Pelvic Organ Prolapse

Pelvic organ prolapse — also called pelvic support problems — occurs when the tissues that support the pelvic organs are damaged or stretched, allowing the organ to drop down out of normal position and causing a bulge. Women with prolapsed pelvic organs may have a feeling of pressure or heaviness in the pelvic region. Sometimes it feels as if something is "falling out."

Childbirth and aging are the two most common causes of this condition. During childbirth, the tissues of the pelvic organs may be damaged or weakened due to the stretching that can occur. As a result, these tissues may not provide as much support for the organs as necessary. Symptoms may worsen after menopause.

The main types of pelvic support problems include:

• Cystocele, when the bladder is not supported properly
• Enterocele, when the small intestine is not supported properly
• Rectocele, when the rectum is not supported properly
• Uterine prolapse, when the uterus is not supported properly
• Vaginal prolapse, when the vagina is not supported properly

Proper diagnosis is the key to treating the problem. Treatment can include pelvic muscle exercises, vaginal inserts to provide better support for the organs, or surgery.

Our Approach to Pelvic Organ Prolapse

UCSF offers innovative, compassionate care for pelvic organ prolapse. Our team includes gynecologists, urologists, colorectal surgeons and physical therapists who specialize in pelvic floor rehabilitation. Treatment options include use of an insert called a pessary (a device placed inside the vagina to support the organs), as well as targeted exercises, biofeedback and electrical stimulation to strengthen the pelvic floor muscles. Stronger muscles can help hold the organs in place. We also offer surgery to return prolapsed organs to their normal positions.

We believe that empowering women with knowledge is an important part of the healing process, and encourage each patient to participate in choosing the best treatment option for her.