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This book is packed with easy-to-understand information on selecting and setting up a habitat, feeding, breeding, and all other aspects of proper leopard gecko care.

Leopard Gecko Prolapse: Causes & Solutions

Male leopard geckos’ reproductive organs, known as hemipenes, stay safely inside their cloaca until it is time to mate. 

However, in some cases, either one hemipenis or both will become “stuck” outside of the body or prolapsed. 

It’s a pretty gruesome sight, but thankfully, it is treatable and preventable.

Hemipenal prolapse in leopard geckos is caused by excess strain or trauma from constipation, impaction, mating, improper sexing, or a lack of humidity. In some cases, prolapsed hemipenes will retract independently, though they usually require veterinary treatment, i.e., sutures or amputation.

If you think your beloved gecko has one or two prolapsed hemipenes, don’t panic! 

You’re in the right place. 

We’ll cover everything you need to know about causes, treatment, and prevention for prolapses.

leopard gecko prolapse 1

What Is Prolapse In Leopard Geckos?

In male leopard geckos, copulatory organ prolapse typically involves either one or both hemipenes. 

Hemipenes are your gecko’s reproductive organs. 

Normally, they are not visible, as they rest inside their vent or cloaca unless they are preparing to mate with a female gecko. 

In a usual courtship scenario, their hemipenes will quickly retract back inside of their cloaca after mating.

By definition, prolapse is when either one or both of your gecko’s hemipenes become stuck outside of the body and will not retract on their own. 

This is problematic because a prolapsed hemipenis (the singular of hemipenes) will often dry out and become infected within a few hours if it doesn’t go back in by itself.

If your gecko experiences a prolapse, you will notice a small pink or red bulge extending from its vent. 

leopard gecko prolapse

This is indicative of a prolapsed hemipenis, and it will require immediate treatment to solve. 

Usually, treatment requires veterinary intervention either in sutures to hold the hemipenis in place or amputation. 

In some cases, it is treatable at home with sugar water baths to minimize swelling and encourage the hemipenis to retract.

What Causes Hemipenal Prolapse In Leopard Geckos?

There are many possible causes of hemipenal prolapse, though all have one thing in common: excess strain or trauma to the cloacal region.

Causes contributing to prolapse in male leopard geckos include:

  • Mating mishaps
  • Strain from constipation or impaction
  • Improper humidity within the gecko’s enclosure
  • Improper sexing

Soon, we’ll take a look at each of these causes in-depth to help you better understand how they affect your gecko’s cloaca and hemipenes. 

Once you understand the causes, you will better control and prevent them from happening in the future.

However, first, you should be aware of the symptoms associated with hemipenal prolapse.

Leopard Gecko Prolapse Symptoms

Hemipenal prolapse is thankfully very easy to diagnose, even at home, without a qualified reptile vet present. 

The main and most noticeable symptom is one or both hemipenes sticking out from the gecko’s vent. 

This typically appears as a very small, moist pink or red fleshy organ, though it will quickly dry out if not treated.

There are a few other additional symptoms to keep an eye out for, though. 

Many geckos will lick their vent excessively in a panicked attempt to retract their hemipenes. 

Check out our post on reasons why leopard geckos lick their vent for a complete discussion on the topic.

It is also common for geckos suffering from a prolapse to exhibit little to no appetite and sudden weight loss as a result, particularly if the prolapse is left untreated for an extended period.

You will also likely notice your gecko pacing around their enclosure or walking in an unusually unsteady manner due to the pain and discomfort from the exposed organ. 

If you notice any of these symptoms, get a closer look at your gecko’s vent to confirm if they have experienced a prolapse or not.

Causes: Mating Mishaps

leopard gecko prolapse 2

In most cases, mating between leopard geckos goes pretty quickly and painlessly for both the male and female involved. 

However, suppose one gecko is significantly larger than the other or isn’t particularly willing to mate. 

In that case, certain accidents will occur, which will cause trauma to one or both gecko’s reproductive organs. 

Another somewhat common occurrence is for male leopard geckos to physically strain themselves too much while mating, resulting in one or both of their hemipenes becoming prolapsed and stuck outside of their body.

Additionally, sometimes male leopard geckos will fall or become unsteady while attempting to mate and damage their hemipenes in the process. 

Their reproductive organs are fairly delicate, so even minor damage will often contribute to prolapsed hemipenes.

Sometimes, the gecko will be able to retract its hemipenes on its own within a few minutes after mating. 

This is normal. 

If you notice a pink or red bulge sticking out of your lizard’s vent after mating and it doesn’t retract afterward, it is likely time to intervene with treatment and contact your local reptile vet.

Causes: Lack of Adequate Humidity

Another common cause of prolapse in leopard geckos is a lack of humidity within their enclosure

Ideally, the humidity in your lizard’s tank should be within 30 to 40% at all times. 

The best way to monitor the humidity levels in their enclosure is to purchase a dual thermometer and hygrometer, such as this one from Repti Zoo, and mount it on the wall in the tank, so you are able to check it at a glance and adjust the environmental conditions if necessary. 

Increasing humidity within your gecko’s tank is done by either misting the enclosure with water, adding a larger water dish, or adding a moist, humid hide.

The main reason why proper humidity is so important to your pet’s health is that humidity keeps their skin hydrated and helps them shed properly. 

Sexually mature adult leopard geckos will typically shed, on average, once every two months or so. 

If the conditions within their enclosure are too dry, they are prone to experiencing “stuck” shed on their limbs and around their tail and vent area.

Your gecko will attempt to remove the shed on their own at first, though if they experience trouble removing the skin, they will strain themselves physically. 

If they undergo too much stress while shedding, one or both hemipenes will become prolapsed and exposed.

Causes: Constipation/Impaction

One of the most common prolapse causes, particularly among male geckos who are housed alone without a mate, is an excess strain from constipation or impaction.

Impaction occurs when your gecko’s digestive tract, usually the intestine, becomes blocked by food, substrate, or other material too large or difficult to properly digest. 

As a result, your gecko will become constipated and unable to defecate normally.

impacted leopard gecko

Constipated and impacted geckos will strain to push out and clear the blockage, sometimes resulting in prolapsed hemipenes. 

They will also exhibit significantly decreased appetite and have a swollen belly due to the blockage. 

Many will stop eating entirely until the impaction clears, meaning they will experience sudden weight loss.

Thankfully, preventing impaction is fairly easy, even if treating it is tricky. 

Avoid loose substrates and only feed your gecko insects that are smaller than the width of the space between their eyes. 

This way, your gecko won’t swallow anything too large or difficult to digest. 

Need more details? Check out our guide to helping with leopard gecko impaction.

It also helps to mist them with water daily and provide them with a clean, freshwater dish to freely drink from so they stay properly hydrated. 

Lack of hydration will cause constipation, which will, over time, become severe impaction.

If your gecko has become impacted but hasn’t displayed prolapsed hemipenes yet, it will help to give them a warm bath and gently massage the area around their belly and vent to help move things along. 

Offer them a few drops of olive oil, as it is a natural laxative.

If these home treatments don’t produce any results, contact your reptile vet ASAP for an official diagnosis and a more comprehensive treatment plan moving forward. 

Ideally, you want to prevent impaction from progressing to an eventual prolapse.

Causes: Improper Sexing

Finally, the last and probably least well-known cause of prolapse in male leopard geckos is improper sexing. 

There are many ways to determine the sex of a leopard gecko, though not all of them are 100% certain or particularly reliable. 

While many reptile owners will examine their gecko’s pre-anal pores or check for the presence of bulges around the lizard’s vent, some will attempt to push on the area around the cloaca to “express” the hemipenes (if they suspect the gecko is a male) and make them visible.

Unfortunately, this method is not recommended unless you are a veterinarian or a reptile expert. 

Even then, it is best to avoid it as it is fairly risky, even with skilled hands. 

Often the hemipenes will be pushed out too far and become stuck outside the body, resulting in a prolapse.

This is especially problematic because this sexing method is often done on younger geckos who are more fragile and unable to retract their hemipenes yet on their own.

If you don’t know your gecko’s sex and are anxious to know, it is best to use the other methods mentioned above, even if they aren’t quite as reliable as checking for the presence of hemipenes. 

It’s better to avoid stressing out your gecko and simply wait a few weeks or months for them to show more prominent signs of their sex, like bulges around their vent or large pre-anal pores. 

Otherwise, you run the risk of causing a prolapse, which might not heal on its own and require veterinary intervention. 

This will be painful and stressful for your pet.

Learn more about how to sex a leopard gecko.

How Do You Treat Hemipenal Prolapse In Leopard Geckos?

Treating hemipenal prolapse almost always requires professional veterinary treatment and physical examination. 

However, there are a few ways to potentially remedy the issue at home.

If you notice a pink or red bulge sticking out of your gecko’s vent, pick up your gecko gently and apply a bit of pressure with a finger directly to the hemipenis if it doesn’t make you too queasy. 

Don’t push too hard, and if you notice it isn’t retracting after a minute or two, leave it alone.

Next, soak your gecko in a bath of warm water like you would if they had trouble shedding. 

soaking leopard gecko in warm water

However, add a few spoonfuls of sugar to the water and allow it to dissolve. 

Sugar water is known to reduce swelling, which will sometimes help the prolapsed hemipenis or hemipenes to retract.

Another possible home treatment for prolapse is to apply a small amount of warm honey to the gecko’s hemipenis or hemipenes. 

Like sugar water, honey is very sweet and will help reduce the swelling of the organ and the area around it.

If none of these measures produce results after an hour, it’s best to contact your vet for further advice and an appointment as soon as possible.

In the meantime, your vet will likely recommend you prevent the hemipenes from drying out and remove any loose substrate from the lizard’s enclosure, so it doesn’t stick to their vent. 

If the hemipenes dry out, they will become prone to infection, which will become even more irritated by a loose substrate.

Use a small amount of vaseline or lubricating jelly applied directly to the hemipenes and the area around the gecko’s vent to keep it from drying out. 

Replace any loose substrate in their enclosure with paper towels or another flat, solid substrate like tile or linoleum.

Once you get your gecko to your vet, they will likely recommend one of two potential treatments: either a stitch to get the hemipenes to retract and keep them in place or amputation.

Will Prolapsed Hemipenes Become Infected?

If they become exposed to dirt, debris, or loose substrate in the gecko’s enclosure, then yes, they will be very susceptible to infection. 

This is why it is important to keep the hemipenes lubricated with vaseline or another safe lubricant to protect them from drying out or coming in contact with debris in their tank.

Like we mentioned above, if your gecko’s hemipenes don’t retract after attempting home treatment, get the lizard to a reptile vet immediately to get professional treatment. 

The longer you leave the prolapse untreated, the more likely it will become infected, in turn making treatment even more expensive and complicated.

Preventing Leopard Gecko Hemipenal Prolapse

Preventing hemipenal prolapse is fortunately fairly simple. 

Just keep these precautions in mind moving forward:

  1. Always closely monitor any geckos you intend on breeding, and only breed geckos of a similar size, so one doesn’t overwhelm the other or cause any injuries. Remove one or both geckos if they show any signs of aggression or unwillingness to mate.
  2. Make sure the humidity stays within 30 to 40% at all times within your gecko’s enclosure, as a lack of humidity will contribute to a stuck shed, meaning your gecko will strain themselves to remove it.
  3. Never attempt to sex a leopard gecko on your own by expressing the hemipenes. If you aren’t able to tell your pet’s sex by simply observing their vent or pre-anal pores, ask a veterinarian for their opinion.
  4. Make sure your gecko stays properly hydrated to prevent constipation and impaction. Additionally, only feed them feeder insects smaller than the width of the space between their eyes; anything larger than this will likely cause choking or eventual constipation/impaction.

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