Vaginal/Pelvic Organ Prolapse
What is it?
Vaginal/pelvic organ prolapse occurs when an
organ in the pelvis, such as the bladder or
uterus, falls or slips out of place, into the
vagina. The rectum and intestine can also prolapse
into the vagina. Bladder prolapse may also be
called a cystocele. Uterine prolapse is also
referred to as a pudendal hernia or pelvic floor
hernia.
Who gets it?
Vaginal/pelvic organ prolapse affects women,
and the risk increases with age. Some women
inherit a condition in which the pelvic floor
muscles are weak.
What causes it?
Vaginal/pelvic organ prolapse is caused by a
weakening of the pelvic floor muscles, which
support the pelvis, holding the bladder, uterus,
and other pelvic organs in place. These muscles
can naturally weaken with age and as a result of
the stress of childbirth. Frequent straining or
heavy lifting can also be contributing factors.
What are the symptoms?
The symptoms of vaginal/pelvic organ prolapse
can range from mild to severe, depending upon the
position of the prolapsed organ. Mild prolapse may
not cause any symptoms. Moderate prolapse may
cause a feeling of pressure in the vagina,
discomfort or pain in the lower abdomen and/or
lower back, and pain during sexual intercourse.
Severe prolapse causes the same types of symptoms,
but the pelvic organ is dropped down so far that
it is visible or protruding through the vaginal
opening. In most cases, standing for long periods
of time causes the discomfort to worsen. Prolapse
can also cause urinary symptoms, including stress
and urge incontinence, and a feeling of being
unable to completely empty the bladder. Urine may
leak when the patient laughs, coughs, or strains
in any way. Being overweight can also make
symptoms worse. Symptoms related to the bowel
include constipation, flatulence, and difficulty
holding in bowel movements.
How is it diagnosed?
Vaginal/pelvic organ prolapse is diagnosed
through a thorough pelvic examination. Your doctor
will also study your medical history for factors
that can contribute to this condition. He or she
may order diagnostic tests, such as urinalysis and
some type of urodynamic study to evaluate the
presence of urinary incontinence.
What is the treatment?
In mild cases, your doctor will recommend Kegel
exercises to help strengthen the pelvic floor
muscles. Kegels involve contracting the vaginal
muscles for a series of 10 to 15 repetitions, at
least 3 times per day. Estrogen supplements may
also help strengthen the pelvic floor. In moderate
cases, the doctor may recommend inserting a round
plastic device called a pessary into the vagina to
help hold the uterus and bladder in place. The
pessary needs to be checked and changed
periodically. Your doctor may also prescribe
medication to control urinary incontinence.
Surgery is necessary when a pessary does not work,
or prolapse is severe. Surgery may repair the
sagging organ and reinforce the support ligaments.
In the case of uterine prolapse, the organ is
often removed through a procedure called a
hysterectomy. Patients who are within childbearing
years who do not want to have a hysterectomy may
be candidates for a procedure in which the uterus
is attached to a ligament for support. All
patients with prolapse should avoid any type of
activity that requires straining in the pelvic
area, follow healthy diet, and maintain a healthy
weight.
Self-care tips
You can help prevent vaginal/pelvic organ
prolapse by learning how to do Kegel exercises and
making them a part of your everyday routine. Do
not strain to move your bowels. If you have
trouble with constipation, make sure your diet
contains enough fiber, and ask your doctor how to
relieve these symptoms. Avoid frequent heavy
lifting. If you are overweight, modify your
lifestyle, as recommended by your doctor, to
include diet and exercise.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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