Definition: what is prolapse? Organ descent, most common known as prolapse, corresponds to abnormal collapsing of a pelvic organ in women. It can occur at any age but primarily affects women over the age of 50. The pelvic organs are normally supported by perineal ligaments and muscles. This is what we call the pelvic floor. If it swells, especially common during labor, it can no longer support the organs properly and they can fall out of their normal position. There are various distinguishable types of prolapse depending on the affected organ: genital prolapse, uterine prolapse, rectal prolapse and vaginal prolapse. Symptoms of prolapse The signs of prolapse can vary according to the fallen organ. Generally, the symptoms that can be observed are as follows: - pressure or strain around the vaginal area - heaviness or pain in the lower groin - urine problems (the constant and urgent need to go to the toilet, difficulty passing urine) - discomfort during sexual intercourse - digestion problems Causes of prolapse The women who are most at risk or having prolapse, are those who have had a long and strenuous labor, most commonly when forceps are used. Prolapse can occur years after, even after all the injuries from childbirth have healed. Ageing, menopause and obesity are other risk factors to take into account. Similarly, intense physical activity or an operation can also be the cause of prolapse. It is also possible for prolapse to occur in women who have not had any children. In this case, the origin is most commonly an anatomic anomaly around the pelvic or spine area. It can also be due to a lack of tissue resistance surrounding the organs. Prolapse treatment Treatment of prolapse depends on many factors: the level of the organ’s descent, age, the number of observed symptoms and whether the woman wants to have more children or not in the future. There are two families of treatment available. Conservative treatments: - Perineal rehabilitation: these are exercises that are done to work the pelvic floor muscles in order to reinforce them. This method is mainly used in cases of mild prolapse. - Inserting a pessary: this is a ring inserted in the vagina in the cervix area, in order to maintain the pelvic organs. This technique is primarily reserved for women who can’t or don’t want to be operated on, or for those awaiting surgery. - Dietary measures: losing weight can help limit the discomfort caused by the prolapse. Surgical treatments: - Surgical procedures are done to correctly reposition the fallen organ as well as helping with the suspension of the pelvic floor. This is done by using a small strip, which is placed under the organ, which acts like a sling. This operation is corrective, meaning that the person who chooses it will not be able to have children in the future.