• What is a Urogynecologist?
• Bladder Problems
• Pelvic Organ Prolapse
• Prevention of Urinary Incontinence and Prolapse

Pelvic organ prolapse is a common condition in which the uterus, vagina, rectum and/or bladder lose support and bulge or fall out of the vaginal opening. Patients may complain of abdominal, pelvic, or back pain, a heaviness or pulling sensation, vaginal or pelvic pressure, an uncomfortable bulge, urinary incontinence or difficulty emptying the bladder, difficulty emptying the bowel and problems with sexual intercourse. A woman with prolapse may describe that she feels like she is "sitting on a ball." The defects are similar to hernias and are called rectocele, cystocele, enterocele and uterine prolapse. Often they occur together.

What will happen if I just ignore this problem?
One of two things will likely happen. The problem will either stay the same or get worse. If prolapse is noticed by a patient soon after having a baby, it will often improve. Otherwise, it is unlikely to do so. The one exception to that rule can occur shortly after having a baby. “New” prolapse (noticed by a patient or doctor in the early postpartum period) will often get better within the first year after the delivery.

Treatment of prolapse is based on a patient's symptoms. Rarely, severe prolapse can cause urinary retention leading to kidney damage or infection. In this case, prolapse treatment is necessary. Patients should be the ones to decide when to have their prolapse treated. If you choose to watch (observe) prolapse, here are some suggestions:

Get yearly pelvic exams and call between visits if you have worsening symptoms. You might also avoid heavy lifting; maintain or return to a healthy weight; quit smoking; avoid constipation; and consider hormone replacement therapy.

Your doctor should measure your prolapse in a systematic way to monitor changes over time.