Ask a Doctor

Joseph M. Novi, DO, FACOG
Riverside Center for Female Continence and Reconstructive Pelvic Surgery - Suite 501
North Medical Building at Riverside
3545 Olentangy River Road
Columbus, Ohio 43214
Phone: (614) 566-2727

Q: What is a prolapsed uterus, what causes it or how can it be prevented - and how is it treated?

A: Pelvic organ prolapse is a type of hernia involving the vagina and supports of the pelvic organs. It results from weakening, breaking or stretching of the connective tissue, muscles and nerves that make up the pelvic floor. Uterine prolapse occurs when the uterus drops down from its normal position at the upper part of the vagina into the vagina, and in some instances, outside of the vagina.

Commonly, prolapse is related to the pressure and stretching involved with vaginal childbirth.  However, it can also be related to repetitive heavy lifting, chronic coughing, chronic constipation, smoking or an inherited weakness of the support tissues.  A cesarean delivery does not appear to prevent pelvic organ prolapse.

Most patients with pelvic organ prolapse have minimal or no symptoms. It is rarely a cause of pain, and most women complain of a bulging in the vagina and/or vaginal pressure. Some women may experience urinary leakage or frequent urination and difficulty with vaginal intercourse. Having prolapse is not harmful and does not relate to or cause cancer.

If left untreated, pelvic organ prolapse usually worsens, but may take many years for this to happen. The exception to this is prolapse that occurs immediately after vaginal delivery. In many instances, this does improve in the first year. There are several options for treating prolapse, although not all of them are appropriate for every woman. Pelvic muscle exercises (also known as Kegel exercises) may help relieve the vaginal pressure and may prevent the prolapse from worsening. Pessaries are silicone devices, often shaped like a ring or diaphragm that can be placed in the vagina to help support the pelvic organs. They can be used for many years and are associated with little risk. 

There are several different kinds of surgery designed to correct prolapse problems. Gynecologists are trained to perform many of these procedures. There is no single operation that is right for every patient. Occasionally, a woman may need the expertise of a urogynecologist, a gynecologist that has had an additional 3 years of training in disorders of pelvic support.