Pelvic Organ Prolapse

You don't have to live with discomfort and embarrassing symptoms caused by uterine or vaginal prolapse. We offer compassionate care and many treatment options.

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Pelvic organ prolapse can cause incontinence, pelvic pain, and other problems. While it can be hard to talk about some of these issues, you're far from alone.

A 2022 study conducted by a University of Iowa Health Care researcher found that nearly one-third of women are affected by pelvic organ prolapse.

It's not just a normal part of aging or something that always happens after giving birth. And you don't have to live with discomfort and embarrassment.

UI Health Care urogynecology experts have intensive training and years of experience in diagnosing and treating pelvic organ prolapse.

They offer a wide range of treatment options, both surgical and nonsurgical.

With the help of our compassionate team, you can get back to the active, engaged life you want.

Pelvic organ prolapse symptoms and diagnosis

Pelvic organ prolapse happens when the muscles and connective tissues that support your pelvic organs are stretched or weakened. Together, these muscles and tissues are called the pelvic floor.

Giving birth, having a hysterectomy, and going through menopause can all cause stretching or weakening.

When weakened tissues can no longer support your pelvic organs, the organs drop down, or prolapse.

Prolapse can affect these organs:

Bladder
Rectum
Urethra
Uterus
Vagina

Symptoms of pelvic organ prolapse

Prolapse isn't usually painful, but it can be uncomfortable. Symptoms include:

A feeling of heaviness, pressure, or pulling in your pelvis
Seeing or feeling a bulge at your vaginal opening
Lower back pain
Painful sex
Frequent or urgent urination
Bladder control problems
Trouble emptying your bladder
Trouble having bowel movements

Types of pelvic organ prolapse

These are the three most common types of pelvic organ prolapse in women:

Cystocele: The front wall of the vagina sags downward or outward, allowing the bladder to drop down. This can result in urinary problems such as frequency, urgency, and incontinence.
Rectocele: The back wall of the vagina sags outward, allowing the rectum to bulge into the vagina. A rectocele can make it hard to empty the rectum when having a bowel movement.
Uterine prolapse: The support around the uterus or cervix weakens, allowing the uterus to drop down. In some cases, the cervix can bulge into the lower vagina or through the vaginal opening.

How UI Health Care experts diagnose pelvic organ prolapse

Your first step will be a conversation between you and your urogynecologist about your symptoms.

Then, they'll do a pelvic exam to determine where the prolapse is occurring and how extensive it is.

Other exams or studies may help your doctor assess your symptoms. These include:

Urodynamic testing to assess bladder function and find the cause of urinary incontinence or trouble urinating
Cystoscopy, which uses a small camera to look for abnormalities in the bladder
Defecography, an X-ray test that assesses bowel function
Pelvic ultrasound, images of your reproductive organs, bladder, or pelvic floor muscles
Pelvic floor MRI that shows pelvic floor tissues and evaluates what happens when you strain
Abdominal and pelvic CT scans to help rule out other medical conditions with symptoms similar to prolapse

Pelvic organ prolapse treatment from UI Health Care

UI Health care specialists offer a wide variety of treatment options for pelvic organ prolapse. Treatments range from lifestyle changes to surgery.

Your care team might include urogynecologists (who have both gynecology and urology backgrounds) gastroenterologists, colorectal surgeons, pelvic floor physical therapists, and others.

Your team will work with you on a personalized care plan. You'll decide what kind of treatment feels right for you, depending on your symptoms.

Lifestyle changes and medication

If your pelvic organ prolapse is mild, these lifestyle changes may help:

Losing weight
Avoiding constipation
Quitting smoking (to prevent coughing)
Avoiding heavy lifting

If a bulge is causing skin irritation at your vaginal opening, medication like topical estrogen or skin protectants may relieve symptoms.

Strengthening your pelvic floor

UI Health Care has one of the largest pelvic floor physical therapy teams in the state.

Your specially trained therapist will design an exercise program just for you.

It might include Kegel exercises that will strengthen your pelvic floor muscles and improve mild to moderate prolapse.

Vaginal devices

A pessary is a silicone device placed in the vagina to lift a prolapsed pelvic organ and hold it in place.

It can help prevent urinary incontinence and relieve the symptoms of a cystocele, rectocele, or uterine prolapse.

When your pessary is properly fitted and cared for, you can wear it comfortably and safely for many years.

Most people can manage their own pessary easily without frequent visits to their provider.

Surgery

If your prolapse is severe, your providers might recommend surgery.

UI Health Care specialists offer a wide range of surgical treatments for prolapse. Your surgical plan will be tailored to your needs and preferences:

Reconstructive surgery uses your own tissue or an implant to return your organs to their original position. Robotic and minimally invasive approaches use small incisions for less pain and faster recovery. Many surgeries can be performed through the vagina, leaving no external scars.

Obliterative surgery (also called colpocleisis) is an option if you no longer want to have penetrative sexual intercourse. This procedure closes the vagina. It's highly effective, and most people have an easy recovery.

If you also need surgery for bowel conditions like rectal prolapse, our surgeons may collaborate with UI Health Care colorectal surgeons. They're often able to perform both surgeries in a single procedure.

Clinical trials

The UI Health Care urogynecology team includes nationally renowned researchers. They are working on innovative ways to prevent and treat pelvic organ prolapse.

If you're eligible for a clinical trial, you may be able to get therapies that aren't available from any other providers.

Urogynecologist