I tend to agree with Dr. Maloof regarding frequency of bowel movements; also I would also like to rule out vestibulitis caused by herpes, severe candidiasis, group B Strep or vulvo-vaginal atrophy. Once these are evaluated and ruled out and if physical examination confirm vaginal prolapse, then surgical intervention is, in my opinion the best approach. If surgical intervention is medically contraindicated, a pessary may then be used.

Gabriel G. Hakim