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Women's Pelvic Health and Reconstructive Surgery

Pelvic Organ Prolapse

Prolapse is a general term used to describe when any part of an organ has fallen or dropped from its normal anatomical position. Several different organs are located in the pelvic region and can become prolapsed due to weakened pelvic floor muscles that hold these organs in place.

Pelvic organ prolapse in women can affect the:

  • Bladder
  • Uterus
  • Vagina
  • Small intestine
  • Rectum

Any one or combination of the following can result in weakening the muscles that hold pelvic organs in place:

  • Genetics
  • Child birth
  • Chronic cough
  • Chronic constipation
  • Diseases that weaken connective tissue

Symptoms of pelvic organ prolapse:

  • A feeling of bulging or pressure at the vaginal opening
  • Difficulty emptying the bladder or bowel
  • Discomfort or pain that interferes with sexual intercourse
  • Vaginal tissue can be seen outside of the vagina
     

The physicians and staff at University Women's Care are a team of caring professionals. Our providers have the expertise to treat even the most complex urogynecologic problems. We provide practiced, thoughtful care and work with patients to find the most appropriate diagnosis and treatment to meet each woman's unique personal needs.

Treating pelvic organ prolapse

In general, there are four treatment options for pelvic organ prolapse:

  1. Observational management
    If pelvic organ prolapse does not result in much annoyance, concern, or lifestyle change for a patient, then she and her physician can simply watch for changes over time. This option can be done for almost any patient with any degree of prolapse.
  2. Pelvic floor muscle exercises
    With mild or moderate prolapse, pelvic floor muscle exercises, often done under the guidance of a pelvic floor physical therapist, can help. These exercises are designed to improve symptoms, decrease progression, and in some patients, can even reduce prolapse.
  3. Pessary
    A pessary is a silicone device that is placed in the vagina to hold up or support whatever organ may be prolapsed. These devices come in different shapes and sizes and are often easy for patients to place and remove themselves. The goal of this treatment is to find a pessary that comfortably relieves the patient of her prolapse symptoms.
  4. Surgery
    Many types of surgery can correct organ prolapse. A patient and her surgeon will work together to choose the procedure most appropriate for her stage of life and type of prolapse. In general, most surgeries for pelvic organ prolapse use one or more of the following procedures:
    • Cystocele repair (Anterior colporrhaphy)
      Performed through a vaginal incision, this procedure uses stitches to reposition and support the bladder. 
    • Rectocele repair (Posterior colporrhaphy)
      Performed through a vaginal incision, this procedure uses stitches to reposition and support the rectum.
    • Vaginal vault suspension
      • Abdominal/Laparoscopic approach: During this minimally invasive surgery, permanent mesh is used to suspend the top of the vagina and keep it in place.
      • Vaginal approach: Performed through a vaginal incision, stitches are used to suspend the top of the vagina and keep it in place.
    • Enterocele repair
      This procedure is designed to prevent a prolapsed small intestine from pushing on the vagina by closing off the space above the vagina. 
    • Hysterectomy
      Removal of the uterus is often recommended for a prolapsed uterus.
    • Colpocleisis/Permanent vaginal closure
      This procedure permanently closes the vaginal canal and is a good choice for women who are sure they will never be sexually active again.

Request an appointment

Our providers have the expertise to treat even the most complex urogynecologic problems with practiced, thoughtful care for the needs of our patients. Request an appointment or learn more about our physicians below.


Healthcare professionals

To refer a patient to the University Women's Care pelvic health program:


Patients

The pelvic health program at UMMC sees patients by physician-referral and self-referral.