Prolapse means “to fall out of place.” With prolapse, the pelvic organs drop and create pressure on each other and the pelvic floor. Discomfort and more severe pain may also develop. The dropped organs may protrude into the vagina, and in severe cases, they can drop through the vaginal opening and outside of the body.
Prolapse is due to a weakening of the muscles and/or tissues that hold those organs in place. Some specific causes include:
- Multiple pregnancies and vaginal deliveries
- Chronic coughing
- Long-term heavy lifting
- Constipation and related straining during bowel movements
- Previous pelvic surgery, especially hysterectomy
- Genetic predisposition
Pelvic organ prolapse may be resolved by strengthening pelvic muscles through:
- Physical therapy – this highly effective treatment may include biofeedback, electrical stimulation, and even vaginal weights. A physical therapist who specializes in female pelvic medicine works one-on-one in a private setting with each patient.
More advanced conditions may require reinforcement or rebuilding of the supportive tissue in the pelvic region. Methods include:
- A pessary, a flexible, removable device that is inserted into the vagina to hold the vaginal walls and neighboring organs in place. Pessaries come in a variety of shapes and sizes for patient comfort.
- Reconstructive pelvic surgery may be the best option for certain cases of pelvic organ prolapse. During surgery, the patient’s ligaments are used to recreate a more natural support of the organs that are out of place. Minimally invasive approaches through the vagina cause less pain and a shorter recovery period as compared to the major abdominal surgeries of the past.
- Because urinary incontinence often occurs in women with prolapse, all women are evaluated before surgery to check if incontinence co-exists. If confirmed, then the incontinence may be addressed at the same time as the prolapse surgery.