Many symptoms have been attributed to pelvic-organ prolapse but the most reliable is the presence of a bulge outside of the vagina. Other symptoms that have been attributed to prolapse include difficulty with urination or constipation and the sensation of something falling out of the vagina.
Your doctor will want to begin with a complete medical history, including your symptoms and your surgical history. This would be followed by a pelvic examination. Often women are examined when standing and (bearing down) which allows the best assessment of the prolapse. Pelvic organ prolapse may also be discovered during a routine pelvic examination as part of your regular medical check-up. Radiological and laboratory tests are rarely used to make this diagnosis but may be ordered for other reasons prior to your being examined by a specialist.
Treatment for pelvic-organ prolapse usually depends on the severity of the symptoms and how much these symptoms interfere with daily activities and general quality of life. Treatments may include:
- Kegel exercises - Exercises that strengthen the pelvic muscles.
- Mechanical devices (pessaries) - Silicone dishes that look similar to contraceptive diaphragms. They are inserted into the vagina to provide support for a drooping vagina or uterus and can reduce the bulge that often interferes with performing daily activities. Woman who choose to use these devices can insert and remove them on a daily or weekly basis. This can be a very viable alternative for women who may have to delay surgery or for women when surgery is not an option.
- Surgery - If other treatments fail to result in satisfactory improvement, your physician may suggest surgery. Various surgical procedures are available to correct pelvic-organ prolapse. Our pelvic floor team was the first to start using minimally invasive approaches such as laparoscopic and robotic procedures to repair pelvic organ prolapse. In developing a surgical plan, you and your physician will consider your level of activity, age, general health and your desire for sexual activity to determine the best surgical approach.