The organs inside a woman’s pelvis are held in place by tissue and muscles. These organs include the vagina, cervix, uterus, bladder, urethra, intestines and rectum.
Prolapse occurs when the support system that holds these organs has been stretched or torn, leading to sagging.
The type of prolapse depends on the organ that is sagging.
- Uterine prolapse occurs when the uterus bulges or protrudes from the vagina.
- Vaginal vault prolapse occurs when the top of the vagina drops down into the vaginal canal. This typically occurs in women whose uterus has been removed.
- Cycstocele occurs when the bladder drops into the vagina.
- Rectocele occurs when the rectum drops down and bulges out of the vagina.
Causes of Prolapse
Prolapse typically results from childbirth, especially with large babies. Nine to ten-pound babies increase your risk for vaginal prolapse. The muscles become lax from all the pushing.
Prolapse also occurs in women who have had surgery or radiation in the pelvic area. This can cause the structures to relax so the organs slip down.
Menopause brings reduction of estrogen in the body. Decreased estrogen leads to sagging muscles.
Any condition that puts strain in the abdomen contributes to prolapse. Overweight women, weight lifters, and people with chronic conditions of the abdomen are at risk.
Symptoms of Prolapse
- Difficulty inserting a tampon
- Trouble with bowel movements
- Painful or uncomfortable intercourse
- Leaking urine
- Noticeable bulging
- Heaviness in the pelvis or back, especially when coughing
- Organs slipping out
Options for Treatment
Prolapse typically occurs early in pregnancy. The uterus is gently coaxed back into place. A device called a pessary holds the uterus in place for the first half of the pregnancy. The uterus won’t prolapse after a certain gestational stage.
Older women who can’t have surgical repair are also candidates for a pessary.
If you aren’t pregnant and are in relatively good health, you may consider a hysterectomy.
There are other surgical options to support the organs. Mesh may help. Sutures are also an option.
Kegels can help strengthen your pelvic muscles as a preventative measure.