Female Pelvic Organ Prolapse

Pelvic organ prolapse is a condition that affects many females. In pelvic organ prolapse, the pelvic floor is weakened and can no longer hold organs in place.

Pelvic organ prolapse may occur along the front side (anterior) or back side (posterior) of the vagina, or at the top (apex) of the vagina. In many cases, pelvic organ prolapse can involve multiple areas of the vagina.

One risk factor for pelvic organ prolapse is elevated intraabdominal pressure. This pressure can occur with chronic constipation and other conditions that cause repetitive elevated intraabdominal pressure, such as chronic obstructive pulmonary disease (COPD). Other risk factors for pelvic organ prolapse include:

  • Childbirth
  • Advancing age
  • Obesity
  • Collagen abnormalities
  • Family history

Symptoms of Pelvic Organ Prolapse

Women with pelvic organ prolapse most commonly experience a bulge, fullness or pressure in the vagina. Some patients may describe it as feeling like a tampon has fallen and needs to come out. However, if the bulging sensation is not outside of the vaginal opening, it could be due to other similar conditions, such as pelvic floor muscle dysfunction.

The extent of pelvic organ prolapse symptoms can vary from person to person. When a patient presents for care of pelvic organ prolapse their provider will ask how much the symptoms are affecting the patient’s quality of life. The impact on quality of life helps guide treatment.

Treating Pelvic Organ Prolapse

Treatment for pelvic organ prolapse can vary from expectant management (“watchful waiting”) to conservative (i.e., non-surgical) to surgical management.  If a patient is asymptomatic with normal bladder emptying then they could decide on expectant management.

Conservative management includes pessaries and pelvic floor muscle exercises. A pessary is a device that can go inside the vagina to support organs in the pelvic region. The pessary can be removed, and various sizes and shapes of pessaries are available.

Many patients desire surgery to treat their pelvic organ prolapse. Most patients can be discharged home on the day of surgery. Different surgical options exist:

  • Reconstructive surgery using your tissue with stitches to fix the pelvic organ prolapse. Certain surgeries also use synthetic mesh. Your surgeon may perform the surgery through small incisions in your abdomen or through the vagina.
  • Obliterative surgery closes the vagina to treat pelvic organ prolapse. It is important to note that after this type of surgery, vaginal sex is not possible due to the closed vaginal opening.

If you feel you could have pelvic organ prolapse, call one of our UofL Physicians – Urogynecology offices to schedule an appointment:

UofL Physicians – Urogynecology
Springs Medical Center
6240 Dutchmans Parkway, Suite 190
Louisville, KY 40205
Drs. Sean Francis and Stacy Lenger

UofL Physicians – Urogynecology Associates
UofL Health – Center for Women’s Health at UofL Health – Mary & Elizabeth Hospital
Plaza 4
4331 Churchman Avenue
Louisville, KY 40215
Dr. Ankita Gupta

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Article by: Stacy Lenger, M.D.

Stacy Lenger, M.D. is a urogynecologist with UofL Physicians – Urogynecology at the Springs Medical Center. She specializes in pelvic floor disorders, prolapse, incontinence and birth-related injuries. She went to medical school at the University of Missouri, completed an internship and residency at the University of Tennessee and a fellowship in Female Pelvic Medicine and Reconstructive Surgery at Washington University in St. Louis. Dr. Lenger provides patient-centered, compassionate care with both the highest quality surgical care and medical management. She aims to improve the quality of life for all patients.

All posts by Stacy Lenger, M.D.
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