When the muscles and ligaments supporting a woman's pelvic organs weaken, the pelvic organs can drop lower in the pelvis, creating a bulge in the vagina (prolapse). Women most commonly develop pelvic organ prolapse years after childbirth, after a hysterectomy or after menopause.
Pelvic organ prolapse can affect the front, top or back of the vagina. The main types of prolapse 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 (hysterectomy)
- posterior wall prolapse (rectocoele or enterocoele) – when the bowel bulges forward into the back wall of the vagina
It's possible to have more than one of these types of prolapse at the same time.
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 sex
- problems passing urine – such as slow stream, a feeling of not emptying the bladder fully, needing to urinate more often and leaking a small amount of urine when you cough, sneeze or exercise (stress incontinence)
Some women with a pelvic organ prolapse don't have any symptoms and the condition is only discovered during an internal examination for another reason, such as a cervical screening.