UrogynecologyPelvic Organ Prolapse

Bulging or pelvic heaviness is actually common.

Nearly half of all women between the ages of 50 and 79 have some form of prolapse. Pelvic organ prolapse occurs when the normal support of the vagina is lost, resulting in “sagging” or dropping of the bladder, urethra, cervix and rectum. Your care provider at Garrison Women’s Health can work with you to develop the most appropriate treatment plan that takes your overall health, lifestyle, and personal goals into consideration.

What are some signs of pelvic organ prolapse?

Bulging tissue

Women often feel bulging tissue protruding through the opening of the vagina, which can feel like sitting on a ball when seated.

Pelvic heaviness

The pelvic area can often feel weighted and that sensation worsens as the day goes on or during bowel movements.

Sexual difficulties

Some women feel like sexual sensation has decreased since their last childbirth experience, sex feels dry or painful, or they experience urinary leakage with intercourse.

Difficulty urinating

Having trouble starting to urinate, a weak or spraying stream of urine, frequent urinary tract infections, or needing to lift up the bulging vagina or uterus to start urination can all be symptoms.

Muscle weakness

The inability to keep a tampon inside the vagina or dampness in the underwear are subtle signs that pelvic organ prolapse is starting.

Difficult bowel movements

The need to strain or even push stool out of the rectum by placing your fingers into your vagina during bowel movements can indicate pelvic organ prolapse.

The most common diagnoses are:

  • Cystocele: bulging in the front of the vagina
  • Rectocele: bulging in the back of the vagina
  • Uterine prolapse: dropped uterus
  • Vaginal prolapse: bulging vagina
  • Perineocele: loose vaginal opening
woman in gym tying shoe

What causes pelvic organ prolapse?

Pelvic organ prolapse can result from a number of factors including vaginal delivery, previous surgery, pelvic radiation, back or pelvic fractures during falls or motor vehicle accidents, heavy lifting, chronic coughing, smoking, obesity, aging, genetic factors and more. Caucasian women are more likely than African-American women to develop prolapse. Whatever the cause, we can work with you to develop an individualized treatment plan.

What treatments are available?

If the symptoms are causing lifestyle changes or even health problems, your physician may recommend conservative (non-surgical) or surgical therapy depending on your preference, the severity of your symptoms, and your general health. A woman generally has four options:

  • No treatment – a “wait and see” approach
  • In mild cases, pelvic floor physical therapy can be helpful
  • Wear a pessary (a medical device inserted into the vagina that provides support)
  • Surgery to correct the prolapse


Once diagnosed, the condition generally does not have to be treated if it is not causing discomfort or interfering with normal, everyday activities. The goals of treatment should include improving quality of life or improving sexual self-esteem. One exception to this rule occurs with severe prolapse, which can block the flow of urine and cause recurrent urinary tract infections or even kidney damage. However, this occurs infrequently and can be checked during the course of a physical exam.

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