 My name is Dr. Harry Johnson. I'm the Director of Urogyne Ecology and Pelvic Reconstructive Surgery at the University of Maryland School of Medicine. Welcome to Drawing Outside the Lines. I'm here today to talk with you about pelvic organ prolapse. It's a common condition in women and something that affects your quality of life. If you look at the normal pelvis, this is the pelvic floor here. It forms a bowl. And usually the rectum, the vagina and the bladder line up as three straight lines across the pelvic floor. When you have pelvic organ prolapse, one of these organs may fall through the pelvic floor or actually pass out through the vagina. If it's the rectum which bulges in, it's called rectocele. If it's the bladder that bulges in, it's called cystocele. If it's the uterus that's falling down, it's called uterine prolapse. And if it's the vagina falling down, it's called vaginal prolapse. This generally occurs when the uterus has already been removed. When you talk about prolapse, there are several different treatments that you can do. There are nonsurgical treatments which consist of a pessary that's placed through the vagina and supports the pelvic floor. Or pelvic floor exercises which strengthen the muscles of the pelvic floor. That's generally for milder forms of prolapse. As prolapse worsens, you may consider surgical repair. And there are several different approaches to do this. Currently, most of our approaches are minimally invasive. This involves either a laparoscopic robotic approach which goes through the abdomen with small ports, directed at the bladder, uterus, vagina or rectum depending on what's prolapsing, or a vaginal approach where you go through the vagina to do the repair. We choose the approach depending on what type of prolapse you have to try to give you the best chance at success. There are two types of repairs that are done. One is native tissue repair where we actually take the tissues of the vagina and the supports of the vagina to re-support the rectum and the bladder. In some cases where the supports are damaged, we'll use a mesh which re-supports the vagina, the bladder and the rectum to ensure the greatest success. At the University of Maryland Medical Center, we're able to treat problems associated with pelvic organ prolapse to return you to your normal quality of life.