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Pelvic Floor Support & Pelvic Organ Prolapse

The Women’s Health Group providers, Drs. Stephen Volin and Cindy Long have 20 years of expertise performing pelvic prolapse repair as well as evaluation and management of urinary conditions. Both do an extensive volume of robotic and minimally invasive surgical repairs for incontinence and prolapse, collaboratively, to ensure expertise and maximize best outcomes for our patients. We offer comprehensive evaluation and treatment options on site.

Pelvic Floor Support

The vagina, female pelvic organs and their surrounding structures (bladder, rectum, etc.) are attached to the pelvis bones by connective tissues such as muscle ligaments, tendons and fascia. These tissues help form walls around the vagina and ensure normal function, urinary voiding and bowel movements can occur. As the pelvic muscles and other supporting structures become weak the connective tissues can fail, allowing pelvic structures like the bladder or rectum to bulge into the vaginal wall.

Pelvic Organ Prolapse

When vaginal prolapse occurs, an organ has dropped (prolapsed) out of its normal position and can sometimes even protrude from the vagina. The definition of pelvic organ prolapse is different depending on what anatomic structure in the pelvis is pushing into the vagina, such as the bladder or rectum. When vaginal prolapse occurs, the upper part (apex) of the vagina has dropped to a lower position. It is possible for more than one organ to prolapse into the vagina at the same time.

Common Causes:

Pelvic muscles, ligaments and connective tissues which have been weakened with age are the primary causes, but many other factors may play a role. These may include vaginal childbirth, previous vaginal surgeries, menopause, smoking, diabetes, obesity, a history of heavy lifting, chronic coughing, and chronic constipation. Sometimes pelvic organ prolapse can be caused simply by genetic factors.


  • A feeling of vaginal fullness, heaviness, or even pain
  • Pain or discomfort during intercourse
  • Loss of bladder control
  • Involuntary urination or inconsistent urinary stream
  • Difficulty with bowel movements
  • Recurrent urinary infections

Types of pelvic organ prolapse:


A cystocele occurs when the bladder falls into the vagina. As the connective tissue in the front wall (sometimes referred to as the roof) of the vagina fails, its attachment to the pelvis may be lost, allowing the bladder to drop into the vagina. This is the most common form of pelvic organ prolapse and is often called a “dropped bladder”.

Cystocele Download


A rectocele occurs when the rectum falls into the vagina. Similar to the cystocele, when the connective tissue in the rear wall (the floor) of the vagina fails, the rectum can then bulge into, or even out of the vagina. As the rectum bulges upward, this can cause difficulty or pain during bowel movements.

Rectocele Download


(pronounced “en’ter-o-sel”)- An enterocele occurs when the small intestines push the back of the vagina toward the opening. This usually occurs in conjunction with another form of prolapse and is repaired during the same procedure.

Enterocele Download

Vaginal Vault Prolapse:

In women who have had a hysterectomy (surgical removal of the uterus), the natural support structures in the vagina provided by the uterus no longer exist. The top portion of the vagina can then push down into the lower vagina, causing vaginal vault prolapse.

Vaginal Vault Prolapse Download

Uterine Prolapse:

For women who still have a uterus, the support structures holding the uterus in place can also be compromised, allowing the uterus to fall down into the vagina. This is called uterine prolapse.

Uterine Prolapse Download


If your symptoms are mild, your provider may recommend lifestyle changes, Kegel exercises to strengthen the pelvic muscles, medication, the use of a pessary, or a biofeedback stimulation device to relieve the symptoms. When the symptoms are severe enough to affect your quality of life, your provider may recommend implantation or surgery.

The Women’s health Group providers offer a variety of non-surgical procedures that are often not offered in other clinics. We want to offer a larger variety of treatments so that each patient is treated individually and specific to what is affecting their quality of life.


Percutaneous Tibial Nerve Stimulation (PTNS) is a low-risk, non-surgical treatment. PTNS works by indirectly providing electrical stimulation to the nerves responsible for bladder and pelvic floor function.


InterStim Therapy is a proven neuromodulation therapy that targets the communication problem between the brain and the nerves that control the bladder.

InterStim® Therapy Download

Minimally invasive surgical procedures:


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