Women's bodies change with time, and as I advise my patients, it takes conscientious effort to counteract gravity, aging, and time's effects on our bodies. One of our most vulnerable places for feeling the pull of gravity over time, is our vaginal support. When the vaginal supports fail, this is called vaginal prolapse, or pelvic organ prolapse (POP).
Over half of women after menopause have some degree of prolapse, but it's mostly asymptomatic and doesn't require any intervention. If the prolapse advances to the point of the vaginal opening, women may experience symptoms of vaginal bulge, pressure, groin pain, sexual pain, and difficulty urinating or having bowel movements. With advanced prolapse, the vaginal tissues become stretched and lose their elasticity, and this can become very uncomfortable. Women may describe feeling "like I'm sitting on a ball...or something is coming out of me...constant fullness in my pelvis...", or symptoms of low back and groin pain are common too.
Vaginal prolapse is considered a weakness in the support tissue, much like a hernia, and can be treated with clinical observation, a support device you can wear in your vagina called a pessary, or surgical reconstruction. Surgery for vaginal prolapse is best done by an expert in urogynecology who has done advanced fellowship training and earned accreditation in Female Pelvic Medicine and Reconstructive Surgery (FPMRS).
There are many options for treating vaginal prolapse, so before a patient commits to a care plan, it's best to become educated on her choices and expected outcomes. Surgeons with the FPMRS board certification are experts in treating vaginal prolapse, so patients should seek a consultation with an FPMRS surgeon before committing to a surgical plan.