Pelvic Organ Prolapse Care & Treatment
Compassionate evaluation and personalized treatment for pelvic pressure, vaginal bulging, bladder symptoms, bowel changes, and other symptoms associated with pelvic organ prolapse.
You don't have to live with pelvic pressure or discomfort.
Pelvic organ prolapse occurs when the muscles and supporting tissues of the pelvic floor can no longer adequately support one or more pelvic organs.
Learn about pelvic organ prolapseWhen pelvic organs lose their normal support
Pelvic organ prolapse, often shortened to POP, occurs when the muscles and connective tissues that support the pelvic organs weaken or become stretched, allowing an organ to move downward into the vagina.
The pelvic organs include the uterus, vagina, bladder, urethra, and rectum. Different types of prolapse are named according to the organ or vaginal wall involved.
Pelvic organ prolapse can take several forms
More than one type of prolapse can occur at the same time. Your evaluation helps determine which structures are affected and how significant the prolapse is.
Anterior Vaginal Wall Prolapse
Also called a cystocele, this occurs when the bladder pushes against or bulges into the front wall of the vagina.
Uterine Prolapse
Uterine prolapse occurs when the uterus descends downward toward the vaginal opening because its supporting tissues have weakened.
Posterior Vaginal Wall Prolapse
Also called a rectocele, this occurs when the rectum bulges against the back wall of the vagina.
Vaginal Vault Prolapse
Vaginal vault prolapse occurs when the upper portion of the vagina loses support. It may occur after a hysterectomy.
Enterocele
An enterocele occurs when the small intestine bulges into the vaginal area because of weakened pelvic support.
Multiple Prolapse
Some women experience more than one type of pelvic organ prolapse. Treatment is tailored to the specific combination of symptoms and findings.
Recognizing the signs of prolapse
Pelvic organ prolapse does not always cause symptoms. When symptoms occur, they can vary depending on the location and severity of the prolapse.
Pelvic pressure or heaviness
A feeling of fullness, pressure, dragging, or heaviness in the pelvis or vagina.
Vaginal bulge
You may feel or notice a bulge or lump inside the vagina or near the vaginal opening.
Urinary symptoms
Symptoms can include urinary leakage, frequent urination, difficulty starting urination, or a sensation that the bladder does not completely empty.
Bowel symptoms
Some women experience constipation, difficulty passing stool, or a sensation of incomplete bowel emptying.
Sexual discomfort
Pelvic pressure or changes in pelvic anatomy can sometimes contribute to discomfort during sexual activity.
Lower back discomfort
Some women with pelvic organ prolapse report lower back discomfort or a sensation of pelvic dragging.
Why does pelvic organ prolapse happen?
Pelvic organ prolapse can develop when the muscles, ligaments, and connective tissues responsible for pelvic support become weakened or stretched.
A careful evaluation starts with listening
Pelvic organ prolapse is usually evaluated through a medical history and pelvic examination. Your symptoms, daily activities, bladder and bowel concerns, sexual health, and reproductive plans may all be relevant to treatment planning.
Discuss your symptoms
Your provider will ask about pressure, bulging, urinary symptoms, bowel changes, discomfort, and how symptoms affect your daily life.
Pelvic examination
A pelvic examination can help identify whether pelvic organs have moved from their normal position and determine the structures involved.
Assess your individual needs
Treatment decisions consider symptom severity, overall health, previous procedures, and your preferences and future plans.
Treatment is personalized to your symptoms and goals
Not every woman with pelvic organ prolapse needs surgery. Treatment depends on the severity of symptoms, examination findings, overall health, and personal preferences.
Observation
If prolapse does not cause bothersome symptoms, your healthcare professional may recommend monitoring rather than immediate treatment.
Pelvic Floor Therapy
Pelvic floor muscle training and specialized pelvic floor physical therapy may help some women improve pelvic support and manage related symptoms.
Vaginal Pessary
A pessary is a removable device placed inside the vagina to provide support for pelvic organs. Different types and sizes are available.
Lifestyle Measures
Addressing constipation, avoiding unnecessary straining, maintaining a healthy weight, and discussing activities that increase pelvic pressure may help manage symptoms.
Vaginal Estrogen
For some postmenopausal patients, a clinician may discuss local vaginal estrogen as part of treatment for specific vaginal or urinary symptoms.
Surgical Treatment
When symptoms are significant and nonsurgical options are insufficient or unwanted, reconstructive or other surgical approaches may be considered.
What is a pessary?
A pessary is a medical device inserted into the vagina to support pelvic organs. It can be an option for women who want nonsurgical management or who are not candidates for surgery.
Pessaries come in different shapes and sizes. A healthcare professional can determine whether a pessary may be appropriate and help with fitting and follow-up.
Discuss your optionsWhen surgery may be considered
Surgery may be considered when prolapse symptoms significantly affect quality of life or when nonsurgical treatment does not provide adequate relief.
Reconstructive procedures
Reconstructive surgery is designed to restore support to the affected pelvic structures. The appropriate procedure depends on the type of prolapse.
Native tissue repair
Some procedures use the patient's own tissues to restore support to the vagina or other pelvic structures.
Laparoscopic or abdominal approaches
Certain procedures may be performed through abdominal incisions or minimally invasive techniques depending on the specific clinical situation.
Individualized surgical planning
Surgical decisions should consider symptoms, anatomy, health conditions, future childbearing plans, and personal preferences.
When should you talk with an OB/GYN?
Consider scheduling an evaluation if you notice a vaginal bulge, persistent pelvic pressure or heaviness, difficulty emptying your bladder, urinary leakage, bowel difficulties, or other symptoms that interfere with your daily activities.
Call 951-351-1071Pelvic organ prolapse FAQs
What is pelvic organ prolapse?
Pelvic organ prolapse occurs when the muscles and supporting tissues of the pelvic floor become weakened or stretched, allowing one or more pelvic organs to move downward and bulge into the vagina.
What are the symptoms of pelvic organ prolapse?
Symptoms can include pelvic pressure or heaviness, a vaginal bulge, urinary leakage, difficulty emptying the bladder, bowel difficulties, lower back discomfort, or discomfort during sexual activity. Some women have no symptoms.
What causes pelvic organ prolapse?
Pregnancy and vaginal childbirth are important risk factors. Aging, menopause, repeated heavy lifting, chronic constipation, chronic coughing, higher body weight, and some pelvic surgeries can also contribute.
Can pelvic organ prolapse be treated without surgery?
Yes. Depending on symptoms and individual circumstances, nonsurgical options may include pelvic floor muscle training, physical therapy, a vaginal pessary, and lifestyle measures.
What is a pessary?
A pessary is a removable medical device placed inside the vagina to help support pelvic organs. Different types and sizes are available, and professional fitting may be needed.
Does pelvic organ prolapse always get worse?
No. Pelvic organ prolapse does not necessarily worsen over time. Symptoms and prolapse can remain stable, and some cases may improve. More significant prolapse may be more likely to progress, so persistent or changing symptoms should be discussed with an OB/GYN.
Can pelvic organ prolapse cause urinary problems?
Yes. Depending on the type of prolapse, women may experience urinary leakage, increased urinary frequency, difficulty emptying the bladder, or a sensation that the bladder does not fully empty.
Can pelvic organ prolapse affect bowel movements?
Yes. Some women experience constipation, difficulty passing stool, or a sensation of incomplete bowel emptying.
Can pelvic organ prolapse affect sexual activity?
Pelvic pressure, discomfort, or changes in pelvic anatomy may affect sexual activity. Treatment may help address symptoms that interfere with comfort or sexual function.
Is surgery always necessary for pelvic organ prolapse?
No. Many women can manage symptoms with observation, pelvic floor therapy, a pessary, and other nonsurgical approaches. Surgery may be considered when symptoms are significant or other approaches do not provide sufficient relief.
Can pelvic organ prolapse come back after surgery?
Prolapse can recur after treatment. Your OB/GYN can discuss the expected benefits, limitations, risks, and potential for recurrence of a specific procedure.
When should I see an OB/GYN for pelvic pressure?
Schedule an evaluation if pelvic pressure, heaviness, vaginal bulging, urinary problems, bowel symptoms, or discomfort are persistent or interfering with your normal activities.
Get the answers you deserve.
If pelvic pressure, vaginal bulging, urinary changes, or other pelvic symptoms are affecting your life, a personalized gynecologic evaluation can help you understand your options.
Request an AppointmentMedical Information Sources
This educational page is based on information from reputable medical and public-health organizations. It is intended for general education and does not replace an individual medical evaluation.