Pelvic organ prolapse
Overview
Pelvic organ prolapse is when your womb, bladder or bowel bulge into the vagina. Treatments and lifestyle changes can help manage it.
Symptoms
Pelvic organ prolapse is common in women over 50. It can affect anyone with a vagina. It may not cause symptoms, but if you do have symptoms they can include: a feeling of heaviness, discomfort or pressure in your lower tummy or vaginafeeling or seeing a bulge or lump inside (or coming out of) your vaginapain, discomfort or numbness during sexproblems pooing, such as constipationproblems peeing, such as feeling like your bladder is not emptying fully, needing to go to the toilet more often, or leaking a small amount of pee when you cough, sneeze or exercise Sometimes pelvic organ prolapse may only be found during tests done for another reason, such ascervical screening.
Causes
Pelvic organ prolapse can happen when the pelvic floor muscles weaken. It's more common as you get older, particularly after the menopause. It can be caused by: pregnancy and childbirthbeing overweightlong-term constipation and strainingpersistent coughingpelvic surgery, such as a hysterectomy Some health conditions can also make a prolapse more likely, including: joint hypermobility syndromeMarfan syndromeEhlers-Danlos syndromes
Treatment
Treatment for pelvic organ prolapse depends on which organs have prolapsed and how severely. Your doctor will also consider your age, overall health, and if you're planning to have children in the future. If you do not have any symptoms, or the prolapse is not bothering you, you may not need medical treatment. If the prolapse is more severe or your symptoms are affecting your daily life, treatment options may include: hormone treatment – a cream applied to the vagina, or tablets or a hormone-releasing ring inserted into the vaginavaginal support pessaries – a plastic or silicone device inserted into the vagina help support the pelvic organsphysiotherapy and pelvic floor muscle training, usually with a specialist women's health physiotherapistsurgery – if the prolapse is severe, surgery to lift and support the pelvic organs may be an option You and your doctor will decide together what's the best option for you. NHS England: surgical treatments for pelvic organ prolapse Surgery to treat pelvic organ prolapse by putting a supportive mesh inside the vagina is no longer done on the NHS, unless there's no alternative. If you have previously had vaginal mesh inserted and think it might be causing problems, speak to a GP or your surgeon.
Prevention
Pelvic floor exercises; Healthy weight; Avoid heavy lifting/constipation.
When to see a doctor
See GP if: symptoms affect quality of life (e.g. leaking urine/pain).