Fortunately, for most patient coming to see a urogynecologist, they do not need surgery. However, the problems of prolapse and incontinence may pose great quality of life issues and many may choose the definitive surgical corrective option.
For symptomatic prolapse (cystocele, rectocele, enterocele or uterine prolapse)
In general there are 3 basic options:
1) After evaluation to ensure that the dropped pelvic organs are not preventing adequate emptying of your bladder, a very viable option is to live with the bulge until the problem worsens
2) A great second option that really should be at least tried by all patients is a pessary. These are soft flexible devices in various shapes and sizes that can be placed into the vagina to lift up what has dropped. One can leave the pessary in the vagina during sex in many cases. If it does not bother you or your partner, it does not need to be removed, and for many this option is appropriate. Alternatively, one may be taught to remove and replace the pessary on your own, in which case, the option to take it out before sex may be a good one. A pessary, in many cases can be left in up to 4-5 months at a time. However, I recommend that this length of time should be arrived at after shorter trials of say, 2-3 months first. For example, if there are no problems upon inspection by your gynecologist after 3 months, then expanding the interval to 4 months and even 5 months may be a good option.
3) In my opinion, surgery should be considered only if the pelvic organ prolapse is symptomatic and a pessary is not a viable option - surgery should always be the last resort and is too often chosen before options 1 & 2 are exhausted.