A Guide to Understanding and Treating Pelvic Organ Prolapse

A Hackensack Meridian Health expert shares some tips

Brick, N.J. - December 3, 2025 - As a urogynecologist, I often talk with women about sensitive health topics. One of the most common, yet least discussed, is pelvic organ prolapse. Many women feel embarrassed or simply don't know what's happening to their bodies, so they suffer in silence. My goal is to change that. If you've ever felt a strange pressure or a bulge "down there," this conversation is for you.

Pelvic organ prolapse occurs when the pelvic floor muscles and tissues, which act like a supportive hammock for your pelvic organs (including the bladder, uterus, and rectum), weaken. When this support system gives way, one or more of these organs can drop or press into the vaginal wall.

Several factors can increase your risk for developing prolapse. The natural processes of aging and menopause can cause a general weakness in the pelvic floor over time. Other conditions that put sustained pressure on this area are also risk factors for prolapse include, obesity, chronic coughing, repetitive heavy lifting, and certain familial or genetic conditions.

One of the most surprising things about prolapse is that you might not feel anything at all. It's not uncommon for a gynecologist or primary care doctor to notice it during a routine exam without the patient having any symptoms, which can include:

• A sense of vaginal pressure or a bulge: Women have described this sensation as feeling like an egg, a golf ball, or even a grapefruit is inside the vagina.

• Changes in bladder function: This can include a weaker urine stream; incontinence (bladder leakage) from coughing, laughing or sneezing (stress incontinence); frequent urination; a sudden urgency that makes it hard to get to the bathroom in time (urge incontinence); or a feeling that you haven't completely emptied your bladder.

• Bowel symptoms: Prolapse can lead to constipation or a frustrating feeling that stool is trapped and won't come out completely.

If you're experiencing these symptoms, the first step is a conversation with your health care provider. In my office, we start with a thorough history to understand exactly what is bothering you. A pelvic exam follows, which helps me understand the extent of the prolapse and assess for incontinence.

Non-surgical treatment options are available

Hearing you have prolapse doesn't automatically mean you need surgery. If the condition isn't causing bothersome symptoms, we can simply observe it. For those who need relief, there are several effective non-surgical options:

• Lifestyle modifications: Simple changes can make a big difference. By analyzing a bladder diary, we can see if caffeine, alcohol, or even the timing of your fluid intake might be contributing to your symptoms.

• Pessaries: These are soft, flexible silicone devices placed inside the vagina to help lift and support the prolapsed organs.

• Pelvic floor physical therapy: This is much more than just Kegel exercises. Specialized physical therapists design exercises to strengthen your pelvic floor muscles.

Surgical options for prolapse are considered when your quality of life is impacted and involve tailored procedures with definitive, durable repair and minimal recovery. These include a vaginal procedure using native tissue from the vaginal area to support the prolapsed organs or a robotic minimally invasive approach through the belly button using mesh to support the body’s own natural tissue.

You don't have to navigate this journey alone. If you feel that something isn't right – physically and/or mentally – I encourage you to start a conversation with your doctor. There are many ways to manage urinary incontinence and pelvic organ prolapse through surgical and non-surgical options. And if needed, seeking help through a mental health program dedicated to the needs of women can help you feel like yourself again.

Anjali Kapur, M.D., is a urogynecologist who specializes in female pelvic floor disorders. She is affiliated with a number of Hackensack Meridian Health facilities in Ocean, Monmouth and Middlesex Counties. To make an appointment, please call her office at (848) 308-4125.

For more information about pelvic organ prolapse, visit https://www.hackensackmeridianhealth.org/en/services/urology/uterine-prolapse. Hackensack Meridian Health is New Jersey’s top ranked Urology Program by U.S. News & World Report for 2025-26 and has dedicated resources and services to support Women’s Health and Women’s Mental Health.

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