Pelvic Organ Prolapse

Many women who have pelvic organ prolapse do not have symptoms and do not require treatment. If your symptoms are bothersome, you may want to consider treatment. Treatment decisions should take into account which organs are affected, how bad symptoms are, and whether other medical conditions are present. Other important factors are your age and sexual activity.

Many women are able to reduce pain and pressure from a pelvic organ prolapse with nonsurgical treatment, which may include making lifestyle changes, doing exercises, and/or using a removable device called a Reference pessary that is placed into the vagina to support areas of prolapse.

If your pelvic organ prolapse is causing pain or problems with bowel and bladder functions or is interfering with your sexual activity, you may want to consider surgery. Surgical procedures used to correct different types of pelvic organ prolapse include repair of the supporting tissue of the prolapsed organ or vagina wall. Another option is the removal of the uterus (hysterectomy) when it is the prolapsed organ or if it is causing the prolapse of other organs (such as the vagina).

Sometimes surgery cannot repair all the prolapsed organs. And sometimes pelvic organ prolapse comes back after surgery.

Initial treatment

Pelvic organ prolapse can be a long-lasting condition. But it does not have to be a cause of symptoms that disrupt your life. Many women with pelvic organ prolapse are able to relieve their symptoms without treatment by adjusting their activities and lifestyle habits. These changes might include:

• Doing Reference pelvic floor (Kegel) exercises every day to tighten and strengthen pelvic muscles.
• Eating high-fiber foods to prevent constipation. Get at least 20 g of fiber a day.
• Reaching and staying at a healthy weight.
• Avoiding activities that stress your pelvic muscles, such as heavy lifting.

If your symptoms are not relieved by these lifestyle changes, you may want to consider treatment for pelvic organ prolapse. Treatment will be different depending on which organs are involved, how bad your symptoms are, and what other medical conditions are present. Treatment may include using a pessary, a removable device that is placed into the vagina to support areas of prolapse.

Ongoing treatment

Pelvic organ prolapse can be a long-lasting condition. But it often responds to adjustments in activities and lifestyle habits. If you have tried self-care, such as eating high-fiber foods, staying at a healthy weight, and doing pelvic floor (Kegel) exercises, but your symptoms are increasingly bothersome, you may want to consider nonsurgical treatment. Treatment will be different depending on which organs are involved, how bad your symptoms are, and what other medical conditions are present. Treatment may include using a pessary, a removable device that is placed into the vagina to support areas of pelvic organ prolapse.

Treatment if the condition gets worse

If you have pain and discomfort from pelvic organ prolapse that does not respond to nonsurgical treatment and lifestyle changes, you may want to consider surgery. The choice of surgery depends upon which organs are involved, how bad your symptoms are, and what other medical conditions are present. Also, your surgeon may have experience with and preference for a certain procedure. Types of surgery for pelvic organ prolapse include:

• Reference Repair of the bladder (cystocele) or urethra (urethrocele).
• Removal of the uterus (Reference hysterectomy).
• Reference Repair of the rectum (rectocele) or small bowel (enterocele).
• Repair of the vaginal wall (Reference vaginal vault suspension).
• Closure of the vagina (Reference vaginal obliteration).

Often the doctor does more than one of these surgeries at the same time. These surgeries are designed to treat specific symptoms. So other symptoms may remain after surgery.

For help deciding about surgery, see:

Opens New Window Pelvic Organ Prolapse: Should I Have Surgery? Opens New Window

What to think about

If you are considering having children, you may want to delay pelvic organ surgery. If you have surgery and then deliver a child vaginally, the strain on your pelvic organs may cause them to prolapse again.

Sometimes surgery cannot repair all the prolapsed organs. And sometimes surgery to repair pelvic organ prolapse will lead to prolapse in another area.

Pelvic organ prolapse may be a progressive condition, gradually getting worse and causing more severe symptoms. But in many cases it does not progress and may improve over time.

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