OverviewVaginal prolapse, or pelvic organ prolapse, describes a weakness in one or more sides of the vagina that allows the pelvic organs to fall into or through the vagina. Prolapse is usually described according to the pelvic organ that is behind that part of the vagina. Prolapse of the bladder, for example, is a cystocele and prolapse of the rectum is known as a rectocele.
Women often have more than one type of prolapse, but a cystocele is the most common finding in an exam. Prolapse is staged or measured according to how much the prolapse has descended into or out of the vagina.
SymptomsWomen with prolapse often complain of pressure or heaviness in the pelvis. Some women may see or feel a bulge from the vagina. Some types of prolapse are associated with particular symptoms. Women with a rectocele might need to push the prolapse to have a bowel movement.
Similarly, women with a cystocele sometimes need to push the prolapse back inside to empty the bladder completely. Women with an enterocele might complain of low abdominal or back pain.
CausesThe cause of vaginal prolapse is not known, but the general consensus is that weak or injured pelvic floor muscles and connective tissue leads slowly to the development of prolapse as a woman ages.
Risk FactorsWoman at highest risk for vaginal prolapse are those who have had multiple vaginal deliveries, usually of large babies, or who have had a surgical delivery with forceps or a vacuum for difficult second stage labor. This stage of labor is the part in which the woman is fully dilated and pushes the baby out of the vaginal canal.
Other risk factors for vaginal prolapse are women who have a family history of prolapse, obese women, women who have a chronic cough from conditions such as smoking or asthma, women who lift heavy weight chronically, and women who have extra fluid inside the abdomen because of liver disease.
DiagnosisYour health-care provider would diagnose vaginal prolapse during a pelvic exam. Some physicians who specialize in treating prolapse and urologic conditions might recommend additional testing for other pelvic floor disorders, such as urinary incontinence, since these conditions tend to occur at the same time.
ComplicationsWomen who have high stage prolapse, or a prolapse that protrudes outside the entrance to the vagina, might develop difficulty emptying the bladder. This condition may lead to bladder infections or damage to the kidneys. Some women also develop sores or ulcerations on the surface of the prolapsed vagina when it is exposed.
RecoveryIf you suspect you might have a prolapse, seek the advice of your primary care physician who will evaluate you or refer you to a specialist such as a urologist, gynecologist or urogynecologist.