Is pelvic organ prolapse dangerous?

Prolapse is uncomfortable, but it is not dangerous and it is not cancer. For most women it is a quality-of-life problem rather than an emergency. The exceptions are trouble passing urine or emptying your bladder, or tissue outside the body that becomes raw or bleeds, and those should be looked at promptly.

Will prolapse get worse over time?

It can, but not always, and it rarely changes quickly. Many women stay about the same for years. Treating constipation, managing a chronic cough, avoiding repeated heavy lifting, and keeping your weight steady all help slow it down.

Can pelvic floor exercises fix prolapse?

Pelvic floor physical therapy can ease symptoms and strengthen the support around the pelvic organs, and it works best for mild to moderate prolapse. It usually will not move the organs all the way back to where they started. Working with a trained pelvic floor therapist is far more effective than doing Kegel exercises on your own.

What is a pessary, and what is it like to wear one?

A pessary is a soft, flexible device fitted into the vagina to hold the pelvic organs in position. We fit it here in the office, and when the fit is right you should not be able to feel it. Many women wear one for years instead of having surgery; it needs periodic cleaning and a checkup now and then.

Can I still have sex if I have prolapse?

Yes. Prolapse does not make sex unsafe, though some women notice reduced sensation, discomfort, or self-consciousness about the bulge. Vaginal estrogen, removing a pessary beforehand, or surgical repair can each help, depending on what is bothering you most.

Do I need to stop lifting or exercising?

Staying active is good for you, and you do not need to give up exercise. What helps is avoiding repeated heavy straining and learning to breathe out rather than bear down during the hardest part of a lift. A pelvic floor therapist can show you how to adjust the activities you already enjoy.

PELVIC ORGAN PROLAPSE

Pelvic Organ Prolapse Diagnosis & Treatment in Sherman, TX

Pressure, bulging, and the feeling that something is falling out

If you feel pressure, heaviness, or a bulge in your vagina, you are not imagining it, and you are not alone. Pelvic organ prolapse is common, it is not dangerous, and it is very treatable. Many women live with it for years before mentioning it, often because they assume nothing can be done or feel awkward bringing it up. You can bring it up here.

What is pelvic organ prolapse? Your bladder, uterus, and rectum are held in place by a hammock of muscle and connective tissue called the pelvic floor. When that support weakens or stretches, those organs can drop downward and press into the vagina. That is prolapse.

It is named for whichever organ has shifted. Cystocele means the bladder presses into the front wall of the vagina, and it is the most common type. Rectocele means the rectum presses into the back wall of the vagina. Uterine prolapse means the uterus drops down into the vagina. Vaginal vault prolapse means the top of the vagina drops after a hysterectomy (surgery to remove the uterus). More than one type can happen at the same time, which is why an exam matters more than guessing from symptoms alone.

What does prolapse feel like? Symptoms vary a lot from woman to woman, and mild prolapse often causes none at all. When there are symptoms, the common ones are a feeling of pressure, heaviness, or dragging in the pelvis; a bulge you can feel or see at the vaginal opening; the sense that something is falling out, often worse by the end of the day; leaking urine, or trouble starting or finishing a stream; difficulty emptying your bowels completely; discomfort or reduced sensation during sex; and low back ache that eases when you lie down.

Symptoms that worsen as the day goes on, or after standing and lifting, are typical of prolapse. That pattern is a useful thing to mention when you come in.

What causes it? Prolapse builds over time, usually from a combination of things rather than one cause. Pregnancy and childbirth, especially vaginal deliveries, large babies, or several births. Menopause, when lower estrogen thins and weakens the supporting tissue. Aging, which gradually reduces tissue strength. Anything that raises pressure in the abdomen repeatedly, such as chronic coughing, constipation and straining, heavy lifting, or carrying extra weight. Previous pelvic surgery, including hysterectomy, can also increase the risk of pelvic organ prolapse as well as family history, since connective tissue strength is partly inherited.

None of this means you did something wrong. These are the ordinary forces that act on the pelvic floor over a lifetime.

Do I have to have surgery? No. Surgery is one option among several, and it is rarely the first one. If your prolapse is mild and not bothering you, watchful waiting is a legitimate choice, and we can simply keep an eye on it.

Pelvic floor physical therapy uses targeted exercises with a trained therapist to strengthen support and ease symptoms, and it works best for milder prolapse. A pessary is a soft, flexible device fitted into the vagina to hold the organs in position; we fit it here in the office, and many women wear one for years rather than having surgery. When tissue has thinned after menopause, vaginal estrogen cream or a tablet can improve tissue quality and sometimes reduce symptoms. And when symptoms affect your daily life and the other options have not been enough, surgical repair is a good option. Dr. Karissa Cryer performs prolapse repair in Sherman, Texas.

How bothered you are matters more than how your prolapse measures on an exam. Two women with identical findings can want very different things, and both can be right.

When should I come in? Make an appointment if you can feel a bulge, if pressure or leaking is interfering with work, exercise, or sex, or if you are simply not sure what you are feeling and want an answer. Come sooner if you have trouble passing urine or emptying your bladder, or if the tissue outside becomes sore or bleeds.

An evaluation is straightforward. We talk through your symptoms and history, then do a pelvic exam, sometimes with you standing or bearing down so we can see how the support behaves under pressure. From there we will explain what we found in plain words and lay out your choices, including doing nothing for now. Your doctor or other healthcare provider can help you decide which option fits your symptoms, your health, and your plans.

We care for women across Sherman, Denison, and the wider Texoma area, with bilingual support available. To schedule an evaluation, text or call us at 903-957-0275.

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Frequently asked questions

Pelvic Organ Prolapse FAQs