Overview

What Is Pelvic Organ Prolapse?

Pelvic organ prolapse occurs when the pelvic floor muscles and connective tissue weaken or tear, causing one or more of the organs inside the pelvis to slip from their normal positions and bulge into the vagina. The pelvic organs consist of the uterus, vagina, bowel, and bladder. Normally, the muscles and tissues in the pelvic region support the pelvic organs and hold them in place. Similar to a hernia, pelvic organ prolapse can develop quickly, but it can also progress over the course of many years.

As many as one in three women will develop prolapse in her lifetime, and up to one in five will have surgery for this very indication. However, because there is a perceived stigma related to the symptoms of pelvic floor disorders, many women are reluctant or embarrassed to discuss them, even with their doctors.

The urogynecologists at Northwestern Medicine Women’s Integrated Pelvic Health Program (IPHP) offer comprehensive evaluations and treatment options for women with pelvic organ prolapse, and they offer both conservative and surgical options. The physicians of the IPHP are committed to providing individualized care for every patient. All IPHP physicians are fellowship-trained and/or board-certified specialists in the field of urogynecology and reconstructive pelvic surgery, urology, and colon & rectal surgery. All serve on the faculty at Northwestern University Feinberg School of Medicine.

The Women’s IPHP is a national leader in treatment and research for women with pelvic organ prolapse, offering a transdisciplinary approach to caring for women with pelvic floor disorders in one location. Specialists from different disciplines work together to create new treatments and innovations that transcend discipline-specific approaches to address each woman’s pelvic floor symptoms.

Types of Pelvic Organ Prolapse

To evaluate a patient for pelvic organ prolapse, a urogynecologist will review your medical history and perform a pelvic examination. They will measure the severity of the vaginal prolapse using a staging system ranging from 1-4. Four types of pelvic organ prolapse include:

• Anterior vaginal wall prolapse (cystocele): The front wall of the vagina sags downward or outward, which allows the bladder to drop from its normal position.
• Posterior vaginal wall prolapse (rectocele): The weakened vaginal wall and perineum causes the rectum to bulge upward into the vagina
• Uterine Prolapse: Weakening of supports to the uterus and upper vagina cause the uterus to slide down into the vaginal canal or past the vaginal opening.
• Vaginal Vault Prolapse: The weakening of the upper support of the vagina in a woman who has previously had a hysterectomy. This allows the vaginal walls to descend into the vaginal canal or past the vaginal opening.

What are Pelvic Organ Prolapse Symptoms?

If a woman has pelvic organ prolapse, she may have one or more of the following symptoms:

• Protrusion of a tissue or a bulge in the vagina or rectum
• Pelvic pressure
• Urinary symptoms such as slow urinary stream, a feeling of incomplete bladder emptying, urinary frequency or urgency, and stress urinary incontinence (leaking with laughing, coughing and sneezing)
• Bowel symptoms, such as difficulty moving the bowels, a feeling of stool being trapped near the opening of the anus, needing to press on the vaginal wall to empty the bowel, or accidental bowel leakage
• Discomfort with vaginal intercourse