One in Three Women Has Pelvic Organ Prolapse, and Most Suffer in Silence

Pelvic organ prolapse affects roughly one in three women, yet it remains one of the most underdiscussed conditions in women's health. According to Savitha Krishnan, M.D., a urogynecologist with El Camino Health, part of the problem starts with patients not knowing they should speak up, and part of it starts with what happens when they do.

Krishnan describes a familiar pattern: A patient mentions accidental urine or stool leakage, is told there are no great options and never brings it up again. “They feel brushed off,” she explains, “or they feel like there isn’t a great option, and this is normal, and I’m going to have to live with this.”

Her message to patients is simple: Keep asking. If a primary care doctor does not have the bandwidth to dig into pelvic floor symptoms, that should prompt a referral to a specialist whose entire practice is built around exactly these issues.

The Treatment Landscape Has Changed Dramatically

When Krishnan started practicing 26 years ago, many prolapse surgeries required open procedures, a three-day hospital stay and six weeks of significant restrictions. That is no longer the reality. Today, the vast majority of her patients, even in older age groups, go home the same day as their procedure.

Options now span a wide spectrum. Physical therapy, often supported by at-home apps, can be highly effective for early prolapse. Pessaries, which are small, individually fitted devices placed in the vagina, offer a conservative, in-office option for patients with mild to significant prolapse, including those who lack the dexterity to manage one themselves.

For patients who want a more definitive fix, minimally invasive surgical options have transformed recovery. Vaginal procedures using a patient’s own tissue, and laparoscopic repairs like sacrocolpopexy, can be completed in about two hours, performed outpatient, with most patients back at a desk job within seven to 14 days. Success rates for these procedures run from 94% to 98% long-term.

Care Tailored to What Patients Actually Want

Krishnan emphasizes that the right treatment depends entirely on a patient’s goals, including whether they are sexually active. For some older patients, particularly those in nursing homes without the dexterity to manage a pessary, a vaginal closure procedure offers a 98 to 99% success rate and eliminates ongoing maintenance entirely.

She also pushes back on outdated assumptions about age. Women between 50 and 80 represent the fastest-growing demographic in the country, and many are healthier and more functional than previous generations at the same age. “A lot of women — their daughters are thanking me for not writing them off,” she says. With outpatient procedures and high success rates, age alone should no longer be a reason to withhold options that can meaningfully restore quality of life.