(Pelvic Floor Hernia; Pudendal Hernia; Pelvic Relaxation)
by Michelle Badash, MS
Uterine prolapse is the slipping of the uterus into the vaginal canal. The severity of uterine prolapse is defined as:
The uterus is normally supported by muscles and ligaments. Weakening of the tissue causes the uterus to sag into the vaginal canal.
Risk Factors TOP
Uterine prolapse is more common in Caucasians.
Factors that may increase your chances of uterine prolapse:
Symptoms may include:
You will be asked about your symptoms and medical history. A physical exam will be done. Uterine prolapse without symptoms may be diagnosed during routine examinations. Your doctor may refer you to a gynecologist, who will do a pelvic exam.
Talk with your doctor about the best treatment plan for you. First or second degree prolapse without symptoms may not require treatment. Treatment options include:
Kegel exercises involve tensing the muscles around the vagina and anus, holding for several seconds, then releasing. The repetition of this exercise will help to tone pelvic muscles. You may be asked to do this up to 100 times a day.
Your doctor may recommend estrogen therapy. This may help prevent further weakness of the pelvic floor. Talk to your doctor about the risks and benefits associated with hormone replacement therapy.
Pessary Insertion TOP
Your doctor may insert a pessary into the upper portion of the vagina. A pessary is a rubbery, doughnut-shaped device. It helps to prop up the uterus and bladder. Pessary placement is more often used in older women.
Surgery may be needed for severe uterine prolapse. These procedures are usually not done until you have finished having children. Options include:
To help reduce your chances of uterine prolapse:
Office on Women's Health
The American Congress of Obstetricians and Gynecologists
Canadian Women's Health Network
Society of Obstetricians and Gynaecologists of Canada
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Pelvic organ prolapse. International Urogynecological Association website. Available at:
...(Click grey area to select URL)
Accessed April 17, 2018.
Uterine and vaginal prolapse. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/gynecology-and-obstetrics/pelvic-relaxation-syndromes/uterine-and-vaginal-prolapse. Updated February 2017. Accessed April 17, 2018.
Vaginal pessary. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/vaginal-pessary. Updated October 24, 2017. Accessed April 17, 2018.
10/21/2008 DynaMed's Systematic Literature Surveillance https://www.dyname...: Shariati A, Maceda JS, Hale DS. High-fiber diet for treatment of constipation in women with pelvic floor disorders. Obstet Gynecol. 2008;111(4):908-913.
5/11/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Fritel X, Varnoux N, Zins M, Breart G, Ringa V. Symptomatic pelvic organ prolapse at midlife, quality of life, and risk factors. Obstet Gynecol. 2009;113(3):609-616.
Last reviewed March 2018 by EBSCO Medical Review Board Marcie L. Sidman, MD
Last Updated: 4/17/2018
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