Types of pelvic organ prolapse

There are several types of pelvic organ prolapse:

Bladder prolapse

This type of pelvic organ prolapse is also called anterior prolapse or cystocele. It occurs when the wall located between your bladder and vagina stretches and weakens. The weakening of this wall causes the bladder to droop down and press into your vagina. This condition may cause you to feel the constant urge to urinate and experience problems with emptying your bladder, such as urinary retention.

Rectal prolapse

Also called posterior vaginal prolapse or rectocele, rectal prolapse occurs when the fascia – the fibrous tissue that serves as a wall to separate the rectum from the vagina – weakens, creating a bulge in your vaginal wall. Various conditions can increase your risk of developing a rectal prolapse, primarily those that can cause pressure on your pelvic floor like chronic constipation, chronic cough, pregnancy, and childbirth. Although small bulges may not show any symptoms and rarely cause any pain, it is still important to have it checked by your doctor, especially when the bulge becomes more prominent and uncomfortable.

Small bowel prolapse

Small bowel prolapse, or enterocele, a form of pelvic organ prolapse in which the small intestine descends into your lower pelvis and presses at the top portion of your vagina, forming a bulge. A mild to moderate small bowel prolapse may not produce any signs and symptoms, and most often, the only way to know that you have the condition is if you go for a pelvic examination.

Urethral prolapse

Also known as urethrocele, urethral prolapse happens when the urethra – the tube part that transports urine from the bladder to the outside of the body – descends and prolapses into your vaginal canal. When the muscles and tissues that support your urethra are damaged due to pregnancy, prolonged labor or menopause, the urethra widens, causing it to curve downward and press into your vagina. Just like bladder prolapse, urethrocele can cause you problems with urination, such as difficulty passing urine and completely emptying your bladder.

Uterine prolapse

Just like other forms of pelvic organ prolapse, uterine prolapse is caused by conditions and activities that can cause pressure on your pelvic floor. When there is excessive pressure on your pelvis, the muscles and tissues that hold the uterus in place become weak. This allows the uterus to slip from its normal position and bulge down into your vagina or birth canal.

What are the causes of a pelvic organ prolapse?

A prolapse is caused by the continuous weakening of the supporting tissues of the pelvic organs. This weakening may be caused by:

• Chronic cough or strain from constipation
• Collagen deficiency
• Congenital (present at birth) weakness of the pelvic floor muscles, ligaments and fascia
• Menopause – The supporting tissues become weaker with age and menopause
• Obesity, large fibroid (fibrous growth), tumour or previous pelvic surgery
• Pregnancy and childbirth, especially after a difficult and prolonged labour
• Strenuous physical work or heavy lifting

What are the symptoms of a pelvic organ prolapse?

• A dragging sensation in the lower abdomen and pelvis
• A swelling sensation in the vagina or a lump outside the vagina
• Backache that progresses through the day
• Difficulty in or inability to have sex – this may cause anxiety or depression
• Difficulty in passing urine or stools
• Difficulty in walking or sitting
• Vaginal bleeding and discharge (not part of the menstrual cycle)