What is pelvic organ prolapse? A condition that occurs when muscles and other supports in a woman's pelvis weaken, allowing her bladder, rectum, uterus, urethra, small bowel or vagina to slip out of place.

What causes it? Prolapse can develop after childbirth, menopause or a hysterectomy. It can be aggravated by excess weight and becomes more common with age.

What are the symptoms? Most commonly, women feel a bulge in their vaginal wall and experience a sense of unusual fullness, discomfort or pain. Depending on the type of prolapse, women may have bleeding, incontinence or trouble emptying their bowels.


How common is it? Experts estimate that 30 to 50 percent of women will develop prolapse over the course of their lifetime. Two to 6 percent of women will experience bothersome symptoms.

What treatments are available? For minor prolapse, no treatment may be necessary. When symptoms emerge, a doctor may suggest that a woman lose weight, address constipation — a complicating factor — or try exercises that strengthen pelvic floor muscles. If symptoms are severe, doctors often recommend surgery. Another option is a pessary, a removable device that provides support when inserted in the pelvic area.

What types of surgeries are there? One type of prolapse surgery involves making an incision through the abdomen and taking measures to pull up and secure collapsing organs. Minimally invasive techniques are now often used. Another type involves going through the vagina, which is cut to reach and secure the bladder, rectum or uterus.

Where does mesh come in? Mesh can be used in both abdominal and vaginal surgeries to help support organs and strengthen the vaginal wall. Many surgeons don't routinely use mesh in vaginal surgeries.

Do complication rates involving mesh vary by surgery? Yes. Mesh used in vaginal surgeries is more likely to protrude through the area where it's been placed, a complication known as erosion.

SOURCES: Mayo Clinic, U.S. Food and Drug Administration, mypelvichealth.org

Judith Graham