Vaginal /pelvic prolapse

Vaginal or pelvic organ prolapse occurs when the uterus, cervix, the bowel (large or small) or the bladder bulges into the wall of the vagina.

Pelvic organ prolapse can affect the front, back or top of the vagina and sometimes more than one prolapse can be present at the same time. The three most common types of prolapse are:

  • anterior prolapse (or cystocele) - where the bladder bulges into the front of the vagina
  • prolapse of the uterus and cervix - at the top of the vagina, perhaps due to previous surgery to remove the womb (hysterectomy)
  • posterior wall prolapse (rectocele or enterocele) - where the bowel bulges into the back of the vagina

A prolapse is caused by weakness of the tissues that support the organs within the pelvis. There is usually more than just one cause and your risks of suffering a prolapse are increased by:

  • age - prolapses are more common the older you are
  • childbirth - the more children you have had, and the more difficult and prolonged your labour, the more likely you are to suffer a prolapse
  • menopause - can change hormone levels and weakening tissue
  • being overweight - can create extra pressure in the pelvic area
  • having fibroids (non-cancerous tumours of the womb) or pelvic cysts
  • earlier pelvic surgery - a hysterectomy for example
  • manual work or heavy lifting
  • coughing or sneezing over a long period - due to smoking, a lung condition or an allergy
  • constipation and straining when going to the toilet
  • suffering from certain conditions such as Ehlers-Danlos syndrome, Marfan syndrome or joint hypermobility syndrome

The risks of suffering from a prolapse can be reduced by doing regular pelvic floor exercises, by eating a healthy diet (to avoid constipation and straining on the toilet), by maintaining a healthy weight, by not smoking reducing caffeine and alchohol intake as they can irritate the bladder and by avoiding lifting heavy weights.

 

Symptoms of a vaginal /pelvic prolapse may include a bulging sensation within the vagina, pain or discomfort during sex or problems passing urine.

Symptoms will vary according to the type of prolapse suffered, and its severity. Many women don’t feel any symptoms at all and may only realise they have a prolapse when it is discovered during an examination for another reason (such as a regular cervical screening).

Typically, symptoms may include a sensation of bulging within the vagina. Sometimes it may feel as though something is coming down or out of the vagina, which may need to be pushed back in. You may experience pain or discomfort during sex.

You may have problems passing urine. These may include a slow stream, a feeling of not being able to fully empty your bladder, needing to urinate more often or perhaps leaking a small amount of urine when you cough, laugh, sneeze or exercise (stress incontinence).

  • a sensation of bulging within the vagina
  • a feeling of something coming down or out of the vagina
  • pain or discomfort during sex
  • problems passing urine
  • stress incontinence

You should see your doctor if you notice a lump in or around your vagina or have any of the symptoms of a prolapse. By discussing your symptoms and carrying out a short internal pelvic examination, your doctor should be able to diagnose your condition and suggest some treatment options. You may need to be referred to a specialist for further tests.

Anterior/posterior colporrhaphy

This is the surgical repair of either the front (anterior) or rear (posterior) vaginal walls, or sometimes both, to treat a vaginal prolapse.

What next?

If you are suffering with a suspected condition, you should seek the advice of your doctor who will be able to refer you to Benenden Hospital for diagnosis and treatment.

There are four ways to access treatment at Benenden Hospital which include self-funding, using private medical insurance or your Benenden membership, or through the NHS e-Referral scheme.