Fellowship-Trained Urogynecologist
Urogynecology & Reconstructive Pelvic Surgery
Green Bay, Wisconsin
✓ Medically reviewed May 15, 2026
What happens if prolapse is left untreated?
Pelvic organ prolapse is not a medical emergency. Leaving it untreated is a valid choice for many women. Prolapse tends to progress slowly over years, and some women have stable prolapse that never gets much worse. Knowing the natural course can help you decide when, or whether, to pursue treatment.
The natural course of prolapse
Without treatment, prolapse generally follows one of three patterns:
- Stays stable – some women have the same degree of prolapse for years
- Progresses slowly – gradual worsening over months to years
- Fluctuates – symptoms change with activity level, time of day, and hormonal shifts
Research supports this. In one study, 78% of women with untreated prolapse had no change after 16 months. Another study found that about 1 in 5 women actually had spontaneous improvement at one year. Only about 11% of postmenopausal women had their prolapse increase by 2 cm or more over three years.
Prolapse is not like cancer. It does not spread or become dangerous. The real question is whether it bothers you enough to want treatment.
What can happen if prolapse gets worse
As prolapse progresses, you may notice:
- A stronger bulge feeling, which is the most common symptom
- Trouble emptying your bladder fully, sometimes needing to shift position to urinate
- Difficulty with bowel movements or feeling like you can’t fully empty
- Discomfort with exercise, walking, or standing for long periods
- Awareness of the bulge during sex
Prolapse can also affect your bladder and bowel in ways you might not connect to it. In one study, correcting prolapse alone resolved bothersome urinary symptoms in about 75-85% of women, showing that the prolapse itself was causing those symptoms.
Rare complications of advanced prolapse
In very advanced, long-standing cases:
- Exposed vaginal tissue can become dry, irritated, or develop sores
- Severe prolapse can occasionally block the ureters (the tubes from your kidneys to your bladder)
- Incomplete bladder emptying over time can raise your risk of urinary tract infections
These problems are uncommon. They almost always happen only with prolapse that has been very advanced for a long time.
When to think about treatment
The right time for treatment is when prolapse affects your daily life. There is no medical deadline. The decision depends on your symptoms and what matters to you.
I see women who have had prolapse for 20 years and are doing fine without treatment. I see others who want treatment right away. Both are reasonable. My job is to help you understand your options so you can choose what feels right.
If you do want to explore treatment, there are good nonsurgical options. Pelvic floor physical therapy can reduce prolapse symptoms, and a pessary (a removable support device placed in the vagina) works well for many women. These are not just “stepping stones” to surgery. For many women, they are the treatment.
References
- ACOG/AUGS Practice Bulletin No. 214: Pelvic Organ Prolapse. Obstetrics & Gynecology. 2019.
- Barber MD. Pelvic organ prolapse. BMJ. 2016. doi:10.1136/bmj.i3853
- Carberry CL, Tulikangas PK, Ridgeway BM, et al. AUGS Best Practice Statement: Evaluation and Counseling of Patients With Pelvic Organ Prolapse. Urogynecology. 2025. doi:10.1097/SPV.0000000000001641
- Hagen S, Stark D, Glazener C, et al. Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial. The Lancet. 2014. doi:10.1016/S0140-6736(13)61977-7
- Andy UU, Meyn L, Brown HW, et al. Outcomes at 12, 24, and 36 Months in Women Treated for Pelvic Organ Prolapse With Pessary or Surgery. Urogynecology. 2025. doi:10.1097/SPV.0000000000001669
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