Vaginal Trauma & Pelvic Organ Prolapse

Conveniently located to serve the areas of Los Gatos, Danville and San Jose

Vaginal Trauma & Pelvic Organ Prolapse

Intimate surgery is sometimes necessary to restore damaged vaginal tissues and address pelvic organ prolapse; a condition caused by muscle and ligament weakness, after the birth of a child. It can also provide a solution to vaginal laxity, decreased sensation, and labial asymmetry, which can make intercourse less enjoyable and lower self-confidence.

Pregnancy is a life-affirming and rewarding experience for most women, however, injury caused by vaginal birth can pose significant concerns for the postpartum mother. This trauma can occur inside the vagina, in the labia, and the perineum, the area of skin between the anus and the genitals. Statistics show that perineal tears occur in between 53-89% of women during delivery, with 60-70% of these requiring stitches.(1) In addition to the physical trauma of childbirth, many women experience negative emotions and concerns related to intercourse following vaginal trauma.(2) 

At Swan Medical we specialize in women’s intimate wellness. We cater our treatments toward rejuvenating tissue damage and provide life-changing services for our patients with care, discretion, and sensitivity. Our services provide relief from the pain and embarrassment of vaginal injury, and allow women to live their lives in comfort, and free from shame and worry. Meet with double board-certified urogynecologist Dr. Peter Castillo to find out more about our services. Call (925) 905-9922 or submit an inquiry form on our website to book a personal consultation and begin your journey toward intimate wellness and increased empowerment. All patient inquiries are dealt with in the utmost confidentiality.

The Effects of Vaginal Birth on the Body

For some women, specialized intervention is necessary to address vaginal trauma and integrative pelvic health. Occult, or hidden injuries occur quite often, leading to distressing symptoms, and are sometimes not identified during regular gynecological examinations. In many cases, damage to the pelvic floor muscles, connective tissue, and vaginal skin can lead to a number of unpleasant symptoms, including:

  • Loss of sexual enjoyment
  • Decreased vaginal sensation
  • Urinary and anal incontinence
  • Prolapse of vaginal structures or pelvic organs
  • Emotional distress
  • Increased labia size
  • Asymmetrical labia
  • Uncomfortable scarring

What is an Episiotomy Procedure?

Doctors perform an episiotomy procedure to prevent serious perineal tears during childbirth. They carefully make the vaginal opening wider with a controlled incision. Although this technique can be effective in many cases, adverse side-effects can include:

  • Bleeding
  • Prolonged wound healing
  • Dyspareunia (painful intercourse)
  • Pelvic floor dysfunction
  • Urogenital fistulas (abnormal openings between the vagina and other structures)
  • Scarring

In some cases, episiotomy can cause complications in future vaginal deliveries.(3)

Weakened Pelvic Floor

Another form of trauma that is common after childbirth is a weakened pelvic floor. Normal pelvic support is provided by the levator ani muscle group. These muscles cradle the pelvic organs, and allow for control of bodily functions. Connective tissue attaches to these muscles to stabilize the vagina. If injury occurs to the connective tissue, pelvic floor defects can occur.(4) And, significantly weakened pelvic floor muscles can cause pelvic organ prolapse.

Pelvic Organ Prolapse

Pelvic organ prolapse is a disorder in which one or more of the pelvic organs drops from its normal position. It is a common condition affecting up to 40% of women after childbirth. The organs that can be affected include the uterus, bladder or rectum and can occur after a hysterectomy where the top of the vagina, known as the vaginal vault, can fall. There are several common types of prolapses that can occur and often occur simultaneously.

Cystocele – A weakening of the wall that separates the vagina and the bladder

Rectocele – A weakening of the wall that separates the vagina and the rectum

Enterocele – Where the small bowel descends, into the vagina.

What Are the Symptoms of Pelvic Organ Prolapse?

Most women experience mild prolapse following vaginal birth. The organs shift position only slightly and do not protrude from the opening of the vagina, which usually results in minimal signs or symptoms. However, in severe prolapse, patients can see or feel a bulge of tissue at or past the vaginal opening. Symptoms can include the following:

  • Feeling of fullness or heaviness in the pelvic region
  • Pulling or aching feeling in the lower abdomen or pelvis
  • Painful or uncomfortable sex
  • Difficulty urinating or having a bowel movement.

Non Surgical Pelvic Organ Prolapse Treatment

Often the first nonsurgical options to treat pelvic organ prolapse is placement of a prosthetic device known as a pessary. It’s small, flexible, and usually circular. A physician places the pessary into the vagina to provide support for the vaginal walls and surrounding organs. 

Targeting specific symptoms may be another option. For example, daily Kegel exercises may help to strengthen the pelvic floor. Weight loss can decrease pressure in the abdomen and help improve overall health. However, if your symptoms are severe and disrupt your life, and if nonsurgical treatment options have not helped, you may need to consider surgery.

Reconstructive Surgery for Pelvic Organ Prolapse

Uterosacral Ligament Suspension and Sacrospinous Fixation Procedures – The surgeon places permanent sutures to restore support to the vaginal vault top of vagina). These procedures are performed through the vagina and can require less recovery time than those performed through the abdomen.  A procedure to prevent urinary incontinence can be performed at the same time.

Anterior and posterior colporrhaphy – Colporrhaphy procedures reinforce the attachments that keep the bladder and rectum in the correct position in relation to the vagina. An anterior colporrhaphy repositions the bladder so that it no longer bulges into the front of the vagina. Likewise, a posterior colporrhaphy repositions the rectum, and can resolve bowel problems. Because these procedures are performed through the vagina, recovery time usually is shorter than with procedures performed through the abdomen.

Sacrocolpopexy – The surgeon performs both sacrocolpopexy and sacrohysteropexy via the abdomen rather than the vagina. The prolapsed uterus or vaginal vault is resuspended with biocompatible mesh. These abdominal procedures may result in less pain during sex than procedures performed through the vagina. However, abdominal procedures do carry slightly different risks as well as potentially longer recovery time. Want to learn more? Discover more about intimate wellness by reading Dr. Castillo’s blog.

Intimate Surgery Services

Perineoplasty – A perineoplasty procedure repairs injured perineal muscles and tissues. Ideal candidates are women who experience decreased sensation during intercourse due to muscle laxity. 

Vaginoplasty – Vaginoplasty restores vaginal tissues and can be used to enhance sexual function. The main purpose of treatment is to solve problems with excessive vaginal laxity. Vaginal injury due to childbirth and pelvic floor complications may be indicators of this form of surgery, though cosmetic issues may also be addressed in this way.

Labiaplasty – If you’re unhappy with the appearance of your labia or the discomfort it causes, a  labiaplasty procedure may help. It is a common way to address labia that are enlarged or asymmetrical. Patients may seek a labiaplasty for the correction of congenital irregularity, or unwanted physical changes that occur over time.

Intimate Makeover – For a comprehensive, multi-treatment procedure that can address many cosmetic and functional concerns, look no further than the intimate makeover . It can repair and revitalize vaginal tissues, and can also address pelvic floor weakness. Depending on your specific findings, service options in this premium treatment may include:

  • Perineoplasty
  • Vaginoplasty
  • Labiaplasty
  • diVA Hybrid Fractional Laser
  • O-shot

Personal Consultation

A clear, well-planned treatment outline is essential for all intimate surgeries. That’s why Dr. Castillo offers each patient a personal consultation in each instance. We will ask you to provide details of your medical history, including the number of vaginal births you have had, if you have had a hysterectomy, and the current problems you are facing. After he performs a thorough pelvic examination, Dr. Castillo will recommend one or multiple avenues for treatment. To make an appointment with Dr. Casillo at Swan Medical, call (925) 905-9922 or fill out an inquiry form with your request. All inquiries are treated with the strictest confidentiality.

Cost of Intimate Surgery in Los Gatos, CA

Every woman’s needs are personal and individual to them. Because of this, the cost of each intimate surgery will vary according to the length and nature of the procedure, and the number of issues to be addressed.

Our goal is to address your needs with professionalism and compassion, so you can live the life you deserve, free from the pain and discomfort of intimate injury. Ask for a free virtual case review from Dr. Castillo, and check our website for details on what to expect from your first visit. We also provide travel support for patients traveling over 100 miles for treatment.


What is obstetric trauma?

Obstetric trauma, or vaginal trauma, is a term that describes damage that occurs to the vaginal tissue during childbirth. Tearing can be addressed immediately after birth, but for many women, further surgery is needed to address vaginal trauma months, even years after the initial injury.

How does reconstructive surgery treat pelvic organ prolapse?

Reconstructive surgery reconstructs the pelvic floor with the goal of restoring vaginal support to its original position. Some types of reconstructive surgery are done through an incision in the vagina.  Others are done through an incision in the abdomen or with laparoscopy.

What is involved in recovery after surgery to treat pelvic organ prolapse?

Recovery time varies depending on the type of surgery.  You usually need to take a few weeks off from work.  For the first few weeks, you should avoid vigorous exercise, lifting, and straining. You also should avoid sexual intercourse for several weeks after surgery.


  1. Ramar, C. N., & Grimes, W. R. (2020). Perineal Lacerations. PubMed; StatPearls Publishing. 
  2. Gommesen, D., Nøhr, E., Qvist, N., & Rasch, V. (2019). Obstetric perineal tears, sexual function and dyspareunia among primiparous women 12 months postpartum: a prospective cohort study. BMJ Open, 9(12), e032368. 
  3. Barjon, K., & Mahdy, H. (2020). Episiotomy. PubMed; StatPearls Publishing. 
  4. Aboseif, C., & Liu, P. (2022). Pelvic Organ Prolapse. PubMed; StatPearls Publishing.