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Johns Hopkins Health - Pelvic Organ Prolapse

Fall 2008
Issue No. 2

Pelvic Organ Prolapse

Date: September 24, 2008

Woman with hands under chin

It’s scary but true: About 95 percent of women walk around with some form of pelvic organ prolapse. Most of the time, the condition is mild, but up to 50 percent have symptoms that can significantly affect their quality of life

What is pelvic organ prolapse?
Pelvic organs—bladder, uterus, vagina, rectum—change over time, says gynecologist Victoria Handa, M.D., of the Johns Hopkins Women’s Center for Pelvic Health. Stretching and other types of damage affect the tissues that hold the organs in place, causing the organs to drop and press into the vaginal wall. The main causes of pelvic organ prolapse are pregnancy and childbirth, but women who’ve never had children can experience a prolapse, too.

Can a prolapse be prevented?
Not really, although there are exercises you can do that may arrest the process, says Women’s Center for Pelvic Health urologist James Wright, M.D. The problem is gravity and a basic design flaw, he says. It’s definitely an age-related problem. It’s not life-threatening but can have an enormous impact on a woman’s quality of life.

How do I know if I have a prolapse?
The symptoms mostly depend on the organs involved. Generally, you may feel pelvic heaviness or fullness, a pulling or achiness in the lower abdomen or pelvis, or you may have urinary incontinence or problems with bowel movements. Intercourse may be painful and, at its worst, a prolapse may be visible outside the vagina. The problem, Handa says, is that it’s not always clear whether a prolapse is the cause. That’s why it’s important to talk to your regular doctor or gynecologist about anything that feels different or unusual.

What are the treatment options?
Treatment depends on the severity of the prolapse and its symptoms. A mild prolapse may need no treatment at all. Or, to relieve symptoms of prolapse, women may choose to try a device called a pessary that supports the vaginal walls. For some women with prolapse, surgery may be an option. No single strategy works for everyone. With surgery particularly, it’s important to investigate the surgeon’s experience. The goal, Wright says, is to get back to as normal an anatomy as possible.

For more information about pelvic organ prolapse or other pelvic floor dysfunctions, visit or call 877-546-1872.

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