Pelvic organ prolapse is the stretching, bulging, or dropping of pelvic organs into an abnormal position. It happens when the muscles and tissues that surround and support pelvic structures are stretched or weak. Pelvic organ prolapse can involve:
- Vagina (vaginal prolapse).
- Uterus (uterine prolapse).
- Bladder (cystocele).
- Rectum (rectocele).
- Intestines (enterocele).
When organs other than the vagina are involved, they often bulge into the vagina or protrude from the vagina, depending on how severe the prolapse is.
- Pregnancy, labor, and childbirth.
- Long-lasting (chronic) cough.
- Chronic constipation.
- Past pelvic surgery.
- Aging. During and after menopause, a decreased production of the hormone estrogen can weaken pelvic ligaments and muscles.
- Consistently lifting more than 50 lb (23 kg).
- Buildup of fluid in the abdomen due to certain diseases and other conditions.
- Loss of bladder control when you cough, sneeze, strain, and exercise (stress incontinence). This may be worse immediately following childbirth, and it may gradually improve over time.
- Feeling pressure in your pelvis or vagina. This pressure may increase when you cough or when you are having a bowel movement.
- A bulge that protrudes from the opening of your vagina or against your vaginal wall. If your uterus protrudes through the opening of your vagina and rubs against your clothing, you may also experience soreness, ulcers, infection, pain, and bleeding.
- Increased effort to have a bowel movement or urinate.
- Pain in your low back.
- Pain, discomfort, or disinterest in sexual intercourse.
- Repeated bladder infections (urinary tract infections).
- Difficulty inserting or inability to insert a tampon or applicator.
- In some people, this condition does not cause any symptoms.
- An internal and external vaginal and rectal exam.
- During the exam, you may be asked to cough and strain while you are lying down, sitting, and standing up.
- Your health care provider will determine if other tests are required, such as bladder function tests.
- Lifestyle changes, such as:
- Avoiding drinking beverages that contain caffeine.
- Increasing your intake of high-fiber foods. This can help to decrease constipation and straining during bowel movements.
- Emptying your bladder at scheduled times (bladder training therapy). This can help to reduce or avoid urinary incontinence.
- Losing weight if you are overweight or obese.
- Estrogen may help mild prolapse by increasing the strength and tone of pelvic floor muscles.
- Kegel exercises may help mild cases of prolapse by strengthening and tightening the muscles of the pelvic floor.
- Pessary insertion is a soft, flexible device that is placed into your vagina by your health care provider to help support the vaginal walls and keep pelvic organs in place.
- Surgery is often the only form of treatment for severe prolapse.
Follow these instructions at home:
- Wear a sanitary pad or absorbent product if you have urinary incontinence.
- Avoid heavy lifting and straining with exercise and work. Do not hold your breath when you perform mild to moderate lifting and exercise activities. Limit your activities as directed by your health care provider.
- Take medicines only as directed by your health care provider.
- Perform Kegel exercises as directed by your health care provider.
- If you have a pessary, take care of it as directed by your health care provider.
Contact a health care provider if:
- Your symptoms interfere with your daily activities or sex life.
- You need medicine to help with the discomfort.
- You notice bleeding from the vagina that is not related to your period.
- You have a fever.
- You have pain or bleeding when you urinate.
- You have bleeding when you have a bowel movement.
- You lose urine when you have sex.
- You have chronic constipation.
- You have a pessary that falls out.
- You have vaginal discharge that has a bad smell.
- You have low abdominal pain or cramping that is unusual for you.
This information is not intended to replace advice given to you by your health care provider.