Diagnosis
Diagnosis begins with a complete medical history and a physical examination, often including pelvic examination. In some cases, further tests may be ordered such as diagnostic and imaging tests. Often a pelvic examination is performed.

Types

• Vaginal vault prolapse: This is when the apex, or upper portion of the vagina, collapses and descends into the vaginal canal. This occasionally happens after a hysterectomy, causing the vagina to turn inside out.
• Bladder prolapse (Cystocele): This is when the wall between the vagina and the bladder deteriorates, which can cause the bladder to sag or drop into the vagina.
• Urethral prolapse: This happens when the tube that carries urine from the bladder loses support, resulting in the urethral tube sagging or bulging down into the vagina.
• Rectal prolapse (Rectocele): When front wall of the rectum sags and pushes against the vaginal wall, causing a bulge.
• Intestinal prolapse (Enterocele): This is when the small intestine pushes and bulges into the upper back vaginal wall.

It’s possible for several of these prolapses to occur at the same time..

Treatment
If you are diagnosed with pelvic organ prolapse (POP), you canbe treated by urologist, a gynecologist, a urogynecologist, or a physical therapist. Your treatment will depend on the severity of the condition and your symptoms.

Often this condition slowly worsens over time and ultimately requires surgery. With milder cases, your doctor may suggest that you refrain from heavy lifting, and suggest Kegel exercises. Sometimes estrogen therapy is used. Depending on the severity of the POP, Kegel exercises can help to improve your condition, but the patient needs to perform these exercises correctly.

There are two types of Kegel exercise: Kegals should be done 10 - 15 times each, at least 3 times a day. Do not do the exercise while urinating.

• Slow contractions–contract the sphincter muscle and hold to a count of 3, gradually increasing to a count of 10
• Quick contractions–rapidly tighten and relax the sphincter muscle

Biofeedback: This is sometimes used together with Kegel exercises to support a proper method. A special device records tiny electrical signals that are produced when muscles contract. These signals are changed into audio and/or visual signs that help patients understand the impact of their exercise and gain greater control over urinary and bowel muscle activity. Muscles can be relaxed with this procedure and it can prove quite helpful.

Neuromuscular electrical stimulation: This is electrical stimulation of nerves in the pelvic area that cause pelvic floor and urethral and anal sphincter muscles to contract. Your doctor will insert a probe into the vagina and a current is passed through the probe at a level below the pain threshold, causing a contraction. You will need to squeeze the muscles when the current is on. After the contraction, the current is switched off for 5 to 10 seconds.

Pelvic organ prolapse surgery: In severe cases that do not respond to more conservative treatment, surgery may be necessary. There are new and more effective options today for POP. Surgery is performed under regional or general anesthesia, and may be performed laparoscopically through the abdomen, or vaginally. Surgery may require grafts, mesh like materials or slings. These newer techniques have markedly reduced the morbidity associated with these repairs. Patients are now most often discharged within a day of surgery.