Pelvic Organ Prolapse or POP can happen to a number of your pelvic organs.
Prolapse is a condition caused by the weakening of the pelvic floor, the muscle and tissue that hold the organs in place inside the bones of your pelvis. This is a hammock-like holder that keeps your bladder, intestines and reproductive organs in place. The pelvic floor also supports pelvic functions like bowel movements and urination, and plays a role in sex, pregnancy, and the delivery of babies.1
These important muscles also help your bladder and rectum contract and relax on demand when you need them, working for you 24 hours a day, seven days a week.2 Problems can occur when those muscles weaken or stretch, causing one or more of the pelvic organs to drop out of position and press against the vagina. This is called pelvic organ prolapse.
The affected organs can include the bladder, bowel, rectum, and uterus, and the upper portion of the vagina can also prolapse. Some of the symptoms are similar, making it hard to know exactly what’s wrong. Let’s look at the different parts of the pelvis where POP can occur.
When your bladder drops from its usual position in the pelvis and pushes or bulges into the vaginal space, this is called a bladder prolapse, anterior vaginal prolapse, or cystocele.3
Here are the most common symptoms:3
- Various problems urinating, such as difficulty starting, feeling like you haven’t completely emptied your bladder, feeling a frequent need to urinate, or urinary incontinence.
- A feeling of fullness or pressure in your pelvis and vagina that increases when you strain or cough.
- Some women see or feel a bulge of tissue in the vagina.
When your uterus is not properly supported by your pelvic muscles, it can slip down into the vagina, or sometimes protrude out of the vagina. Called uterine prolapse, this condition often affects women after menopause who have delivered one or more children by vaginal births. It can also occur along with prolapse of other organs.4
The most common signs of uterine prolapse include seeing or feeling tissue bulge out of your vagina, along with heaviness, pressure or discomfort in the pelvis and sometimes lower back. Urination problems can also happen, like feeling your bladder doesn’t empty, or suffering from incontinence leaks.4
Vaginal prolapse is when the top of the vagina, known as the vaginal vault, sags and falls into the vaginal canal. In severe cases, the vagina can protrude outside of the body.5
The most common symptoms include feeling pressure or fullness in your vagina, almost like you’re sitting on a small ball. Some women have the sensation that something has fallen out of the vagina. Other prolapse conditions often occur with vaginal prolapse, such as bladder or rectum prolapse.5
A small bowel prolapse, which is also called enterocele, happens when your small intestine or small bowel descends into the lower pelvic cavity. The bowel pushes on the top part of the vagina, creating a bulge.6
Here are some common signs:6
- A soft bulge of tissue in your vagina.
- Low back pain or a pulling sensation in your pelvis.
- Pain during sex (dyspareunia).
- Pelvic pressure or pain.
When the tissue between the rectum and the vagina weakens or tears, the rectum pushes into the vaginal wall, creating a condition known as posterior vaginal prolapse or rectocele. Once again, some women with this condition also have prolapse of other pelvic organs.7
Common conditions include trouble having a bowel movement, pressure in the rectum, or a feeling that the rectum has not fully emptied. Another symptom is splinting, which is when a bulge of tissue pushes through the opening of the vagina. To pass stool, you might need to support the vaginal wall with your fingers.7
Seek Medical Treatment
Some women who have a prolapse don’t have any symptoms. If you have signs that cause you to suspect you have a prolapse of one of your pelvic organs, it’s important to see a doctor. Particularly if caught early, most pelvic health problems can be treated without surgery.2
Use our Physician Finder to find a doctor near you with expertise in women’s health, who can diagnose your prolapse and help determine the best treatment for your specific condition.