Pelvic Organ Prolapse (POP) is a condition in which the muscles of your pelvic floor become too weak to hold your organs in place.  POP can affect your uterus, bladder, and/or rectum. 

What are the types of POP?

Uterine Prolapse

When the ligaments and muscles supporting the uterus weaken, the uterus and cervix drop down into the vagina, and it is called uterine prolapse. 

Cystocele

When the tissue and muscle of the anterior vaginal wall (between your vagina and bladder) weaken, the bladder will bulge into the vagina, and this is called a cystocele.  This is the most common type of POP.

Rectocele

When the tissue and muscle of the posterior vaginal wall (between your vagina and rectum) weakens, the rectum will bulge into the vagina, and this is called a rectocele.    

Vaginal Vault Prolapse

In women who have had a previous hysterectomy, the top innermost part of the vagina can prolapse, and this is called vaginal vault prolapse. 

What are the risk factors for POP?

POP is very common.  Having a previous vaginal birth is probably the most common risk factor.  Most women who have had vaginal births have some degree of POP.  Age is also a risk factor since your muscles get weaker as you get older.  Other risk factors include chronic cough, chronic straining due to constipation, and frequent heavy lifting.  There also seems to be a genetic component, so you may be at increased risk for POP if your sister or mom has it. 

What are the symptoms of POP?

With mild cases of POP, you probably won’t have any symptoms at all.   In more severe cases, your organs may extend to the opening of the vagina and cause a bulge.  POP is not dangerous or painful, but the bulging can be uncomfortable.  In some cases, women experience stress incontinence (urine leaking with cough, sneeze and exercise).   Sometimes it can cause incomplete emptying of the bladder.  Difficulty with bowel movements can occur with rectoceles. 

How is POP treated?

Mild POP does not need treatment.  If the bulging symptoms are bothersome, you can elect to have treatment.  Your doctor may recommend pelvic floor therapy, especially if the prolapse is causing urinary symptoms.  They may refer you to a physical therapist who specializes in pelvic floor therapy.  The physical therapist will work with you to strengthen your pelvic floor.  Another non-surgical option for POP is a pessary, which is a plastic device that fits in the vagina and supports the pelvic organs.  Surgery is also an option for treating POP.  Surgery for POP depends on what organ is involved.  Uterine prolapse can be treated with a hysterectomy.  Cystoceles and rectoceles are repaired vaginally with a procedure called anterior colporrhaphy (for cystoceles) and posterior colporrhaphy (for rectoceles).  Frequently, all three procedures are performed at the same time. 

What if I think I have POP?

You should make an appointment with an ob/gyn. Your doctor will do an exam and determine if you have POP.  Then you can discuss what treatments, if any, are appropriate.