Prof. Dr. Derya Sivri AydınObstetrician & Gynaecologist
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Uterine and bladder prolapse

Pelvic organ prolapse is the downward movement of the uterus, bladder or the last part of the large bowel into the vagina, caused by weakening of the muscles and ligaments that support them. Pregnancy, vaginal birth, older age, excess weight and chronic constipation increase the risk.

Written by Prof. Dr. Derya Sivri Aydın
Obstetrician & Gynaecologist, November 2026

Types of prolapse

  • Cystocele: the bladder bulging into the front wall of the vagina
  • Rectocele: the last part of the large bowel bulging into the back wall of the vagina
  • Uterine prolapse: the uterus descending into the vagina
  • Vaginal vault prolapse: the top of the vagina descending in women who have had a hysterectomy

Symptoms

  • A feeling of fullness, pressure or a bulge in the vagina
  • Pain or a dragging sensation in the pelvis or lower back
  • Urinary leakage, frequent urination or incomplete bladder emptying
  • Difficulty opening the bowels

The diagnosis is made by gynaecological examination; no special test is needed.

Treatment options

Prolapse that causes no symptoms does not need treatment. If there are symptoms:

Pelvic floor exercises

A muscle-strengthening programme lasting several months with a physiotherapist can reduce symptoms of mild prolapse.

Pessary

A silicone device placed in the vagina to support the organs; suitable for women who do not want surgery or wish to postpone it.

Vaginal surgery

Front and back wall repair and, if needed, vaginal hysterectomy and suspension procedures such as sacrospinous ligament fixation. No abdominal incision is made.

Laparoscopic surgery

In selected patients the uterus or vaginal vault is suspended by keyhole surgery.

The surgical approach is chosen together according to the type and degree of prolapse, age, sexual activity and previous operations. If urinary incontinence accompanies the prolapse, sling surgery can be planned in the same session.

Prevention

Losing excess weight, treating constipation, avoiding heavy lifting and pelvic floor exercises reduce the risk of prolapse developing or progressing.

Frequently asked questions

Does prolapse get better on its own?

It usually does not, but mild prolapse can remain unchanged for many years and may not need treatment.

Does the uterus have to be removed in prolapse surgery?

Not always. In selected patients the uterus can be preserved and suspended; the decision depends on the type of prolapse and your preference.

Can prolapse come back after surgery?

It can recur over time in some patients. Weight control, preventing constipation and avoiding heavy lifting reduce this risk.

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Prof. Dr. Derya Sivri Aydın sees patients at Medical Park Bahçelievler Hospital, Istanbul. International patients are supported by the hospital's International Patient Services Center.

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The information on this page is for general guidance only; the right diagnosis and treatment for you are decided after a consultation. Last updated: November 2026.

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