In the past 3 days I have been asked by at 21 year old, a 24 year old and a 32 year old woman if it is possible she could have prolapse. One of these women had a five month old baby but the other two had never been pregnant. Although it is not too common, it can happen that the support in the pelvic area is less than it should be and the uterus, bladder and rectum can sag a bit and possibly bulge at the vaginal opening. If the prolapse is not severe, Kegel exercises are helpful in reducing the bulge, especiallyif there is not any birth trauma. If the bulge is significant it is helpful to use a device in the vagina to support the pelvic organs such as a pessary, a diaphragm-like object that gives extra support to the uterus, bladder and rectum. The pessary is not felt, can be placed by the woman herself and is removed every night for hygiene and to allow for sexual intercourse.
There is a relatively new device on the market called a Colpexin which is ideal for younger women. It is a spherical firm ball that is used to give added support to the pelvic organs by placing it in the vagina. Kegel exercises are performed with it in place and it increases the effectiveness of the Kegels with a mild biofeedback letting you know to contract the correct pelvic floor muscles. It can be fit by a urogynecologist in the office and costs under $150 for the device.
If you plan to have children, definitive surgical repair should be put off until you are finished with pregnancies. When this is not possible and surgical repair is a necessity, cesarean birth is usually recommended to avoid disruption of the previously repaired area.
There are some risk factors to prolapse at any age: childbirth trauma is top of the list but after this are heredity, vocations that increase pelvic pressure (like parachuting), use of steroids that weaken tissue, other medical conditions that weaken tissue.
