Pelvic Organ Prolapse

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i.e., Cystocele, Rectocele, Uterine Prolapsed, Enterocele

Frequently asked Questions about Pelvic Organ Prolapse:

What does “prolapsed” mean?
Prolapse literally means "to fall out of place." Another way to think of it is as a hernia of the vagina.  The hernia is named by the pelvic structure right next door.  Therefore when the from side of the vagina has fallen, it is called a cystocele; when the back side has fallen, it is called a rectocele; and when the top of the vagina has fallen it is called either uterine prolapsed or enterocele (referring to bowel).

What symptoms caused my prolapse?
This really depends on which type of prolapse you have.  Usually, a prolapsed occurs slowly over a period of time.  The very first sign can be subtle, such as feeling a vaginal lump or having difficulty keeping a tampon inside the vagina.

Why did this happen to me?  Did I do something to cause this problem?
No.  There are many factors that you cannot control that can cause a prolapsed; one of them being genetics.  Everyone inherits genes that determine the strength of their tissues.  Some people have a tendency toward weaker tissues.  Also if a patient needs to take steroids (such as prednisone) for an extended period of time, this can also weaken tissues.  Diabetics also have a tendency to weaker tissues, for example.

Do I need to have surgery for my prolapse?
No.  You can either choose to wear a pessary, which is like a diaphragm that provides support, or to do nothing about your condition.

If I choose to use a pessary, won’t that give me an infection”?
Infections are rare as long as you follow the protocol of using the vaginal cream that is prescribed to use with the pessary 2 nights per week.  If you are sexually active, your doctor will teach you how to remove and replace the pessary.  Otherwise typically a patient goes to the office for a pessary check/cleaning every 3 months.

What will happen if I just ignore this problem?  Will it get worse?
It may not happen quickly but if not treated pelvic organ prolapsed can get worse.

If I decide to have surgery, what can I expect during the recovery period?

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Urogynecology Preoperative Packet (pdf format)

If my surgery is successful, how long will it last?
Nothing is follproof. However, our goal for the surgery is to recretae normal atatomy permanently. Women who follow the recommended restrictions for up to 12 weeks after surgery usually have the best change for permanent surgical success.

I have prolapsed, but I don’t leak urine.  Do I still need bladder testing?
Yes, you will need bladder testing if you are going to have surgery to correct your problem.  There is a risk that urinary incontinence can occur after the surgery.  A urodynamics test is a way to assess your bladder function prior to surgery to anticipate your risk of incontinence after surgery.

How will my prolapsed treatment affect my sex life?
Your sex life shouldn’t change except if you have a pessary.  Usually the pessary needs to be removed prior to intercourse.  If your condition required surgery you should wait to have intercourse for 8 to 12 weeks after your surgery to allow healing.  After the waiting time it may take some getting used to having intercourse, but most women report they have a good sex life afterwards.