Pelvic organ prolapse is a common condition caused by weakening of the pelvic floor muscles.
If you have a prolapse, it means the muscles and ligaments that support your pelvic organs have weakened enough that the organs have dropped. The dropped organ may create a bulge in the vagina, known as prolapse. This most commonly happens after childbirth, after a hysterectomy or after menopause.1
Pelvic organ prolapse or POP is said to affect as many as 50% of women who have had children, with 14% to 19% of women undergoing a surgical correction.2
There are different kinds of prolapse, depending on which organ has been affected. There are also a variety of treatment options for pelvic organ prolapse, one of which is surgery. The types of surgery can vary for each condition too.
Let’s explore the surgeries available for the different prolapses that can occur.
Bladder Prolapse Surgery
Bladder prolapse is a condition in which your bladder has dropped or bulged into your vagina.
There are options for treating a prolapse before surgery is required, but surgery may be done to repair the vaginal wall support and reposition your bladder.
The most common type of surgery is called anterior vaginal repair, in which an incision is made in the wall of your vagina and extra supportive tissue is sewn between the vagina and bladder. This will also tighten the layers of tissue that support the bladder.3
Uterine Prolapse Surgery
Uterine prolapse is another situation in which your pelvic floor muscles have weakened, with the result that your uterus sags or drops down into your vagina.
There are typically two types of surgery, if it’s determined to be necessary:
A hysterectomy: your uterus is removed, a major surgery that means you will not be able to get pregnant.4
Prolapse repair without hysterectomy: surgery is done to put your uterus back into its normal position. That can be done by uterine suspension, in which the pelvic ligaments are reattached to the lower part of your uterus to hold it in place.4
Vaginal Prolapse Surgery
With vaginal prolapse, those weakened pelvic floor muscles result in your vagina slipping out of position.
There are ways to treat it without surgery, but here are the options for vaginal prolapse surgery:
Vaginal vault suspension: your vagina is attached to the ligaments that hold it up inside your pelvis.5
Sacrocolpopexy: a piece of mesh is attached to your vagina and then secured to your tailbone to lift the vagina. This is most commonly done with laparoscopy.5
Colpocleisis: in this procedure, your vagina is stitched shut. While it eliminates the risk of getting another prolapse, it also eliminates your ability to enjoy penetrative sex.5
Rectal Prolapse Surgery
Rectal prolapse is when the last part of your large intestine, or rectum, stretches and protrudes from your anus. If required, surgery will put the rectum back in place.
Here are the types of rectal prolapse surgery:
Abdomen surgery: the surgeon pulls the rectum back into place through an incision in the abdomen. Then the rectum is anchored to the back wall of the pelvis with sutures or a mesh sling.6
Laparoscopic surgery: this procedure uses smaller incisions to complete a similar repair.6
Repair through the area around the anus: this involves pulling the rectum through the anus, removing a portion of the rectum, and then attaching the remaining rectum to the large intestine or colon. A short prolapse could be repaired by removing the lining of the rectum and folding the muscular layer to shorten the rectum.6
There is also a surgery that can be performed to assist with prolapse conditions by reconstructing the pelvic floor. This surgery is not invasive and can help the dropping of pelvic organs including the uterus, vagina, bladder and/or rectum.7
Known as “laparoscopic colposuspension,” the surgery involves making four small incisions in the abdomen and then resuspending the pelvic organs through these incisions. The vagina and pelvic organs are resuspended internally with a combination of sutures and a supportive mesh without the need for a large abdominal incision.7
Get a Treatment Plan
If you have the symptoms of a prolapse, or you know you have the condition and you’re wondering about treatment, see a doctor.
Use our Physician Finder to find a doctor near you with expertise in women’s health, who can help determine whether surgery is necessary for your prolapse, or if you can find other treatment options.