Pelvic organ prolapse occurs when the supporting structures of the pelvic floor become weakened, allowing the uterus, vagina, or adjacent pelvic organs to descend from their normal position.

Pelvic organ prolapse is common and can vary considerably in severity. Mild changes may cause few or no symptoms, while more pronounced prolapse can significantly affect everyday activities and quality of life.

What Types of Prolapse Are There?

Depending on the area affected, different types of prolapse may occur:

• prolapse of the front vaginal wall and bladder (cystocele)
• prolapse of the back vaginal wall and rectum (rectocele)
• uterine prolapse
• prolapse of the vaginal vault following a previous hysterectomy
• a combination of several forms of prolapse

Typical Symptoms

Pelvic organ prolapse can cause a variety of symptoms, including:

• a feeling of pressure or a foreign-body sensation in the vagina
• the feeling that “something is coming down”
• a visible or palpable bulge at the vaginal opening
• a feeling of heaviness or pulling in the lower abdomen or pelvis
• symptoms that worsen after prolonged standing or physical activity
• difficulty emptying the bladder
• difficulty with bowel movements
• discomfort or limitations during sexual intercourse

The severity of symptoms does not always correspond to the anatomical degree of prolapse. For this reason, the examination findings are only part of the assessment. It is equally important to understand how much the symptoms affect everyday life and quality of life.

Dr. Arsenakis has many years of experience in urogynecology and the treatment of pelvic floor disorders. During his time at Nuremberg University Hospital, he was responsible for a specialized urogynecology clinic for several years.

Pelvic organ prolapse is not something that simply has to be accepted. Careful assessment provides the foundation for targeted and appropriate treatment.