What is pelvic organ prolapse?

Pelvic organ prolapse means that a pelvic organ—such as your bladder—has moved from its normal position and is pressing against your vagina. This can happen when the muscles and tissues that hold your pelvic organs in place get weak or damaged.

Pelvic organ prolapse is common. It isn't usually a big health problem, but it can be uncomfortable or painful. It can be treated if it bothers you. And it may get better with time.

More than one pelvic organ can prolapse at the same time. Organs that can be involved include the:

• Bladder.
• Urethra.
• Uterus.
• Vagina.
• Small bowel.
• Rectum.

You may not have any symptoms. Or pressure on your vagina may cause discomfort or problems with your pelvic organs. Symptoms may include:

• Feeling pressure or fullness in your lower belly.
• Feeling as if something is actually falling out of your vagina.
• Feeling a pull or a stretch in the groin area or a low backache.
• Pain during intercourse.
• Urinary problems. For example, you may release urine without meaning to (incontinence). Or you may have a frequent or urgent need to urinate.
• Problems with bowel movements. You may be constipated or need to support the back (posterior) of the vaginal wall to have a bowel movement.

Symptoms are worse when you stand, jump, or lift. They usually are relieved if you lie down.

A prolapse of a pelvic organ can be hard to diagnose. Pelvic organ prolapse that doesn't cause symptoms may be found during a routine exam. You may be aware that there's a problem, but you might not be sure of the exact location or cause. If your doctor thinks you may have an organ prolapse, your doctor will ask you questions about your past and current health. This includes questions about your symptoms and your history of pregnancies and other health problems. Your doctor will also do a physical exam, including a pelvic exam.

Tests may be done to find out more about the prolapse, particularly if it's causing problems with bladder or bowel function. These may include urodynamic tests and imaging tests, such as ultrasound or MRI.

Decisions about treating pelvic organ prolapse are based on which organs have prolapsed and how bad your symptoms are. You may not need or want treatment.

If your symptoms are mild, you may be able to relieve them at home.

• Try Kegel exercises. These can make your pelvic muscles stronger.
• Reach and stay at a healthy weight.
• Avoid lifting heavy things. This can put stress on your pelvic muscles.

If these changes don't help, you can ask your doctor to fit you with a pessary. It's a removable device that you can put in your vagina to support areas of prolapse.

Surgery may be an option if symptoms don't get better with other treatments or if you prefer surgery over other treatments. But you may want to delay surgery if you plan to get pregnant in the future. The strain of childbirth could cause the prolapse to come back.

Home treatment can relieve the discomfort of pelvic organ prolapse. It can also help to keep prolapse from getting worse. Do Kegel exercises daily to strengthen muscles and ligaments in the pelvis. Prevent or treat constipation. Reach and stay at a healthy weight. Avoid activities that stress your pelvic muscles, such as heavy lifting.