Published: Sep 10, 2016, edited: Jan 25, 2019 by Dr. Zelmanovich (Gynecologist in NYC), Manhattan Women's Health & Wellness

Uterine Prolapse

Uterine ProlapseYour womb or uterus is an organ comprised of muscles designed to protect your baby as it grows inside you and then push it forth into the world. This muscular structure is in turn held in position by an intricate system of muscles and ligaments that serve as anchors and supports. They support not only your uterus, but also your bladder and bowel, cradling them like a hammock between your tailbone and the pubic bone. This structure is known as your pelvic floor.

If these muscles or ligaments become weakened or compromised for any number of reasons, they’re no longer able to support your uterus, causing prolapse. When your uterus loses its support, it can sag and possibly even slip all the way into your birth canal. This is what’s known as uterine prolapse.

Uterine prolapse should always be evaluated with a thorough consultation and examination by your New York City gynecology specialist for an accurate diagnosis and treatment plan to exclude any underlying serious condition.

Causes Vary Widely

The pelvic floor, comprised of the muscles and ligaments that hold the pelvic organs in place, can be weakened, stretched or damaged for a number of various reasons:

  • Vaginal childbirth with an extended period of pushing
  • Having a large child or a fast delivery
  • Pregnancy, especially in cases of multiples (such as twins or triplets)
  • Other conditions that put stress or strain on your pelvic muscles, such as severe coughing
  • Aging
  • Lack of estrogen
  • Obesity
  • Straining on the toilet to have bowel movements
  • Uterine fibroids
  • Some rare cases of pelvic tumors

Symptoms Start Small and Progress

Initially, minor uterine prolapse may not be noticeable at all. If left untreated, though, the symptoms will worsen. Moderate to severe prolapse manifests as:

  • Sensations of weight, heaviness or pressure in your pelvis or vagina
  • A feeling of sitting on an object or ball
  • A distinct lump in your vagina
  • A bulge protruding out of your vagina
  • Problems or pain with sexual intercourse
  • Vaginal bleeding
  • Leaking urine
  • Sudden and intense urges to empty your bladder
  • Increased vaginal discharge
  • Persistent lower back pain
  • Recurring bladder infections
  • Frequent constipation

Symptoms can be aggravated or worsen with prolonged periods of sitting, standing, or strenuous exercise.

Symptoms should always be evaluated with a thorough consultation and examination by your gynecologist for an accurate diagnosis and treatment plan to exclude any underlying serious condition.

Complications That Can Arise

Your cervix and vaginal walls may become ulcerated or infected if the condition isn’t treated appropriately. In cases of cystocele, where your forward-facing vaginal walls have prolapsed, urinary tract infections and other urinary issues may occur.

In cases of rectocele, where the back walls of your vagina have prolapsed, constipation and hemorrhoids may appear, leading to even more uncomfortable symptoms and potentially dangerous outcomes. Symptoms should always be evaluated with a thorough consultation and examination by your gynecologist for an accurate diagnosis and treatment plan to exclude any underlying serious condition.

Uterine Prolapse During Pregnancy

Uterine prolapse during pregnancy is a fairly rare event. Usually, this means it was either a pre-existing condition or came about in the course of the pregnancy. Complications of this nature can manifest anywhere from a minor cervical infection to spontaneous miscarriage.

This highly uncommon occurrence is potentially dangerous, though. It can cause preterm labor or be fatal to mother or child. Risk of dystocia during labor is also increased. Obstetricians have therapeutic options available. Early detection and appropriate prenatal care are vital to the continued health of both mother and child. Under a physician’s care, it’s possible to achieve an uneventful pregnancy and successful delivery.

Preventative Measures

Uterine prolapse can’t be avoided in all cases, but there are some things you can do to reduce your risk:

  • Exercise regularly, including both aerobic and weight training
  • Maintain a recommended, healthy weight
  • Do Kegel exercises
  • Avoid heavy lifting
  • Have chronic coughs treated and quit smoking
  • Undergo hormone replacement therapy during menopause
  • Treat constipation; do not overly strain your bowels

Degrees of Prolapse

Uterine prolapse occurs in stages. These stages indicate how far the uterus has descended into the birth canal. Since the pelvic floor is holds several organs in place, it’s common for more than one organ, such as the bladder or bowel, to slip into your vagina. This can also cause your ovaries to shift lower than normal. The uterine prolapse stages are:

  • Stage 1: The uterus is entering the upper half of your vagina.
  • Stage 2: The uterus has slipped nearly to the opening of your vagina.
  • Stage 3: The uterus is protruding from your vagina.
  • Stage 4: The uterus falling out of your vagina is evident.

Get a Proper Diagnosis

Your OBGYN is able to diagnose whether you are in prolapse and determine your stage of prolapse by performing a pelvic exam. Using a speculum to look inside your vagina enables the doctor to evaluate the vaginal canal and uterus. You may be asked to bear down as if you are having a bowel movement. Other things the pelvic exam may help determine are:

  • Whether your bladder and the front wall of your vagina have prolapsed (cystocele)
  • If your rectum and the back wall of your vagina have prolapsed (rectocele)
  • The existence of prolapsed vaginal walls or the presence of a vaginal hernia

Another potentially problematic issue determined by a pelvic exam is to see if the urethra and bladder have shifted lower in your pelvis than they should.

Symptoms should always be evaluated with a thorough consultation and examination by your gynecologist for an accurate diagnosis and treatment plan to exclude any underlying serious condition.

Treatment Options

In some cases, surgical procedures may be necessary to correct a uterine prolapse. Operations include a uterine suspension, Sacrospinous fixation or hysterectomy. A uterine suspension and sacrospinous fixation involve your gynecologist, Dr. Zelmanovich in Midtown NYC placing the uterus back into its original position and using either pelvic ligaments or surgical materials to secure it. This can be done either laparoscopically through your navel or through an abdominal incision.

Some more severe cases or cases in postmenopausal women may require that your uterus be removed, a procedure known as a hysterectomy. This surgery can be highly effective, but isn’t recommended if you plan on having children in the future.

A vaginal pessary is another option. A pessary is a device that can be inserted into your vagina to support the uterus. Your gynecologist, Dr. Zelmanovich in Midtown NYC can show you how to use a pessary on your own. It’s a lot like using a tampon. There are, however, some side-effects to pessaries:

  • Vaginal irritation
  • Vaginal discharge
  • Vaginal ulcers
  • Problems or pain with sexual intercourse


Important Reminder: This information is only intended to provide guidance, not a definitive medical advice. Please consult ob/gyn doctor about your specific condition. Only a trained, experienced board certified gynecologist can determine an accurate diagnosis and proper treatment.

Do you have questions about Uterine Prolapse? Would like to schedule an appointment with the NYC best rated OBGYN, Dr. Anat Zelmanovich, please contact our office.

Manhattan Women’s Health & Wellness
Dr. Anat Zelmanovich, Gynecologist (Gynecologist NYC, Midtown OB/GYN)
51 East 25th Street, Ste 403
New York, NY 10010
(Between Madison Ave & Park Ave)
(212) 533-4575
Manhattan Women’s Health & Wellness
Dr. Anat Zelmanovich, Gynecologist (Gynecologist NYC, Upper East Side OB/GYN)
983 Park Ave, Ste 1D
New York, NY 10028
(Between 83th & 84th Street)
(212) 533-4575
The information on this website is to provide general guidance. In no way does any of the information provided reflect definitive medical advice and self diagnoses should not be made based on information obtained online. It is important to consult a best in class gynecologist in Midtown regarding ANY and ALL symptoms or signs as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or our Gynecology NYC office today and schedule a consultation with a top Midtown OBGYN gynecologist.