Pelvic Organ Prolapse

"Prolapse" refers to a descending or drooping of organs. Pelvic organ prolapse refers to the prolapse or drooping of any of the pelvic floor organs, including:

  • Bladder
  • Uterus
  • Vagina
  • Small bowel
  • Rectum

These organs are said to prolapse if they descend into or outside of the vaginal canal or anus. You may hear them referred to in these ways:

  • Cystocele: A prolapse of the bladder into the vagina, the most common condition
  • Urethrocele: A prolapse of the urethra (the tube that carries urine)
  • Uterine prolapse
  • Vaginal vault prolapse: prolapse of the vagina
  • Enterocele: Small bowel prolapse
  • Rectocele: Rectum prolapse
Symptoms

Some women notice nothing at all, but others report these symptoms with pelvic organ prolapse:

  • A feeling of pressure or fullness in the pelvic area
  • A backache low in the back
  • Painful intercourse
  • A feeling that something is falling out of the vagina
  • Urinary problems such as leaking of urine or a chronic urge to urinate
  • Constipation
  • Spotting or bleeding from the vagina

Symptoms depend somewhat on which organ is drooping. If the bladder prolapses, urine leakage may occur. If it's the rectum, constipation and uncomfortable intercourse often occur. A backache as well as uncomfortable intercourse often accompanies small intestine prolapse. Uterine prolapse is also accompanied by backache and uncomfortable intercourse.

 

Causes

Anything that puts increased pressure in the abdomen can lead to pelvic organ prolapse. Common causes include:

  • Pregnancy, labor, and childbirth (the most common causes)
  • Obesity
  • Respiratory problems with a chronic, long-term cough
  • Constipation
  • Pelvic organ cancers
  • Surgical removal of the uterus (hysterectomy)

Genetics may also play a role in pelvic organ prolapse. Connective tissues may be weaker in some women, perhaps placing them more at risk.

Treatment

Treatment of pelvic organ prolapse depends on how severe the symptoms are. Treatment can include a variety of therapies, including:

  • Behavioral treatments, such as doing Kegel exercises designed to strengthen the pelvic floor muscles
  • Mechanical treatments, such as inserting a small plastic device called a pessary into the vagina to provide support for the drooping organs
  • Surgical treatment, either to repair the affected tissue or organ or to remove the organ (such as removal of the uterus by hysterectomy)