Three Ways to Treat Pelvic Organ Prolapse and Tips to Prevent It

by Andrew Ian Sokol, MD, Female Pelvic Medicine and Reconstructive Surgeon
February 11, 2020

Pelvic organ prolapse, often just called prolapse, is a common condition in which the walls of the vagina drop (bulge) from their usual position. The most common symptoms of prolapse include:

  • Bulging at or through the opening of your vagina
  • Pelvic pain, pressure, or fullness
  • Urinary incontinence
  • Incomplete bladder or bowel emptying
  • Vaginal bleeding or spotting
  • Vaginal pressure
  • Pain or blockage during sex

Prolapse most often develops in women who had a vaginal delivery—especially if their doctor used instruments during delivery, such as forceps (tools that resemble large spoons) or vacuums. This is because many women’s pelvic floor muscles weaken after delivery. Other common causes of prolapse include:

  • Age, as postmenopausal women are at higher risk
  • Connective tissue disorders
  • Chronic constipation or anything that chronically increased abdominal pressure
  • Family history

Symptoms of prolapse affect the quality of life for many women, making it difficult to perform a variety of everyday activities. As a result, it’s important to understand what treatments are available and ways to prevent prolapse, if you don’t already have it.

How Can We Treat Prolapse?

Our urogynecology team is nationally recognized for the expert care we provide to patients with prolapse and other pelvic floor disorders. We generally treat prolapse in three ways:

  1. Monitor it: Prolapse in general isn’t dangerous if you aren’t experiencing symptoms. In this case, we create a care plan for you in which we explain prolapse symptoms and ask that you come back to see us right away if you experience them so we can help you manage symptoms with the treatments listed below.
  2. Use a pessary: This is a vaginal support device made of silicone that’s placed inside the vagina and worn throughout the day. While pessaries don’t treat the actual prolapse, they are nonsurgical and normally relieve symptoms of prolapse. Pessaries have to be removed, cleaned and replaced periodically and are fit in the office by your doctor.
  3. Surgical treatment: We offer a variety of minimally invasive procedures in an outpatient setting in which we resuspend and repair your prolapse. A majority of these surgeries are done through the vagina, not requiring any external incisions, and often don’t require general anesthesia. Other surgeries are performed with “keyhole” surgery. The exact surgery can vary depending on type of prolapse however, so make sure to speak to your doctor to understand how surgery will work for you and your particular situation.

Our No.1 goal when treating your prolapse is to make you happy. One of my mantras is to fit the surgery to you, not fit you to surgery. It all depends on your goals and your particular situation. We want to work with you to ensure you receive the treatment that works best.

Using a pessary is one way to treat #PelvicOrganProlapse, or #prolapse, a condition in which one of your pelvic organs drops down from its usual position. Learn how pessaries work and other treatment options, via @MedStarHealth

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How Do We Diagnose Prolapse?

Prolapse is typically diagnosed during a doctor’s visit in which you discuss your symptoms and undergo a physical exam. Physical exams often involve your doctor taking measurements of the areas of your body that could be prolapsing. In rare cases, an imaging test, such as a magnetic resonance imaging (MRI), is required for a diagnosis.

Can You Prevent Prolapse?

One way to help prevent prolapse is to maintain a healthy body weight, as studies show that overweight and obese women are signficantly more likely to experience pelvic organ prolapse, compared to women of normal weight.

Pelvic floor training, such as Kegel exercises, may also be helpful in preventing prolapse symptoms, as they strengthen the muscles in and around your pelvic floor. Make sure to speak to your doctor if you’re interested in pelvic floor training to learn proper technique, as incorrect form can actually be counterproductive. If your doctor determines that you would benefit from seeing a physical therapist, MedStar Health has a large network of physical therapists who specialize in pelvic floor training.

If you’re experiencing symptoms of prolapse, make sure to schedule an appointment with a fellowship-trained urogynecologist. Treatment is widely successful—and it can get you back to your everyday activities symptom-free.

Are you experiencing vaginal bulging, difficulty emptying your bladder or bowels, pain during sex, or another symptom of pelvic organ prolapse?
Click below to contact Dr. Sokol for an appointment.

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Category: Living Well     Tags: Women's Health