Pelvic organ prolapse is a condition that affects the “pelvic floor.” The pelvic floor is the name for the muscles that support the organs in the pelvis, including the bladder, rectum, and uterus (figure 1). Pelvic organ prolapse is when these muscles relax too much. This causes the organs to drop down and press against or bulge into the vagina.

Prolapse can affect different organs (figure 2). Doctors use different terms for the types of prolapse:

  • Bladder – If the bladder bulges into the vagina, it is called “cystocele.”
  • Rectum – If the rectum bulges into the vagina, it is called “rectocele.”
  • Uterus – If the uterus bulges into the vagina, it is called “uterine prolapse.”

Some things can increase your risk of having pelvic organ prolapse. They include pregnancy, obesity, and older age.

Many times, prolapse does not cause any symptoms. But when symptoms do happen, they can include:

  • Fullness or pressure in the pelvis or vagina
  • An aching feeling in the pelvis
  • A bulge in the vagina or coming out of the vagina
  • Leaking urine when you laugh, cough, or sneeze
  • Needing to urinate all of a sudden
  • Trouble having a bowel movement

When using the toilet, you might need to press on the bulge in your vagina with a finger to get out all your urine or to finish a bowel movement.

Your doctor or nurse will be able to tell if you have it by doing a pelvic exam.

Yes. Some people feel better if they do pelvic muscle exercises. These exercises strengthen the muscles that control the flow of urine and bowel movements. They are also known as “Kegel” exercises. Your nurse or doctor can teach you how to do them or refer you to a physical therapist who specializes in pelvic floor problems.

People who have no symptoms or who are not bothered by their symptoms do not need treatment. If you do have symptoms that bother you, your treatment options might include:

  • Pelvic floor muscle exercises – This involves working with a physical therapist for 8 to 12 weeks to strengthen your pelvic muscles.
  • A vaginal pessary – This device fits inside your vagina to support the bladder and push it back into place. Pessaries come in different shapes and sizes. Your doctor or nurse will talk to you about your options and make sure your pessary fits your body.
  • Surgery – A surgeon can move organs back where they belong and strengthen the tissues that keep them in place. You should only consider this type of surgery if you do not plan to have children or are done having children.

You can reduce your chances of pelvic organ prolapse if you:

  • Lose weight if you are overweight
  • Get treated for constipation if you are constipated
  • Avoid activities that require you to lift heavy things