Patient education: Pelvic organ prolapse (The Basics)

What is pelvic organ prolapse? — Pelvic organ prolapse is a condition that affects the "pelvic floor." The pelvic floor is the name for the muscles that support the organs in the pelvis. These organs include the bladder, rectum, and uterus (figure 1). Pelvic organ prolapse is when these muscles relax too much. This causes the organs to drop down and press against or bulge into the vagina.

Prolapse can affect different organs (figure 2). Doctors use different terms for the types of prolapse:

●If the bladder bulges into the vagina, it is called "cystocele."

●If the rectum bulges into the vagina, it is called "rectocele."

●If the uterus bulges into the vagina, it is called "uterine prolapse."

Some things can increase your risk of having pelvic organ prolapse. They include pregnancy, obesity, and older age.

What are the symptoms of pelvic organ prolapse? — Many times, prolapse does not cause any symptoms. But when symptoms do happen, they can include:

●Fullness or pressure in the pelvis or vagina

●Aching feeling in the pelvis or lower back

●Bulge in the vagina or coming out of the vagina

●Leaking urine when you laugh, cough, or sneeze

●Needing to urinate all of a sudden

●Trouble having a bowel movement

When using the toilet, you might need to press on the bulge in your vagina with a finger to get out all of your urine or to finish a bowel movement.

Is there a test for pelvic organ prolapse? — Your doctor or nurse will be able to tell if you have it by doing a pelvic exam.

Is there anything I can do on my own to feel better? — Yes. Some people feel better if they do pelvic muscle exercises. These exercises strengthen the muscles that control the flow of urine and bowel movements. Your nurse or doctor can teach you how to do them. Or they might refer you to a physical therapist who specializes in pelvic floor problems.

How is pelvic organ prolapse treated? — People who have no symptoms or who are not bothered by their symptoms do not need treatment. If you do have symptoms that bother you, your treatment options might include:

●Pelvic floor muscle training – This involves working with a physical therapist for 8 to 12 weeks to learn exercises to strengthen and relax your pelvic muscles.

●Vaginal pessary – This is a device that fits inside your vagina. It supports the bladder and pushes it back into place. Pessaries come in different shapes and sizes. Your doctor or nurse will talk to you about your options and make sure that your pessary fits your body.

●Surgery – A surgeon can move organs back where they belong and strengthen the tissues that keep them in place. Surgery might be an option if you do not plan to have children or are done having children.

Can pelvic organ prolapse be prevented? — You can reduce your chances of pelvic organ prolapse if you:

●Lose weight if you are overweight.

●Get treated for constipation if you are constipated.

●Avoid activities that require you to lift heavy things.

More on this topic

Patient education: Pelvic floor muscle exercises (The Basics)
Patient education: Constipation in adults (The Basics)
Patient education: Urinary incontinence in females (The Basics)
Patient education: Urinary retention (The Basics)

Patient education: Pelvic floor muscle exercises (Beyond the Basics)