• Pelvic organ prolapse is bulging of one or more of the pelvic organs into the vagina.
    • Uterus, vagina, bowel and bladder.
  • Caused by weakening of tissues that support the pelvic organs.
    • Risk of developing pelvic organ prolapse increases by:
      • Age –more common in older ages.
      • Childbirth – long or difficult labor, multiple babies or large baby.
      • Menopausal changes– weakening of tissue and low levels of estrogen hormone.
      • Being overweight or obese.
      • Previous pelvic surgery.
      • Repeated heavy lifting and manual work.
      • Long-term coughing or sneezing.
      • Excessive straining when going to the toilet.
  • Certain conditions can predispose the body to prolapse, such as:
    • Joint hypermobility syndrome
    • Marfan syndrome
    • Ehlers-Danlos syndrome

If pelvic organ prolapse is confirmed, it will usually be staged to indicate how severe it is (1-4; 4 being the most severe).

The main types are:

  • anterior prolapse (cystocele) – where the bladder bulges into the front wall of the vagina.
  • prolapse of the uterus and cervix or top of the vagina –which can be the result of previous treatment to remove the womb.
  • posterior wall prolapse(rectocoele or enterocoele) –when the bowel bulges forward into the back wall of the vagina.

Symptoms may include:

  • a sensation of a bulge or something coming down or out of the vagina, which sometimes needs to be pushed back.
  • discomfort during intercourse.
  • Problems during urination – such as slow stream, a feeling of not emptying the bladder fully, needing to urinate more often and leaking a small amount of urine upon coughing, sneezing or exercise (stress incontinence).

Some women with a pelvic organ prolapse do not have any symptoms and the condition is only discovered during an internal examination for another reason, such as a cervical screening.


Physician may do/request:

  • History & Physical Exam
  • Urodynamics



  • Usually does not require treatment, as long as it does not affect activities of daily living.
  • For mild cases, lifestyle changes may be recommended.
    • Weight lose
    • Pelvic floor exercises
  • Vaginal Pessary
  • Surgery

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