Prolapse

As women age, the muscles and connective tissue of the pelvic floor tend to lose strength and elasticity. This can lead to an uncomfortable condition called pelvic organ prolapse, in which organs such as the uterus and bladder can descend into the vagina. Prolapse is common and benign, but it can severely negatively impact a woman’s quality of life. At Premier Women’s Care of Southwest Florida, our expert providers will help you get relief from prolapse and its effects. Based on the severity of your symptoms, we will guide you through your treatment options—from physical therapy to restore strength to the muscles of your pelvic floor, to placement of a pessary device to keep your pelvic organs in place, to surgery in more severe cases. 

Causes of prolapse

The primary cause of prolapse is pregnancy and vaginal childbirth, but menopause, aging, and repeated heavy lifting can also play a role. In fact, any conditions that create pressure on the abdomen can lead to pelvic organ prolapse. This includes being overweight, chronic straining to have bowel movements when constipated, and even chronic coughing from smoking or other conditions. Although prolapse can occur in younger women, symptoms more typically develop after menopause, and the peak incidence of symptoms is in a woman’s 70s. About 13% of American women have a lifetime risk of undergoing surgery for prolapse, although this number is expected to increase as the population ages. 

Symptoms of prolapse

Prolapse symptoms can vary widely, from no symptoms in mild cases to severe symptoms that impact a patient’s daily life. These can include: 

• Feeling of pelvic pressure or fullness
• A bulge inside the vagina
• Leakage of urine (urinary incontinence)
• Difficulty completely emptying the bladder
• Problems having a bowel movement
• Lower back pain
• Uncomfortable or painful sex
• Problems with inserting tampons or applicators

Some women can sense that something is falling out of their vagina and may even be able to feel an organ. Symptoms generally depend on the organ affected. For example, prolapse of the bladder is associated with urinary incontinence, while prolapse of the bowel or rectum often leads to constipation.

Diagnosis and treatment of pelvic prolapse

Your Premier Women’s Care of Southwest Florida gynecologist will ask if you have risk factors, from a family history of prolapse to difficult vaginal deliveries. Our providers will also take into consideration age and weight, as well as reported symptoms. We can often detect prolapse through a pelvic exam, but we may also conduct a CT scan, MRI, or ultrasound, as imaging can reveal more hidden evidence of prolapse. Treatments for prolapse depend on the severity of your symptoms, as well as your life situation, including whether or not you want to have future children, whether the prolapse is affecting your sexual activity, and whether you have other health problems. Treatment options include:

• Pelvic floor exercises, also called Kegel exercises, to strengthen the pelvic floor muscles
• Physical therapy to help increase muscle strength of pelvis
• Placement of a pessary, a plastic device inserted into the vagina to support the pelvic organs
• surgery to repair supporting tissue or remove the prolapsed organ, such as a hysterectomy to remove the uterus

Once we’ve reviewed all the factors in your case with you and thoroughly explained your treatment options, our providers will personalize your prolapse treatment based on your symptoms, your life situation and your preferences. 

To learn more about pelvic organ prolapse, you can request a new patient appointment online. If you are already an established patient, you can book online through the patient portal. Or you can always call (239) 432-5858 to schedule a consultation with one of Premier Women’s Care of Southwest Florida’s women’s health-care providers in Fort Myers or Cape Coral.