Pelvic Prolapse

Overview

When an organ becomes displaced, or slips down in the body, it is know as prolapse. Pelvic prolapse, a type of pelvic floor disorder, affects about one-third of all women over their lifetime. Women may sometimes refer to pelvic prolapse as their “dropped bladder” or “fallen uterus.”

The pelvic floor is a group of muscles that form a kind of hammock across your pelvic opening. Normally, these muscles and the tissues surrounding the pelvic organs keep them in place. The pelvic organs include your bladder, uterus, vagina, small bowel and rectum. However, in the case of pelvic prolapse, the muscles weaken or become stretched, causing the organs to “droop” and descend outside the vaginal canal or anus. This may be due to childbirth, but most cases occur in older women.

Education/General Information

Pelvic prolapse may be referred to in these ways:

Cystocele: A prolapse of the bladder into the vagina, which is the most common condition
Urethrocele: A prolapse of the urethra, the tube that carries urine out of the body
Uterine prolapse
Vaginal vault prolapse: Prolapse of the vagina
Enterocele: Small bowel prolapse
Rectocele: Rectum prolapse

The causes of pelvic prolapse are varied. Anything that puts increased pressure on the abdomen can lead to prolapse, such as:

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

The symptoms of pelvic prolapse vary depending on which organ is drooping. These might include:

A feeling of pressure, discomfort or fullness in the pelvic or vaginal area that may be worsened by physical activities
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 or loss of bowel control
Spotting or bleeding from the vagina

Diagnosis

Pelvic prolapse is most often discovered during a routine pelvic exam or Pap smear. A variety of tests may be performed to confirm pelvic prolapse, including:

Diagnostic tests, such as urinalysis and urodynamic study to evaluate the cause of urinary incontinence
Urinary tract X-ray (intravenous pyelography)
Computed tomography (CT or CAT) scan of the pelvis
Ultrasound of the pelvis
Magnetic resonance imaging (MRI) scan of the pelvis

Treatment

Treatment of pelvic prolapse varies depending on the type and severity of the prolapse, and may include:

Changes to your diet and fitness routine, such as Kegel exercises that strengthen the pelvic floor muscles
Insertion of a pessary, a rubber or plastic device designed to relieve symptoms and provide support
Surgical procedures to either repair the affected area or organ or to remove the fallen organ, such as a hysterectomy