Pelvic prolapse, the loss of support to your pelvic organs, is common as we age. The OHSU Center for Women’s Health offers leading-edge care that will help you get back to your regular activities.

You’ll find:

• A team of top experts working together to create the best care plan for you
• A complete evaluation of all your pelvic organs using the latest tests and technology
• Effective treatment options, such as physical therapy, that don’t involve surgery
• Minimally invasive surgeries for quicker recovery

What is pelvic prolapse?

Pelvic prolapse is the loss of muscle and tissue support to your vagina, uterus, bladder or rectum. Without support, one or more of these organs can drop from their regular position. This can cause discomfort, urine leaks or bowel problems.

Prolapse becomes more common with age. It can range from a slight drop to a bulge you can see or feel outside your vagina.

Types of pelvic prolapse

Bladder prolapse (cystocele): Your bladder falls onto your vagina, creating a bulge. It may cause urinary leakage, difficulty starting your flow, or trouble emptying your bladder. This is the most common type of prolapse.

Rectocele: Your rectum presses into your vaginal wall, making it hard to start or complete bowel movements.

Uterine prolapse (or vaginal vault prolapse): Your uterus drops into your vagina and creates a bulge. If your uterus has been removed, the top of your vagina collapses into the lower part. It may affect your bowel or bladder function or give you a feeling of pressure on your pelvic floor.

Enterocele: The vaginal skin is weak, allowing your small intestine to drop into the space of your vagina. This sometimes happens along with other types of prolapse.

What causes pelvic organ prolapse?

It is normal for the muscles and connective tissues in your pelvic floor to relax as you get older. Sometimes they become so weak, stretched or torn that your pelvic organs start to slip out of place. Doctors often don’t know why it happens. Aging, injuries, menopause and having a baby make it more likely.

Who gets pelvic organ prolapse?

About half of all women will experience some degree of pelvic prolapse during their lifetime. For most, the symptoms are mild. In about 3% of women, prolapse causes enough discomfort or disruption to need treatment.

Prolapse is most common in older women and in white and Latina women. It can also run in families.

Risks for women include:

• Pregnancy and vaginal childbirth
• Aging and menopause
• Injuries from childbirth, surgery, falls, radiation, or accidents
• Chronic pelvic pressure from obesity, heavy lifting, coughing or constipation
• Smoking
• Pelvic surgery, like a hysterectomy to remove your uterus
• Nerve and muscle disorders

Symptoms

Most women with mild prolapse do not have symptoms. If you have more serious prolapse, your symptoms may include:

• Discomfort, pressure or fullness in your vagina or pelvis
• Urinary leaks or frequent urination
• Trouble starting your urine flow or completely emptying your bladder
• A bulge of tissue coming out of your vagina
• Constipation or trouble completing bowel movements
• Pain in your lower back
• Difficulty using tampons
• Bleeding or sores in your vagina
• Painful sex

Diagnosing pelvic prolapse

We check your entire pelvic floor to find your type and degree of prolapse. We also check for any related bladder or bowel problems with the latest tests and imaging.

Your care team will talk with you about your options and explain each test. These may include:

Urodynamics: If you have urinary symptoms, we may suggest a series of tests to measure the pressure and muscle strength in your bladder.

Cystoscopy: We look inside your bladder using a lighted flexible telescope to check for problems.

Ultrasound: We are a leader in using high definition, 3D ultrasound imaging to check for pelvic floor disorders. Ultrasound uses sound waves to create moving images of your organs. We place a probe on the outside of your abdomen or near your vagina and anus.

Pelvic organ prolapse treatments

We build your care plan based on your condition and preferences. We offer the safest and most effective treatment options available. Your care team will talk with you about the best plan for you.

Resources about pelvic organ prolapse

• Pelvic Organ Prolapse: An Overview, U.S. National Library of Medicine
• Pelvic Organ Prolapse, Voices for PFD
• Pelvic Organ Prolapse, National Association for Continence
• Pelvic Organ Prolapse, Office on Women’s Health, U.S. Department of Health & Human Services
• Pelvic Organ Prolapse Videos, The American College of Obstetricians and Gynecologists
• Pelvic Support Problems, The American College of Obstetricians and Gynecologists