Pelvic organ prolapse, or simply “prolapse” occurs when the tissues that support and hold the pelvic organs (the uterus, bowel, and bladder) in their normal positions become damaged and weakened.
As a result, one or more of these organs prolapse (or “drop”) into the vagina. It is a bit like a hernia except that it occurs through the vagina.
There are a number of factors that contribute towards weakening the pelvic floor muscles and causing prolapse. These include labour and childbirth, obesity, longstanding constipation, coughing, straining, heavy lifting, and smoking. Advancing age, and especially the reduction of oestrogen after menopause, leads to further weakening. Some women also have a genetic predisposition towards prolapse.
A small amount of prolapse is normal in many women who have had a baby and if there are no significant symptoms it is not a cause for concern.
When present, symptoms vary from minimal to quite distressing, and depend upon which organ is prolapsing and how severely. Symptoms are often worse after exercise, prolonged standing, or at the end of the day, and may include:
Treatment of prolapse is generally only indicated for women with bothersome symptoms. In such cases, treatment options include physiotherapy, pelvic floor rehabilitation exercises, vaginal pessaries, surgery, or a combination of these. The choice of treatment will depend upon the extent of your prolapse, the severity of your symptoms, and the acceptability to you of the treatment methods.