KATHIE HULLFISH: Pelvic organ prolapse is a very common condition for women who have the pelvic organs that are, we should say, out of position. When I explain it to patients, the main risk factors for the development of pelvic organ prolapse are multi-factorial-- genetics, vaginal delivery, anything that can continually increase what we call intra-abdominal pressure, so chronic coughing, obesity, really strenuous, repetitive, heavy straining and lifting. 

Many women might choose just to watch and wait. Most women, by the time they come to see us, however, are symptomatic and want to know treatment. 

So nonsurgical, we can offer women a conservative treatment right in the office called a pessary. Pessaries are basically non-latex rubber devices that come in a variety of shapes and sizes. They fold up. They fit inside the vagina. And when they do their job, they support all the walls of the vagina. 

When it comes to surgery, again, we really individualize that, based on not only the patient's goals, but also what's prolapsing and where, because there are a host of different surgeries that are available that can be done as an outpatient, that can be done as an inpatient, that are strictly all from the vagina, that may involve some abdominal or minimally invasive approaches. So it really depends on each patient, their goals, and their entire evaluation. 

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