Pelvic Organ Prolapse

What causes uterine prolapse?

Uterine prolapse occurs when the muscles and supportive tissues of the pelvic floor and vaginal canal weaken, allowing the uterus to descend into the vaginal area. Pregnancy and vaginal childbirth are two of the most common factors that can weaken these muscles.

Muscle strength in the pelvic floor can also decline with age, particularly during menopause. As estrogen levels decrease, the vaginal tissues and pelvic floor muscles may become thinner and weaker, increasing the risk of uterine prolapse.

In some cases, other health conditions can contribute to the development of uterine prolapse. These may include chronic coughing, obesity, or ongoing constipation that causes frequent straining during bowel movements.

What are the symptoms of pelvic organ prolapse?

• Urinary incontinence
• Vaginal wall prolapse
• Bulging of your vagina
• Difficulty emptying your bladder
• Difficulty having a bowel movement
• Loss of sexual sensations during intercourse

How is uterine prolapse treated?

Initial treatment for uterine prolapse often focuses on strengthening the pelvic floor. Daily pelvic floor exercises, such as Kegels, can help improve muscle strength and may prevent the condition from worsening.

Additional treatment options may include:

Estrogen vaginal therapy: Your provider may recommend estrogen therapy delivered through vaginal suppositories, tablets, or rings. This treatment can help improve the strength and health of vaginal and pelvic floor tissues.

Supportive devices: A pessary is a device placed in the vagina to support the uterus and help keep it in position. This option is often recommended for patients who are not candidates for surgery or prefer a non-surgical approach.

Physical therapy: Specialized pelvic floor physical therapy may help reduce pelvic discomfort and improve muscle support, which can improve overall quality of life.

Surgery: If the prolapse becomes severe or does not respond to conservative treatment, surgical options may be considered. Procedures may include minimally invasive techniques to repair pelvic support structures or remove the uterus if necessary.

Cystocele repair: This procedure corrects a bulging bladder by repairing and reinforcing the weakened tissue between the bladder and vagina.

Rectocele repair: This surgery repairs tissue weakened between the rectum and vagina, restoring proper support and reducing bulging.

Vaginal vault suspension: This procedure restores support to the top of the vagina by attaching it to supportive pelvic tissues.

Hysterectomy: In cases where the uterus has descended significantly into the vaginal canal, removal of the uterus may be recommended.

If you would like to learn more about treatment options for uterine prolapse at any stage, contact our office to schedule a consultation.