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Prolapse: A Common Problem

Written By: Mary Powell, MD/OB/GYN Pelvic organ prolapse is a common condition that affects many women. It is estimated 1 out of 4 women in their 40s have some degree of prolapse. The prevalence increases as women age so much; that more women in their 80s have prolapse than do not. Prolapse literally means “to drop”. The pelvic organs (bladder, uterus with cervix, or bowel) can fall or drop out of their normal anatomical position. Some people find it easier to think of it as a type of hernia that occurs in the vaginal canal.

The most common symptoms from prolapse include noticing a bulge vaginally and/or feeling pressure. Many women will find that prolapse may interfere with their bladder and/or bowel function. It can be difficult to empty the bladder fully with prolapse. This can lead to a higher chance of getting a urinary tract infection and more urinary frequency. Some women with prolapse can also experience urinary incontinence, but not all will have that symptom. In fact, the more severe bladder prolapse present the less likely that incontinence will be present. The ability to pass stool easily can also be affected by prolapse. Constipation can make it worse, but it can happen even without constipation.

There is good news for the many women that will be affected by pelvic organ prolapse. We have a variety of treatments that can help to manage the associated symptoms to treat the condition. Doing regular pelvic floor strengthening exercises like Kegels can really help prevent prolapse, reduce symptoms of prolapse that is already present, and lower the chance of the prolapse progressing in severity. Pelvic floor physical therapy is a wonderful tool to help women learn how to most effectively strengthen their pelvic floor muscles.

Vaginal pessaries are noninvasive, nonsurgical treatment for prolapse. A pessary is a support device that comes in many different shapes and sizes that can be fitted specifically to each woman. When the correct size and shape is found the pessary should be very comfortable and can work very well to minimize prolapse and associated symptoms.

Prolapse surgical procedures are also available as a more advanced and invasive treatment for the condition. Many women get great relief from surgical repairs of their prolapse. However, it is important to know that there is still a risk of prolapse returning after surgical repairs have been completed.

Pelvic organ prolapse is not something that everyone feels comfortable discussing with their friends and/or family. However, it is important for women to know there is no reason to be embarrassed by this common condition. Women should feel free to discuss it and bring it up with their healthcare provider.


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