Generally, the bladder, vagina and rectum are maintained in their position by a body of connective tissues and muscles that form a strong shelf. Damage from aging, child birth, pelvic surgery or trauma can cause the organs to lose their normal positioning resulting in pelvic organ prolapse. More that 50% of women ages 55 and older suffer one or more types of prolapse. There are four main types of prolapse:

The uterus drops down into the vagina.

• feeling a lump in the vagina
• dragging/heaviness in the pelvic area
• if prolapse is total (obvious), pain during walking, sores on protruding cervix, urinary or bowel problems
• it is possible to have no symptoms

A hernia where the small bowel falls and pushes the top of the vagina down and potentially out of the vaginal opening. This is most common in women with a hysterectomy.

• pain while sitting or walking
• sores on protruding vaginal tissue

The bladder drops down and potentially protrudes into the wall of the vagina.

• stress incontinence
• difficulty emptying the bladder
• urinary tract infections
• urge incontinence
• pain in the pelvis or lower back
• protrusion of tissue out of the vagina

The rectum drops and protrudes into the back of the vagina.

• difficulty evacuating bowel movements
• sensation of constipation
• the need to place a finger in the vagina in order to have a bowel movement

Living with pelvic organ prolapse can be challenging both physically and emotionally. Many women live for years with a sense of fullness or bulge and never seek help. A urologist can usually evaluate and treat your pelvic organ prolapse after a thorough examination. Non- surgical treatments such as pessary placement, pelvic floor exercises, a high fiber diet, or estrogen vaginal suppositories or cream may be tried. Surgical treatments aim to lift the prolapsed organs back into place. The choice of surgery depends on the type of prolapse you have, your age, and your stage in life. Your doctor will recommend treatment that is the best for you.

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