Navigation Search

Pelvic Organ Prolapse

Pelvic organ prolapse occurs when muscles and connective tissue become too weak to support the bladder, rectum or uterus. You may feel a bulge or pressure in the pelvic area. You may also find physical activity or intercourse uncomfortable.

Maimonides Pelvic Floor Center is the only full-service center in Brooklyn providing advanced treatments for women with pelvic organ prolapse.

What Is Pelvic Organ Prolapse?

Pelvic muscles and tissues act like a hammock to support pelvic floor organs. When the muscles and tissues stretch or weaken, one or more pelvic organs can drop into the vagina. The organs can even start to slip out. Our doctors expertly diagnose and treat all types of pelvic organ prolapse, including prolapsed:

  • Bladder (cystocele): A prolapsed bladder is the most common type of pelvic organ prolapse in women. It occurs when the bladder drops into, or out of, the vagina.

  • Uterus: With uterine prolapse, the uterus bulges into, or out of, the vagina.

  • Rectocele: The rectum (the last portion of the large intestine) bulges into the back wall of the vagina.

  • Small bowel (enterocele): Part of the small intestine, or bowel, protrudes into the vagina.

What Causes Pelvic Organ Prolapse?

Certain factors increase the likelihood of pelvic organ prolapse, including:

  • Age: Pelvic floor muscles naturally weaken with age.

  • Childbirth: Vaginal childbirth can stretch and weaken pelvic floor muscles. A woman is also more at risk if she has had multiple pregnancies or she has given birth to a baby weighing more than 8.5 pounds.

  • Long-term abdominal pressure: Obesity, chronic coughing and straining during bowel movements can weaken muscles.

Diagnosing Pelvic Organ Prolapse

When a physical examination cannot determine the cause of prolapse symptoms, we use sophisticated technology such as:.

  • Dynamic pelvic floor MRI: Using a magnetic field and radio waves to create cross-sectional images of the pelvic floor muscles as they contract, the test gauges the strength of muscles and ligaments that support pelvic organs.

  • Ultrasound: Scans with sound waves can also provide detailed images of the pelvic floor.

Nonsurgical Treatments for Prolapse

We offer comprehensive treatments for pelvic organ prolapse. Your doctor starts with the least invasive treatment first. Options that avoid surgery include:

  • Medications: Loss of estrogen after menopause can weaken pelvic floor muscles. Hormone replacement therapy may help.   

  • Pelvic floor exercises (Kegels) with biofeedback: We teach you how to correctly perform pelvic floor exercises (often called Kegels) to strengthen supporting muscles. You perform the exercises using sensors which provide biofeedback and ensure you properly engage the right muscles.

  • Pessaries: A removable pessary device (small plastic ring inserted in the vagina) can hold up a prolapsed bladder, uterus or rectum. This device helps stop stress urinary incontinence that can occur when you cough or sneeze.

Surgical Treatments for Prolapse

Our pelvic floor specialists use minimally invasive techniques, including vaginal, laparoscopic and robotic-assisted approaches, to surgically correct pelvic organ prolapse. You benefit from smaller incisions, less blood loss during surgery, reduced pain after surgery and minimal scarring. You also return to daily activities faster.

Surgical treatments for prolapse include:

  • Hysterectomy: A hysterectomy treats uterine prolapse by surgically removing the uterus.  We offer vaginal hysterectomies, which avoid all incisions in the vagina, and laparoscopic or robotic-assisted hysterectomies that use smaller incisions.

  • Uterine-sparing surgery: We also offer hysteropexy if you have prolapse but want to keep your uterus. Your uterus is held in place with your own tissue and novel surgical devices.

  • Cystocele and rectocele repair: We use your own tissue to secure the bladder and rectum. Our doctors perform this procedure through small incisions in the vaginal wall.

  • Sacrocolpopexy: We use synthetic material to lift the top of the vagina, bladder and rectum toward the tailbone. Our doctors perform this procedure laparoscopically or robotically to allow for smaller incisions and quicker recovery. Learn more about prolapse surgery.

Contact Us

To make an appointment at the Maimonides Pelvic Floor Center, call 718-PELVIC-1 (718-735-8421) or request an appointment online.