
- Uterine prolapse: Prolapse of the uterus.
- Enterocele: Prolapse of the small intestine/small bowel.
- Urethrocele: Prolapse of the urethra.
- Rectocele: Prolapse of the front wall of the rectum into the vagina.
- Vaginal vault prolapse: Prolapse of the upper section of the vagina into the vaginal canal or outside the vagina.
Symptoms
The symptoms of pelvic organ prolapse vary depending which organ has dropped. Here are some common symptoms you may notice:
- Bulging at the opening of the vagina
- Vaginal pressure
- A constant urge to urinate
- Leaking urine (incontinence)
- Constipation
- Painful sex
- Lower back pain or pressure
- Pelvic pain, pressure, or fullness
- Vaginal bleeding or spotting
Diagnosis
Pelvic organ prolapse can be diagnosed through a multitude of ways:
- A routine pelvic exam
- Pelvic floor strength testing
- Ultrasound
- MRI
- X-ray
- CT scan
Treatment
Treatment options include:
- Physical Therapy: A common, early treatment used to strengthen the pelvic floor muscles. This usually involves kegel exercises.
- A Pessary: A removable device that’s inserted into the vagina to support organs.
- Surgery: If the stage/grade of the prolapse is high, surgery may be needed to repair the organ or tissue. The exact surgery will vary depending on the organ involved, with some being far more simple or complex than others. If the uterus is the organ involved, a hysterectomy is often recommended. Sometimes a procedure called a sacrocolpopexy is performed on women who are at high risk of experiencing repeated prolapse.
Next Steps
It’s important to see your women’s health provider if you think you’re dealing with pelvic organ prolapse. In most cases, the condition isn’t harmful, but may get worse over time. It can also result in urinary tract infections or other urinary problems when left untreated.
Learn more:
- Women’s Health Arizona Services: Pelvic Floor Health
- Vaginal Strengthening Exercises to Improve Sexual Health
If you would like to meet with a knowledgeable doctor, consider contacting Women’s Health Arizona. As Arizona’s largest ObGyn group, we’re trained and solely dedicated to delivering the best ObGyn experience in convenient and comfortable settings around Phoenix.
