prolapsing

Prolapsing, or prolapse, is the descent or downward displacement of an organ from its normal position due to weakened support structures. It most commonly affects pelvic organs, particularly in women, but can occur in other parts of the body where supportive tissues fail. In pelvic prolapse, one or more organs may press into or beyond the vaginal canal, leading to a sense of bulging, pressure, or fullness.

In pelvic prolapse, the uterus may descend toward or into the vaginal canal (uterine prolapse); the bladder can protrude into the vagina (cystocele or anterior prolapse); and the rectum can bulge into the vaginal space or protrude from the anus (rectal prolapse). Prolapse is often related to weakening of the pelvic floor muscles and connective tissue, and risk factors include pregnancy and childbirth, aging, obesity, chronic coughing or constipation, heavy lifting, prior pelvic surgery, and certain connective tissue disorders.

Symptoms vary by area and severity but commonly include a vaginal bulge or fullness, a sense of pressure in the pelvis, urinary symptoms such as frequent urination, urgency, or incontinence, bowel symptoms such as constipation or feeling of incomplete evacuation, discharge or vaginal irritation, and discomfort with physical activity or sexual intercourse. Some cases are mild and asymptomatic.

Diagnosis is usually based on history and a pelvic examination. Additional tests, such as imaging or defecography, may be used to assess the extent and effect on surrounding organs.

Treatment ranges from conservative to surgical. Conservative options include pelvic floor physical therapy (Kegel exercises), lifestyle modifications, and the use of a pessary to support the prolapsed organ. When symptoms persist or are severe, surgical repair may be considered, with procedures chosen based on the organ involved and overall health. Prevention focuses on pelvic floor strengthening and managing risk factors.