Pelvic organ prolapse (POP) is a condition where weakened muscles in your pelvis cause one or more organs in your pelvis (vagina, uterus, bladder and rectum) to sag. In more severe cases, an organ bulges onto another organ or outside your body. Your healthcare provider can recommend treatments to repair your prolapse and relieve symptoms.
Pelvic organ prolapse (POP) is a condition in which your pelvic floor (the muscles, ligaments and tissues that support your pelvic organs) become too weak to hold your organs in place. Your pelvic floor muscles act like a powerful sling that supports organs like your vagina, uterus, bladder and rectum. If these muscles become too loose or sustain damage, the organs they support shift out of place.
With mild cases of POP, your organs may drop. In more severe cases, they may extend outside your vagina and cause a bulge.
The type of prolapse you have depends on where the weaknesses are in your pelvic floor and what organs are affected.
People of all sexes can experience POP, but you’re at greater risk if you’re a woman or person assigned female at birth (AFAB). Men and people assigned male at birth (AMAB) can experience a dropped bladder and a dropped rectum.
Around 3% to 11% of people AFAB experience POP. About 37% of people with pelvic floor disorders, including POP, are between ages 60 and 79. Over half are 80 or older. POP doesn’t always cause symptoms, though. As a result, it’s hard to know how common POP is among people who don’t see their healthcare providers for symptom relief.
The most common symptom is feeling a bulge in your vagina, as if something were falling out of it. Other symptoms include:
Your symptoms depend on where your prolapse is located. Telling your healthcare provider about your symptoms helps them locate the spots where your pelvic floor is weakest.
Stress incontinence, urge incontinence and fecal incontinence often coexist with POP because they share similar risk factors. Symptoms include:
Your pelvic floor can weaken for many reasons. A weak pelvic floor increases your likelihood of a prolapse.
During your appointment, your healthcare provider will review your symptoms and perform a pelvic exam. During the exam, your provider may ask you to cough so that they can see the full extent of your prolapse when you’re straining and when you’re relaxed. They may examine you while you’re lying down and while you’re standing. Often, a pelvic exam is all it takes to diagnose a prolapse.
Additional tests may include:
The Pelvic Organ Prolapse Quantification (POP-Q) system classifies POP based on how mild or severe your prolapse is. The scale ranges from zero to four. Stage Zero means your organs haven’t shifted out of place at all. Stage Four means you have a complete prolapse. A complete prolapse is the most severe kind. It may involve an organ bulging out of your body.
Both the type of prolapse and the extent of the prolapse will shape your treatment.
Because any surgical procedure may pose risks or create complications, nonsurgical procedures are usually the first line of treatment for POP. If more conservative treatments don’t work, your provider may recommend surgery.
Surgery may be an option if your symptoms haven’t improved with conservative treatments and if you no longer wish to have children. Childbirth following surgery may increase the risk of your prolapse returning.
Two types of surgeries are available: obliterative surgery and reconstructive surgery. Obliterative surgery sews your vaginal walls shut, preventing organs from slipping out. Reconstructive surgery repairs the weakened parts of your pelvic floor.
Your provider may suggest additional procedures while you’re in surgery for POP. For instance, some procedures may require a hysterectomy so that pelvic floor muscles can be accessed and repaired. Your provider may treat other conditions that may accompany POP, like stress urinary incontinence, during surgery.
Many causes of POP are out of your control. But you can put healthy habits into place to reduce your risk.
Your prognosis depends on your prolapse (where it’s located, it’s severity) and your goals (to have children, to continue having penetrative sex, to have a less invasive surgery, etc.). Talk to your healthcare provider about how your prolapse shapes your treatment options. Discuss how the benefits of treatment will allow you to achieve your goals, and ask about any risks that may prevent you from achieving them, too. Grounding your expectations in honest conversations with your provider will improve your experience with POP.
Left untreated, your prolapse and your symptoms can worsen. Your healthcare provider can monitor your prolapse and recommend treatments if it progresses to the point where it’s negatively impacting your quality of life.
Most people with POP describe a feeling of bulge, fullness or pressure in their vagina, as if something were falling out. Your symptoms will depend on what type of prolapse you have and how severe it is.
Common symptoms like pressure or fullness in your vagina or issues related to incontinence may be signs of a prolapse. Your provider can diagnose POP during a pelvic exam.
It can, with treatment. With mild POP, you can strengthen your muscles so that they hold the organs in their correct locations. Reconstructive surgeries strengthen the weaknesses in your pelvic walls so that your organs return to their original locations.
With more severe prolapse, you may have to push the bulging organ out of the way to poop or pee. The fix is temporary. See your healthcare provider for treatment if your prolapse is this severe.
A note from Cleveland Clinic
Pelvic organ prolapse can harm your body image and your sexuality. It can cause symptoms that prevent you from living your life to the fullest. But POP isn’t something you have to accept. Don’t be embarrassed to talk to your healthcare provider if you have POP symptoms or if you suspect you have a weakened pelvic floor. They can suggest procedures, medical devices and even lifestyle modifications that can repair your prolapse and improve your quality of life.
Last reviewed by a Cleveland Clinic medical professional on 08/22/2022.
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