What Is Pelvic Organ Prolapse and How Is It Treated?

What is pelvic organ prolapse?

Pelvic organ prolapse (also known as “dropped bladder,” “dropped uterus,” “cystocele” or “rectocele”) is a condition where the muscles and tissues in the pelvis become weak and less supportive. This can cause the pelvic organs like the bladder, rectum, or uterus to bulge into the vagina. When this happens, the person experiencing this may feel something bulging out of the vagina like a ball. 

Is this common?

Pelvic organ prolapse is very common. 50% of women over the age of 50 have some level of prolapse. For some, this condition can be very uncomfortable and bothersome. Many women can feel sad or isolated when experiencing symptoms of prolapse because they are not always openly discussed. It is important to know that you are not the only person experiencing these symptoms, and there are treatment options.  

Is pelvic organ prolapse dangerous?

Pelvic organ prolapse is not a life-threatening condition. In fact, many people who have prolapse don’t have any symptoms as a result of it. On the other hand, many people with prolapse will feel a bulge in their vagina or an uncomfortable pressure in the pelvis or vagina. In some cases, pelvic organ prolapse may make it difficult for women to empty their bowels or bladder. Some women may experience pain or discomfort with sex as a result of pelvic organ prolapse. 

What causes pelvic organ prolapse?

Many different things can contribute to having pelvic organ prolapse, but there is no one reason that this happens. 

• Past pregnancies/vaginal deliveries and forceps deliveries
• Aging
• Family history of pelvic organ prolapse 
• Chronic heavy lifting 
• Chronic cough
• Connective tissue disorders (eg, Ehlers-Danlos Syndrome)

What can I do about pelvic organ prolapse?

If the prolapse is not causing any issues or discomfort, it is safe to choose to do nothing about it. However, if the prolapse is causing discomfort, the first step is to be evaluated by a gynecologist or urogynecologist. Some reasons you would need to see a doctor include:

• Pelvic pain or pressure that limits your activities
• Any abnormal bleeding
• Urinary symptoms like bladder leaking, recurring bladder or kidney infections, or difficulty urinating
• Pain or difficulty with sexual intercourse
• A bothersome bulge in the vagina that you can feel
• Any other concern you have about your body

What treatment options will a doctor recommend?

Your doctor will discuss options with you, and you will decide together what is best for you. If your prolapse is not bothersome to you and is not causing any issues with your bladder or bowel, a doctor may recommend that you do nothing and follow up with them if you do develop symptoms. If you are bothered by the prolapse, your doctor will discuss all the options with you which may include a special kind of physical therapy, a pessary, or surgery. A pessary is a silicone ring that can be inserted into the vagina and help to provide more support to the pelvic organs.

If you decide with your doctor to proceed with surgery, there are often many options and your doctor will discuss this with you. Your doctor will be able to talk you through all these different types of treatment, make a plan, and help you to feel comfortable again. 

At Women & Infants Hospital, our team is also able to provide you with minimally invasive options under the guidance of Dr. Christine Foley. Learn more about the Spaulding Outpatient Center for Pelvic Health at Care New England and to ask if this could be an option for you.