Pelvic Organ Prolapse Frequently Asked Questions

Just starting your journey with pelvic organ prolapse, or have questions about the condition? You’re in the right place.

What is Pelvic Organ Prolapse?

Pelvic organ prolapse (POP) occurs when the muscles and connective tissues that support the pelvic organs weaken or become damaged. This can cause one or more organs to shift out of place and push against the vaginal walls into the vaginal space. Over time, the organ(s) move down in the vaginal canal and eventually the prolapsed organ(s) bulge outside of the vaginal opening. 

There are five types of POP and women often experience two or three types at the same time.

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Prevalence | Types | Symptoms | Causes | Diagnosis | Treatment | Outlook

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How Common is Pelvic Organ Prolapse?

Pelvic organ prolapse is more common than most people realize. POP affects women of all ages, teen through end-of-life, in every country around the world.

Researchers estimate that 50% of women experience POP. The exact prevalence is hard to estimate, as POP screening isn’t standard practice during pelvic exams, women are sometimes too embarrassed to talk about symptoms with their doctors, and practitioners providing pelvic exams are not always sufficiently trained to diagnose and treat POP.

Why haven’t I heard of pelvic organ prolapse before?

The stigma surrounding POP symptoms has kept this condition shrouded in silence for thousands of years. Although pelvic organ prolapse has been documented in medical history dating back to the Kahun Gynaecologic Papyrus circa 1835 B.C., it remains underdiagnosed, underscreened, and underacknowledged. But awareness is growing, as more women start speaking openly about their pelvic, vaginal, and intimate health.

What Are the Types of Pelvic Organ Prolapse?

There are 5 types of pelvic organ prolapse. Each type of pelvic organ prolapse affects different organs. Organs that can prolapse include the bladder, rectum, intestines, uterus, and vagina.

Medical illustration of a cystocele, showing bladder prolapse into the vaginal wall, with labels for bladder, cystocele, and vaginal walls.

Cystocele
(bladder prolapse)

Occurs when the bladder drops into the front wall of the vagina

Medical illustration of uterine prolapse with labeled anatomy: small bowel, rectum, bladder, and uterus.

Uterine prolapse

Occurs when the uterus descends into the vaginal canal

Medical diagram illustrating a rectocele, showing the female pelvic anatomy including the bladder, rectum, urethral compression, and perineum.

Rectocele
(bowel prolapse)

Occurs when the rectum pushes into the back wall of the vagina

Medical diagram showing female pelvic anatomy, labeled with vaginal canal, bladder, rectum, and vaginal vault.

Vaginal vault prolapse

Occurs when the upper walls of the vagina collapse down into the vaginal canal after a hysterectomy

Diagram of female pelvic anatomy showing an enterocoele, small intestine, bladder, and vaginal walls.

Enterocele
(intestinal prolapse)

Occurs when the intestines push out of the abdominal sack and drop into a space within the pelvic cavity

What are the stages of pelvic organ prolapse?

There are 4 levels of severity. Grade 1 is mild, and grade 4 is severe.

What Are the Symptoms of Pelvic Organ Prolapse?

Each type of POP has its own symptoms. Some women describe pelvic organ prolapse as feeling their “insides are falling out” or that they’re sitting on a ball. Pelvic organ prolapse can look like tissues sitting at the edge of the vagina, or in more advanced cases, bulging outside of the vagina.

Common pelvic organ prolapse symptoms include:

  • Pressure, pain, or ‘fullness’ in vagina, rectum, or both

  • Urinary incontinence

  • Urine retention (inability to urinate)

  • Back or pelvic pain

  • Tampons pushing out

  • Athletic incontinence (leakage during fitness activities)

  • Pain with intercourse or intimacy

  • Lack of sexual sensation

  • Coital incontinence (urine or stool leakage during intimacy)

Not familiar with some of these terms?

What Causes Pelvic Organ Prolapse?

The leading causes of pelvic organ prolapse are vaginal childbirth and menopause, but several other factors can also lead to POP. Women who have never given birth can still develop POP due to non-childbirth-related causes including lifestyle factors and co-existing conditions.

Vaginal childbirth: 

Childbirth can weaken or damage the pelvic floor, especially in cases of large baby weight, extended pushing phase, the use of forceps or suction during delivery, multiple births, and improperly repaired episiotomy. The effects of childbirth may appear immediately after delivery or develop decades later.

Menopause: 

Estrogen helps maintain muscle strength and elasticity. As estrogen levels drop during menopause, pelvic tissues can weaken, lose elasticity, and lose density. This increases the risk of prolapse.

Chronic constipation: 

Repetitively baring down to have a bowel movement strains pelvic tissues. A hernia in the colon (rectocele) may either cause or occur from POP. Diet, exercise level, and conditions like irritable bowel syndrome (IBS) can contribute to chronic constipation.

Chronic coughing: 

Coughing from smoking, allergies, bronchitis, and emphysema repetitively jerks pelvic floor tissues downward.

Heavy lifting: 

Lifting children, weightlifting, and physically demanding jobs that include heavy lifting can strain the pelvic muscles.

High-impact physical activities: 

Hard foot-strike fitness activities like jogging, marathon running, aerobics, and gymnastics repetitively jerk internal structures downward.

Genetics: 

Genetic conditions such as Ehlers-Danlos Syndrome (EDS) or Marfan (connective tissue disorders), may indicate an increased risk, especially when present in close family members such as a mother or sister.

Neuromuscular disease: 

Neuromuscular conditions such as multiple sclerosis (MS) can weaken pelvic floor structural tissue support.

Spinal and mobility conditions: 

Spinal conditions such as spina bifida, paralysis, or long-term wheelchair use can contribute to a weaker pelvic floor. (Learn more about the connection between spina bifida and POP.)

Abdominal surgery: 

Soft tissue structural weakness, myofascial tissue restrictions, and scar tissue can complicate POP surgery.

Diastasis rectus abdominus (DRA): 

Stretching of the two bellies of the rectus abdominus muscle during pregnancy may predispose women to a core weakness, which can increase POP risk.

Suspect that you might have POP?

How is Pelvic Organ Prolapse Diagnosed?

Pelvic organ prolapse is usually first diagnosed through a pelvic exam, but the process can vary. While gynecologists, primary care physicians, or other practitioners who provide pelvic exams may recognize and diagnose POP, they do not usually have specialized training to accurately determine the type or grade of severity.

After initial diagnosis, you may be referred to a urogynecologist (a specialist in Female Pelvic Medicine and Reconstructive Surgery) to receive a more detailed diagnosis and discuss treatment options. Various types of women’s health practitioners provide nonsurgical POP treatments, including physiotherapists and occupational therapists. Learn which practitioners treat POP. 

Diagnostic tests for pelvic organ prolapse

A specialist may use a combination of a pelvic exam and other diagnostic tools to assess the severity and type of prolapse. Common diagnostic methods for pelvic organ prolapse include: 

  • Urodynamics: A small catheter is inserted into the bladder to determine bladder and urethra function during filling and emptying, as well as degree of leakage.

  • Cystoscopy: A lighted scope is used to view the inside of the bladder.

  • Electromyography (EMG) test: This test evaluates nerve and muscle function.

  • Intravenous pyelogram (IVP): This is an x-ray procedure that views the size, shape, and positioning of the kidneys, bladder, and urethra.

  • Dynamic cystoproctogram: This procedure involves evacuation of the bowels to determine the degree of prolapse.

  • Urinalysis: This test evaluates the cell tissues and chemicals in the urine.

  • CT scan: This provides detailed pictures of the structures within the pelvic area.

  • Ultrasound or MRI: These imaging techniques provide detailed visuals of pelvic structures to aid in diagnosis.

How is Pelvic Organ Prolapse Treated?

Pelvic organ prolapse can be treated with or without surgery. Once a definitive diagnosis (including type and stage) is made, you can explore treatment options with a practitioner. The best treatment option for you will depend on several factors, listed below.

Pelvic organ prolapse treatment considerations

  • Your type(s) of POP

  • Your grade of severity

  • Your lifestyle

  • Your age

  • Whether or not you wish to have more children

  • Intensity of your symptoms 

  • How long you’ve had symptoms

  • Any co-existing medical conditions

  • Your sexual health goals

  • Financial and insurance considerations

Non-surgical treatments

Multiple types of practitioners can introduce you to therapies, exercises, devices, and other non-surgical treatment options for prolapse. Because each woman’s POP experience varies, treatment plans must be individualized. Many women find the best relief by combining multiple non-surgical treatments.

Non-surgical POP treatments include:

  • Kegel exercises

  • Kegel assist devices

  • Pessaries 

  • Core and pelvic floor strengthening exercises

  • Biofeedback therapy

  • Vaginal tissue rejuvenation radio frequency or laser therapies 

  • Electrical stimulation 

  • Hormone replacement therapy (HRT)

  • Support garments 

  • Tibial nerve stimulation

  • Bulking agents

Surgical treatment options

In some cases, surgery may be recommended as the most promising option to alleviate symptoms and improve quality of life. There are many types of pelvic organ prolapse surgeries and the right procedure for you depends on your type of POP, severity, lifestyle, and preference.

Surgical approaches include:

  • Abdominal repair: Surgery performed through an abdominal incision.

  • Transvaginal repair: Surgery performed through the vaginal canal.

  • Robotic-assisted repair: A minimally invasive procedure using robotic technology for precision.

  • Laparoscopic repair: A minimally invasive procedure using small incisions and a camera.

  • Combination: A mix of techniques based on individual needs.


Do you have a procedure scheduled? Learn how to prepare for POP surgery.

POP surgeries using mesh

Urogynecologists use polypropylene mesh for some POP surgical procedures to provide a sustainable, long-term repair. However, transvaginal mesh use has been controversial due to complications reported in some cases. The use of mesh for POP surgery varies by country, and ongoing research continues to shape best practice. Don’t let fear steer your treatment — get the facts.

Anxious about POP treatment?

Living With Pelvic Organ Prolapse

Pelvic organ prolapse impacts every aspect of women’s lives, from their physical, emotional, and intimate health to their ability to socialize, exercise, and thrive at work.


There is help and hope for women with POP. Treatment options evolve daily that can be used to manage, improve, or heal symptoms of this stigmatized condition. As pelvic organ prolapse becomes common knowledge and routine POP screening becomes standard practice, women will be able to pursue earlier diagnosis and less aggressive treatment options.

Don’t Face Pelvic Organ Prolapse Alone

Join a community of women with POP who share their experiences, knowledge, and support.