Pelvic Organ Prolapse
Pelvic organ prolapse is a condition that occurs when the pelvic organs, such as the bladder, uterus, or rectum, drop or bulge into the vagina due to weakened or stretched pelvic floor muscles and ligaments. This can lead to symptoms such as a feeling of heaviness or pressure in the pelvis, discomfort or pain during sexual intercourse, and difficulty emptying the bladder or bowel.
Treatment options may include pelvic floor exercises, pessaries, or surgery.

The pelvic floor is a hammock of pelvic muscles that supports the pelvic organs. Improper functioning or weakness of the pelvic floor may lead to a condition called pelvic organ prolapse. During such a condition, patients feel a bulge from the vagina.
There are variations of this condition based on which organ is bulging out of the vaginal opening.
- A cystocele occurs when the bladder drops down into the vagina.
- When the uterus drops down, this is called uterine prolapse.
- Enterocele refers to the small bowel pushing into the vagina and causing a bulge.
- Vault prolapse occurs when the top part of the vagina is weakened after a hysterectomy.
- Rectocele occurs when the lower part of the vagina is weak, allowing the rectum to push into the vagina.
WHY DOES PELVIC ORGANIC PROLAPSE OCCUR?
Pelvic organ prolapse occurs due to weakened or damaged pelvic floor muscles and ligaments that support the pelvic organs, such as the bladder, uterus, or rectum. These muscles and ligaments can become stretched or damaged as a result of pregnancy, childbirth, menopause, chronic coughing, heavy lifting, or other factors that put pressure on the pelvic area. Other factors that may contribute to the development of pelvic organ prolapse include aging, obesity, chronic constipation, and certain medical conditions that affect connective tissues.
WHAT ARE THE SIGNS OF PELVIC ORGAN PROLAPSE?
The symptoms of pelvic organ prolapse include:
- A sense of bulging, pressure, or heaviness in the vagina or pelvic area
- Difficulty with intercourse
- Problems with urination
- Problems with having bowel movements.
HOW IS PELVIC ORGAN PROLAPSE DIAGNOSED?
History along with pelvic exam helps detect this condition. Factors like the location of the bladder, rectum, and uterus and the degree of prolapse determine what type of prolapse a person is suffering from.
WHAT IS THE TREATMENT FOR PELVIC ORGAN PROLAPSE?
Pelvic Floor Physical Therapy:
It helps strengthen the pelvic floor. While this treatment option does not completely treat or correct the organ prolapse, it can help relieve the discomfort associated with pelvic heaviness in patients.
Pessary:
Pessaries are silicon devices that are inserted in the vagina, that are available in different shapes and sizes. They are very easy and safe to insert and remove.
According to studies, approximately 40% of women who give birth vaginally will experience some degree of pelvic organ prolapse. They may not be symptomatic, but if they are, the conservative approach of using a prescription can be beneficial.
Surgical Treatments
There are two ways of going about surgery for pelvic organ prolapse – vaginally and abdominally.
When vaginal surgery is performed, strong ligaments are used in the patient’s pelvis to provide support in the vagina. We can also use an absorbable graft to support the weakened tissue.
This surgery can also be done laparoscopically Or robotically. Such a surgical procedure is more convenient for the patients as it reduces the recovery time to a great extent. In this surgery, FDA-approved mesh OR stitch (absorbable or permanent stitch) can be used to provide support for aiding pelvic organ prolapse.
HOW LONG IS THE RECOVERY PROCESS AFTER THE SURGERY?
The recovery process post-surgery depends on the kind of procedure patients opt for. Usually, patients who undergo vaginal, laparoscopic, or robotic surgeries start feeling healthy and normal within a couple of weeks after the procedure. The main instructions are no heavy lifting and vaginal rest for about 6-8 weeks.