Pelvic Organ Prolapse

Pelvic organ prolapse occurs when the vagina, uterus, bladder, urethra, small bowel or rectum slide out of their natural position. Doctors at Virginia Mason Franciscan Health deliver exceptional care that helps you get relief. Our experience from regularly treating pelvic prolapse gives you the best chances for good results. 

Highly respected urogynecologists, gastroenterologists and colorectal surgeons guide your care. Some of our specialists are nationally recognized and are advancing the field through research. No matter which doctor you see, you can count on us for the latest evidence-based services. Meet our team.

Highlights of our program include: 

• Comprehensive approach: We’re one of the few Puget Sound programs delivering comprehensive prolapse care. You have access to any test or treatment you may need, including advanced options. Our team coordinates services and tailors them to the diagnosis and severity of the condition you’re experiencing.

• Nonsurgical treatments: We help many patients with mild prolapse feel better without surgery. You may benefit from pelvic floor physical therapy or other nonsurgical pelvic floor treatments. Virginia Mason Franciscan Health offers every available option.

• Minimally invasive prolapse surgery: We use techniques that offer a quicker, more comfortable recovery than traditional open surgery, including robot-assisted procedures. We offer operations with both colorectal surgeons and urogynecologists supporting your needs in a coordinated manner. Our patients consistently achieve excellent outcomes and maintain long-term symptom relief. Find out more about surgery for pelvic floor disorders.

• Advanced care: We successfully treat the region’s most complex cases, including symptoms that return after a previous prolapse surgery. Our expertise also includes repairing complications from surgical mesh and other challenging pelvic reconstruction procedures.

Prolapse typically occurs when the pelvic floor cannot hold pelvic organs in place due to: 

• Aging
• Chronic constipation or coughing 
• Hormonal changes that occur with menopause 
• Obesity
• Pregnancy and vaginal childbirth
• Previous pelvic surgery, like a hysterectomy

You may experience multiple types of pelvic prolapse, including:

• Cystocele: The bladder presses on the front wall of the vagina.
• Enterocele: The small intestine pushes against the top of the vagina.
• Rectal prolapse: The lining or entire rectal tube sags through the anal canal.     
• Rectocele: The rectum presses on the back wall of the vagina.     
• Urethrocele: The urethra (tube that allows urine to exit the body) pushes against the front wall of the vagina.
• Uterine prolapse: The uterus falls into the vagina or protrudes through it.
• Vaginal prolapse: The top of the vagina (vaginal vault) sags into the vaginal canal.

Patients with pelvic prolapse typically notice a bulge in their vagina or a sensation that something has fallen out of place. Depending on which organs are affected, you may experience other symptoms, such as: 

• Low back pain 
• Painful sex 
• Pressure in your vagina or pelvis that may worsen as the day goes on
• Protruding pelvic organs

It's common to experience additional pelvic health concerns along with pelvic organ prolapse. You may have:

• Urinary incontinence: Involuntary leaks can occur due to pressure on your bladder (stress incontinence) or a sudden, uncontrollable urge to urinate (urge incontinence).
• Fecal incontinence: The inability to control bowel movements may result from rectal muscle or nerve damage, constipation, diarrhea or other causes.

Our team performs a thorough exam and tests to determine prolapse type and severity. We offer sophisticated studies, such as dynamic MRI, that provide real-time images of pelvic organs. Our detailed approach leads to a precise diagnosis. Read more about diagnostic testing for pelvic floor disorders.

Your evaluation may include:

• Medical history and exam 
• Cystoscopy
• Urodynamic testing
• Imaging studies such as defecography
• Anorectal manometry    

Our conservative approach helps many patients get lasting relief with nonsurgical treatments, like pelvic floor physical therapy and medications. Doctors may also recommend lifestyle changes, such as losing weight, drinking less fluids and engaging in gentle exercise.

Surgery may be right for moderate to severe prolapse. Our experts frequently use minimally invasive techniques that are gentler on your body and maintain exceptional results. Get more information about pelvic organ prolapse surgery.

Our multidisciplinary team cares for patients across the Puget Sound area and beyond. Contact us to learn more or to schedule an appointment.