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A pelvic prolapse is a sign of a serious weakness in the muscles of the pelvic floor. Exercises can help strengthen these muscles, decrease symptoms and prevent further prolapse, although they will not reverse the damage. Exercises for the pelvic floor are described in Coping with Urinary Incontinence.

Making Decisions about Surgery

Surgery is not usually necessary for mild cases of pelvic prolapse. Whether or not surgery is appropriate for you will depend on your age and general health, whether or not you hope to get pregnant in the future, whether you are and/or intend to be sexually active, and how much your symptoms are affecting your life. For example, a vaginal bulge might cause great discomfort for a woman who regularly has sexual intercourse, but be less of a concern for a woman who is not sexually active. Feelings of pelvic pressure may be very disturbing for some women, yet seem trivial to others. It is important for you to communicate with your doctor so you can receive the treatment that is best for you.

Some symptoms are clearly disruptive and need to be dealt with. For example, if you have urinary incontinence that severely disrupts your life and does not respond to more conservative treatments, your doctor may recommend surgery. Although some women may choose to live with mild incontinence, there are many treatments to address this problem. Women who are experiencing incontinence due to a cystocele are usually encouraged to consider surgery. One option for women who wish to delay or avoid surgery is a pessary.

Women who have difficulty having complete bowel movements should also consider surgery to repair a rectocele as soon as possible. Straining associated with bowel problems is likely to make the problem worse. Some women with a rectocele may need to insert fingers into the vagina and press down to empty their bowels. This is a clear sign of a case where surgery would be appropriate.

Hysterectomy is sometimes performed at the same time as the surgery to repair the pelvic floor muscles. Although hysterectomy may have benefits for some women with pelvic prolapse, it is not an essential part of pelvic prolapse surgery. For details, read our FAQs.


The pelvic floor is a layer of muscles that stretches like a hammock from the pubic bone at the front of the pelvis to the base of the spine in the back. These muscles support the weight of the pelvic organs and enable everyday activities like walking and sitting. Ligaments within the pelvis hold the organs in place.

The pelvic floor muscles also play a crucial role in the functioning of pelvic organs. For example, bands of muscle encircle the urethra (the opening you urinate through) and bowel. These bands are called sphincters. Sphincters control the release of urine and feces. Other muscles surrounding these organs control the filling and emptying of the bowel and bladder.

Muscles throughout the pelvis also work when a woman gives birth. Some of these same muscles contribute to the enjoyable sensations of female orgasm.

Damage or weakness in these muscles can interfere with all of these functions. One of the most obvious signs of damage is a prolapse.

Think of the pelvic floor as a mesh of muscles, like a nylon stocking. When these muscles are weakened or damaged, runs or even holes appear in the mesh and it can no longer support the pelvic organs. A prolapsed organ is an organ that has shifted position and begun to protrude through this mesh. Most commonly, prolapsed organs press down against the vagina, since this is the largest opening to the pelvic floor. This causes a bulge in the wall of the vagina. In severe cases, a prolapse can push part of the vaginal wall out through the vaginal opening.

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Pelvic Prolapse

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