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Pelvic organ prolapse refers to descent of the pelvic organs into the vagina, which can be experienced as a sensation of pressure or bulging in the vagina. This is also commonly referred to as a “dropped uterus, bladder or rectum.” Prolapse is the result of weakening of the pelvic support tissues, which allows the uterus, bladder or rectum to bulge into the vagina. Some women with prolapse feel pressure in the vagina, and some may actually notice tissue protruding through the opening of the vagina. Other symptoms of prolapse may include leakage of urine with intercourse, a weak stream of urine, or the need to use your fingers to lift the prolapse up in order to urinate or have a bowel movement.

Pelvic prolapse will affect 50% of women at some point in their lives. There is often a genetic predisposition to this tissue weakening, with other factors playing a role as well. These include pregnancy, childbirth, obesity, smoking, chronic coughing, heavy lifting and menopause, among others.

Many women suffer needlessly with prolapse for years due to the misconception that it is simply a normal part of aging. This is not the case. There are a variety of treatment options for this condition. If you or someone you love has been living with prolapse, consultation with Dr. Nelken can help you understand the treatment options available to you. The most common treatments are pelvic floor physical therapy, pessary use, or surgery.


  1. Nonsurgical Treatment

    There are a variety of options for women who decide to pursue non-surgical treatment for their prolapse. These include:

    Physical Therapy
    Dr. Nelken can recommend a pelvic floor physical therapy regimen designed to meet your specific needs.

    A pessary is a simple plastic device used to provide structure and support when the body’s own structures have weakened. They can lift the bladder, rectum, or other prolapsed organ back into position, and help prevent urinary leaking by compressing the urethra during certain activities that cause pelvic strain. Pessaries can also be used to treat bladder and bowel incontinence. A pessary often carries lower risk of complication than corrective surgery, but they do require special care and regular checkups.

  2. Surgical Treatment

    For women who desire to pursue surgical treatment of their prolapse, Dr. Nelken has extensive experience and expertise in minimally invasive surgery. She has performed over 500 prolapse surgeries through either the vaginal, laparoscopic, or robotic approach.

Call Dr. Nelken

(310) 652-0100