Pelvic organ prolapse

Pelvic organ prolapse

What is pelvic organ prolapse?

The pelvic organs include the vagina,

uterus

,

bladder

and bowel.

A pelvic organ prolapse happens when the ligaments and muscles that support pelvic organs stretch, causing the organs to drop down.

There are different types of pelvic organ prolapse, including uterine prolapse, and bladder and bowel prolapse (vaginal prolapse).

Uterine prolapse

A uterine prolapse is when the uterus (womb) and cervix (the opening to the uterus) drop down towards the vaginal entrance and may even protrude outside the vagina.

Bladder and bowel prolapse (vaginal prolapse)

Bladder prolapse (cystocele) is when the bladder bulges into the front wall of the vagina.

Bowel prolapse (rectocele)

is when the rectum bulges into the back of the vaginal wall.

Bladder and bowel prolapses usually happen together, but they can happen separately.

This type of prolapse is also known as ‘vaginal prolapse’ because the walls of the vagina become overstretched and bulge down towards the vaginal entrance.

Symptoms of a prolapse

The symptoms of a prolapse depend on the severity of the prolapse and your general health.

Symptoms can include:

inability to completely empty your bladder or bowel when going to the toilet

straining to wee or poo

a slow flow of wee that may stop and start

a feeling of fullness or pressure inside the vagina

a sensation of vaginal ‘dragging’ or ‘heaviness’.

There may also be:

a feeling of swelling or a lump at the vaginal opening

needing to go to the toilet quickly

inability to control your wee or poo (

incontinence

)

lower back ache.

In severe cases, the vaginal wall or cervix may protrude outside the vaginal entrance.

What causes a prolapse?

Anything that puts pressure on your

pelvic floor muscles

can cause a prolapse.

For example:

pregnancy

and childbirth

constipation or regularly straining when trying to go to the toilet

being overweight or obese

coughing due to smoking or chronic lung disease

repetitive lifting of heavy weights at work, home or

the gym

squatting for long periods of time.

The risk of prolapse increases:

with previous pelvic or gynaecological surgery

after menopause when oestrogen levels drop, causing pelvic floor muscles to lose elasticity.

Note that being sexually active does not cause or worsen prolapse.

Diagnosing prolapse

Prolapse is usually diagnosed by your doctor after discussing your symptoms and medical history. They will also do a physical pelvic examination to check:

the degree of prolapse

how well the pelvic floor muscles are working

which organs are involved in the prolapse.

Other tests

You may also need other tests, including:

a pelvic

ultrasound

a

bladder

function test (urodynamics)

a bladder scan

a midstream urine test.

Stages of prolapse

The severity of prolapse is measured using the POP-Q system to understand the stages of prolapse. Stages one to 4 are defined by how far the prolapse comes down into the vagina.

Treatment and management

Without intervention, symptoms of prolapse will usually get worse over time. Treatment and management will depend on the severity of the prolapse and how much it interferes with your daily life.

Mild and moderate prolapse

If you have a mild or moderate prolapse (stages one and 2), regular sessions with a pelvic floor physiotherapist will help.

If the prolapse is more severe you may need to try different approaches, including devices that support the pelvic organs (pessaries) or surgery.

What you can do

There are practical things you can do to reduce the risk of prolapse. These may also help you to recover well after a prolapse or surgery. For example you can:

manage constipation by eating a

balanced diet

and drinking enough water

do regular

physical activity

avoid heavy lifting

make lifestyle changes, like quitting smoking.

You can also do pelvic floor exercises every day. For example, squeeze up pelvic floor muscles before lifting, coughing, laughing or sneezing. A pelvic floor physiotherapist can show you how to do this.

More information

For more detailed information, related resources, articles and podcasts, visit

Jean Hailes Women’s

Health

External Link

.

Where to get help

Your

GP (doctor)

Gynaecologist

Pelvic floor

physiotherapist

External Link

Continence Foundation of Australia

Helpline

External Link

Jean Hailes for Women’s

Health

External Link