Pelvic Organ Prolapse
Pelvic organ prolapse — also called pelvic support problems — occurs when the tissues that support the pelvic organs are damaged or stretched, allowing the organ to drop down out of normal position and causing a bulge. Women with prolapsed pelvic organs may have a feeling of pressure or heaviness in the pelvic region. Sometimes it feels as if something is "falling out."
Childbirth and aging are the two most common causes of this condition. During childbirth, the tissues of the pelvic organs may be damaged or weakened due to the stretching that can occur. As a result, these tissues may not provide as much support for the organs as necessary. Symptoms may worsen after menopause.
The main types of pelvic support problems include:
- Cystocele, when the bladder is not supported properly
- Enterocele, when the small intestine is not supported properly
- Rectocele, when the rectum is not supported properly
- Uterine prolapse, when the uterus is not supported properly
- Vaginal prolapse, when the vagina is not supported properly
Proper diagnosis is the key to treating the problem. Treatment can include pelvic muscle exercises, vaginal inserts to provide better support for the organs, or surgery.
Our Approach to Pelvic Organ Prolapse
UCSF offers innovative, compassionate care for pelvic organ prolapse. Our team includes gynecologists, urologists, colorectal surgeons and physical therapists who specialize in pelvic floor rehabilitation. Treatment options include use of an insert called a pessary (a device placed inside the vagina to support the organs), as well as targeted exercises, biofeedback and electrical stimulation to strengthen the pelvic floor muscles. Stronger muscles can help hold the organs in place. We also offer surgery to return prolapsed organs to their normal positions.
We believe that empowering women with knowledge is an important part of the healing process, and encourage each patient to participate in choosing the best treatment option for her.
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Signs & symptoms
Women with prolapsed pelvic organs may feel pressure or heaviness in the pelvic region. Sometimes it feels as if something is "falling out." Prolapse also may cause incontinence.
The main treatments for pelvic organ prolapse include pelvic muscle exercises, vaginal inserts and surgery.
Pelvic Muscle Exercises
Pelvic muscle exercises, also known as Kegels, can strengthen and tone the muscles that support the pelvic organs. To get good results, you must perform them regularly and use correct technique.
Vaginal inserts and pessaries are frequently used to treat bladder and pelvic support problems. These devices are placed into the vagina to provide support for the uterus, bladder, urethra and rectum. A number of types are available, and the inserts are fit to meet your needs and anatomy.
Surgery attempts to restore the prolapsed areas to their normal anatomic position and to improve symptoms. The choice of surgical procedure depends on the individual patient. Factors that may influence this choice include examination findings, previous surgery, age, other medical illnesses and the preference of the patient or doctor.
The surgery typically includes repair of tears in the fascia — a sheet of connective tissue that covers or binds structures in the body — or suspension of the prolapsed tissues to stronger structures in the pelvis. In some cases, a graft may be used to help strengthen the area. The surgery may be performed through a vaginal or abdominal incision or a combination of both.
We can perform certain repairs using robotic surgery, a minimally invasive technique that can reduce recovery time and the risk of surgical complications.
UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.