Pelvic organ prolapse occurs when the muscles and connective tissues that support the pelvic organs become weakened, allowing the bladder, uterus, rectum, or top of the vagina to bulge downward into the vaginal canal. Prolapse is common, particularly after pregnancy and childbirth or with aging, and symptoms can range from mild to bothersome.
Women with prolapse may notice a feeling of vaginal pressure or bulging, pelvic heaviness, difficulty emptying the bladder or bowels, urinary leakage, or discomfort with intercourse. Treatment depends on the type and severity of prolapse, as well as your symptoms and personal goals.
The resources below provide information about pelvic organ prolapse, nonsurgical treatment options, pelvic floor exercises, pessaries, and surgical management.
Pelvic organ prolapse occurs when one or more pelvic organs lose their normal support and descend into the vagina. Depending on which organ is involved, prolapse may affect the bladder (cystocele), uterus, rectum (rectocele), small intestine (enterocele), or the top of the vagina after hysterectomy (vaginal vault prolapse). Many women have mild prolapse that causes few or no symptoms, while others experience vaginal bulging, pressure, urinary or bowel symptoms, or discomfort during daily activities. Treatment is based on your symptoms rather than the stage of prolapse alone.
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Many women with mild or moderate prolapse do not require surgery. Treatment is based on how bothersome your symptoms are, rather than how severe the prolapse appears on examination. Some women choose observation, while others improve with pelvic floor physical therapy or a vaginal pessary. Surgery is generally considered when symptoms significantly affect quality of life or when conservative treatments are not effective or desired.
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