Pelvic Prolapse

If you have pelvic organ prolapse, you know just how much discomfort it causes. You also know how harmful it is to your quality of life. Fortunately. Neeraj Kohli, MD, MBA, of Boston Urogyn in Wellesley, Massachusetts specializes in pelvic surgery and advanced technologies for the treatment of pelvic prolapse care. To learn about Dr. Kohli’s minimally invasive techniques and physical therapy treatments, call Boston Urogyn or schedule an appointment online today.

Pelvic Prolapse Q & A

What is pelvic prolapse?

Pelvic organ prolapse (POP) is a type of pelvic floor disorder involving a hernia of the pelvic organs: the uterus, bladder, rectum, and vagina.

Your pelvic floor — a group of ligaments, fibers, nerves, and muscles that form a sling attached to the bony pelvic structure — holds these organs in place. When this supportive sling weakens, your pelvic organs can drop, causing pelvic prolapse.

The symptoms of POP and pelvic floor disorders include:

  • Constipation

  • Pressure or pain in the rectum or vagina

  • A feeling of heaviness in the pelvis

  • A bulge in the rectum or vagina

  • Muscle spasms in the pelvis

  • An urgent need to urinate

  • Painful urination and intercourse

Although pelvic floor disorders are more common in aging women, this condition isn’t a normal part of the aging process.

What causes pelvic organ prolapse?

Pelvic organ prolapse is usually the result of vaginal childbirth. Additional risk factors include a family history of POP, a prior hysterectomy, radiation treatments, and obesity. Chronic conditions that increase intra-abdominal pressure, like constipation or asthma, can also lead to pelvic organ prolapse.

POP commonly occurs with other pelvic floor disorders, such as urinary and fecal incontinence.

How is pelvic organ prolapse treated?

Dr. Kohli offers several treatments for pelvic floor disorders. Depending on the extent of your pelvic prolapse, he might recommend minimally invasive surgery to correct your pelvic anatomy and return your bladder, bowel, and vaginal function to normal.

These repairs are done laparoscopically, abdominally, or transvaginally and may include the following procedures:

  • A hysterectomy to remove the uterus

  • A rectocele to repair and correct the small bowel and fallen rectum

  • A cystocele to repair and correct a prolapsed urethra or bladder

  • A vaginal vault suspension to repair the vaginal wall

  • Vaginal obliteration to close the vagina

Dr. Kohli might also recommend physical therapy, such as exercises to strengthen the pelvic floor, or behavioral modifications, like biofeedback or pelvic floor stimulation. Medication, hormone therapy, and non-surgical treatments -- such as vaginal devices called “pessaries” -- may also be an effective option for your pelvic prolapse.