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North Texas and San Antonio

Pelvic Organ Prolapse

Pelvic organ prolapse is the medical term for “things falling out of the vagina.” POP is the result of laxity within the vagina walls and/or laxity or detachments of the ligaments in the pelvis which leads to different parts of the anatomy to “fall” or “bulge” out of place. These parts can include your cervix/uterus, bladder, rectum, or your vaginal cuff (if you’ve had a hysterectomy in the past).

These problems are much more common than most people know. Approximately 50% of all women have some level of prolapse on exam by the time they have completed their childbearing. While there are conservative treatments available, about 20% of all women will have surgery for POP at some point in their lifetime.

POP can take multiple forms:

  • Cystocele: the bladder and front vaginal wall bulging downward into the vagina, resulting in a bulge that can be felt and/or seen near the opening of the vagina. This can sometimes lead to the sensation of something “blocking” the vagina during sex or painful sex, difficulty urinating, overactive bladder symptoms, or recurrent urinary tract infections due to incomplete emptying during urination.
  • Rectocele: the rectum and rear vaginal wall bulging upward into the vagina, resulting in a “bulge” or “ball” that can be felt and/or seen near the opening of the vagina. This can sometimes lead to the sensation of something “blocking” the vagina during sex or painful sex, difficulty in having a bowel movement – sometimes requiring you to place your fingers in your vaginal or near the vaginal opening to help have a bowel movement, or incomplete bowel movements.
  • Uterine/Cervical Prolapse: the cervix and uterus sliding downward in the vagina, resulting in a “bulge” or “ball” that can be felt and/or seen near the opening of the vagina. This can sometimes lead to the sensation of something “blocking” the vagina during sex or painful sex, difficulty urinating, overactive bladder symptoms, or recurrent urinary tract infections due to incomplete emptying during urination. In rare extreme cases, the cervix/uterus can protrude out from the vaginal opening, or the entire vagina and fall out.
  • Vaginal Vault Prolapse After Hysterectomy: this typically involves a combination of issues that begins with top of the vagina falling down.