Pelvic organ prolapse or pelvic prolapse is a common condition – mostly found in women over age 45 - in which the uterus, vagina, rectum and/or bladder are bulging
or falling out of the vaginal opening. A woman with prolapse may describe that she feels like she is “sitting on a ball.”
Depending what is bulging, the specific names of pelvic prolapse are rectocele, cystocele, enterocele and uterine prolapse. They can frequently occur together in one patient. Each of these can cause similar symptoms such as:
- a heaviness or pulling sensation
- vaginal or pelvic pressure
- an uncomfortable bulge
- difficulty emptying the bladder
- difficulty having a bowel movement
- problems with sexual intercourse
These symptoms usually don’t occur until the bulge comes out beyond the vaginal opening.
Yearly pelvic exams can track the progression of prolapse and how much it bothers you as your prolapse can be measured in
a systematic way so that subtle changes over time can be noticed. It is impossible to predict whether the problem will get
worse with time, but some methods that may help to prevent it from getting worse are:
- Watching your weight. Being overweight increases pressure on your pelvic floor.
- Quitting smoking. Smoking decreases circulation to your pelvis and a chronic cough will aggravate pelvic floor prolapse.
- Avoiding constipation. Straining with bowel movements increases prolapse.
Treatment of prolapse should be based on how severe the symptoms are for a woman. The patient herself should be the one to
decide when to have her prolapse treated. Pelvic floor muscle or Kegel’s exercises may help reduce some symptoms if the prolapse
is not large. The non-surgical treatment option is a pessary, which is a vaginal support device that can removed and reinserted
by the patient. If surgery is chosen, there are many different types of surgeries that can be performed to correct the problem.
Your doctor can best explain these surgical options to you.
