Pelvic organ prolapse occurs when the uterus slips out of place and into the vaginal canal (uterine prolapse) or when the vagina bulges inward and downward (vaginal prolapse). Sometimes called pelvic organ relaxation, these conditions are typically the result of injury to the organs’ support during childbirth or other strenuous activities.
Many women do not notice these conditions until they reach middle age when their hormones begin to change and their muscle strength decreases. Often pelvic prolapse occurs with urinary incontinence.
The most common types of pelvic organ prolapse are cystocele (dropped bladder), rectocele, uterine and vaginal prolapse.
Risk factors for pelvic organ prolapse
- Increased age; post-menopause
- Multiple vaginal deliveries
- Straining caused by chronic cough, constipation, or heavy lifting
- Family history
Symptoms of vaginal and uterine prolapse
- Pelvic pressure
- A feeling of vaginal fullness or heaviness
- A feeling of pulling in the pelvis
- Vaginal discharge
- Urinary urgency and frequency
- Urination when laughing, sneezing, coughing, or exercising
- Protrusion of pink tissue from the vagina that may be irritated or itchy
Treatment for uterovaginal prolapse
At Rose, your doctor will diagnose your prolapse with a physical exam and/or an advanced imaging study called an MRI defogram. This study is only offered at a few centers in the region and can help your doctor clearly visualize the compartments of the vaginal tract that might be prolapsing.
The level of prolapse is measured by degrees. First degree prolapse is the least severe and third degree prolapse is the most severe. With a clear diagnosis, your doctor then will create an individualized plan to meet your needs. This may include:
- Kegel Exercises: Tensing the muscles around the vagina and anus, holding for several seconds, then releasing. When repeated, this exercise tones the pelvic muscles.
- Medication: Estrogen therapy may help prevent further weakness of the pelvic floor.
- Pessary Insertion: A pessary is shaped like a donut and is made of a rubbery material. Your doctor may place this in the upper part of your vagina to give added support.
- Surgery: Surgery may be needed for severe uterine prolapse. Options include a hysterectomy (which can be done robotically), repair with sutures or the insertion of a support device, and colpocleisis (closing the vagina; only done in women who are elderly and who are no longer sexually active).