What Does Leaking Urine Feel Like With Pelvic Organ Prolapse?

You may leak when coughing, sneezing, standing, lifting or walking. You may also feel a sudden urge, need to urinate often, or difficulty starting the stream. Some people feel that urine remains after using the toilet or need to change position to empty.

Other clues can include heaviness or dragging in the pelvis, a bulge or pressure in the vagina, or symptoms that worsen after standing for a long time. The bladder, bowel or uterus can be involved, and symptoms vary with the type and extent of prolapse.

Most people with Pelvic Organ Prolapse notice leaking urine, but leakage alone does not establish prolapse. A pelvic examination and discussion of bladder symptoms can identify what needs treatment.

Arrange an assessment if leakage is persistent or you notice a bulge, pelvic heaviness or incomplete emptying. Record triggers, urgency, toilet frequency and whether symptoms change when lying down or standing.

Avoid straining, manage constipation with advice from a clinician, and ask about pelvic floor physiotherapy. Depending on symptoms, treatment may include supervised exercises, a pessary or other options discussed after examination.

Seek prompt care for inability to pass urine, severe pelvic pain, fever, blood in the urine or rapidly worsening symptoms. Urgent assessment is needed for new leg weakness, numbness around the genitals, loss of bowel control or severe back pain.

Contact a clinician if a vaginal bulge becomes painful, bleeds, or cannot be gently reduced as previously advised. Do not ignore repeated incomplete emptying, which can require timely review.

Could prolapse be affecting how my bladder empties? Which type of prolapse is present? Would pelvic floor therapy or a pessary help? Should I keep a bladder diary or have a urine test?