By Riva Preil

Mild prolapse may be asymptomatic, and POP may only first become noticeable at later stages of the dysfunction.  The signs and symptoms of bladder or urethral prolapse include urinary incontinence, urgency (sudden strong urge to urinate), urinary frequency (voiding more frequently than normal, generally assumed to be more than 8x/day).  It may also be associated with difficulty initiating the flow of urine (hesitancy). Signs of rectal prolapse include difficulty with passing bowel movements and/or constipation. Signs of uterine prolapse include a feeling of heaviness in the pelvic floor, and women often describe it as if they feel their “insides are falling out.”  They may even feel or see a pinkish colored lump at the vagina, especially at the end of the day or after hours of prolonged standing or walking.  There may also be pain with intercourse.

The first line of treatment for POP is pelvic floor physical therapy.  By strengthening the pelvic floor muscles, additional support can be provided to the organs from below. If that alone is insufficient, some women find a pessary helpful. This is a device which is inserted vaginally to support one or multiple pelvic floor organs.  When physical therapy and pessary are not enough, some women may decide to undergo surgery to bolster the lax pelvic floor.  One of the most common surgical techniques is transvaginal placement of synthetic mesh for POP. Research about the mesh materials are mixed, and it is important to discuss further details with one’s physician regarding what the best options are for them.