Frequently Asked Questions

Q. What does "prolapse" mean?
A. The word “prolapse” means displacement from the normal position. It is used to describe female organs that bulge, sag, or fall. Prolapse usually takes many years, though it can happen quickly.

Q. What are the symptoms of prolapse?
A. The first signs can be subtle: difficult intercourse or inability to keep a tampon inside the vagina. As the prolapse gets worse, you may feel a bulging or heavy sensation in the vagina that gets worse by the end of the day or during bowel movements. Women with severe prolapse sometimes have to push stool out of the rectum by placing their fingers into the vagina during bowel movements. Because prolapse usually happens slowly, the symptoms can be hard to recognize. Most women don't seek treatment until they actually feel something protruding outside of their vagina.

Q. Why did this happen to me?
A. Many factors contribute to prolapse, and almost none of them are controllable. Genetics plays a major role. Some women are predisposed to develop prolapse after vaginal deliveries, but we can’t predict which women will have this predisposition. Severe obesity, pelvic tumors, chronic constipation, and repeated heavy lifting also seem to contribute.

Q. Do I need surgery to correct my prolapse?
A. You have two other choices. You can do nothing or you can wear a pessary. Pessaries come in different shapes and sizes for support of different organs. They are worn inside the vagina like a diaphragm. Many women are satisfied using a pessary for years.

Q. Will a pessary give me an infection?
A. Ideally, a pessary should be inserted each morning and taken out for cleaning each night. When this can’t be done, women come to the office four to six times a year for an exam and pessary cleaning. Vaginal infections are rare, even when a pessary is worn almost continuously.

Q. If I just ignore this problem, will it get worse?
A. If left untreated, pelvic organ prolapse usually gets worse. In rare cases, severe prolapse can cause urinary retention that progresses to kidney damage or infection, making treatment necessary. Most of the time, however, patients should gauge their symptoms and decide when they need to have their prolapse treated.

Q. If I decide to have surgery, what can I expect during the recovery period?
A. The hospital stay usually lasts one to four days, depending on the kind of surgery you have. A catheter is usually worn for 3 to 7 days after you go home. Most patients need to take a prescription strength pain medicine for a week or two after surgery. For 12 weeks after surgery, you must not lift more than 8 pounds (the weight of a gallon of milk), have no sexual intercourse, and avoid any activity that causes you to strain. While exercise should be limited, walking is definitely encouraged.

Q. How long will a surgical repair last?
A. The goal is to recreate normal anatomy permanently. However, failures occur in about 5 to 15% of women who have prolapse surgery. The failure is usually partial and may require no treatment, pessary use, or a minimally invasive surgical repair. Patients who follow the guidelines for 12 weeks after surgery have the best chance to permanently alleviate prolapse symptoms.

Q. I have prolapse, but I don't leak urine. Do I still need bladder testing?
A. Bladder testing (called urodynamics) must be done before any surgery to correct prolapse because the prolapsed portion of your vagina may be pushing on your urethra and preventing urine leakage. If that is the case, correcting the prolapse may cause urinary incontinence. Bladder testing is the only way to tell whether a continence procedure is needed at the time of prolapse surgery.

Q. How will my prolapse treatment affect my sex life?
A. If you choose to use a pessary, your sex life shouldn't change except that the pessary usually has to be removed before intercourse. If you have reconstructive surgery, you should wait three months after your operation before having intercourse. After the three month period, getting used to having intercourse will take some time.