What is a prolapse?
The pelvic organs are held in place by ligaments and connective tissue while being supported underneath by the pelvic floor muscle. If the ligaments, tissue or muscle become stretched, weak or damaged, one or more organs may drop out of place, putting everything out of alignment and impacting function.
What causes a prolapse?
Prolapses generally occur due to extreme or repeated strain and downward pressure which stretches and weakens supporting tissue. This includes:
- Pregnancy and childbirth
- Persistent constipation
- Chronic coughing from smoking or lung disease
- Repetitive lifting heavy weight (for example young children or gym)
- Being overweight or obese
Scientific papers suggest that the long-held belief that the loss of osetrogen associated with menopause causes a loss of muscle strength isn’t conclusive. Although the lack of oestrogen can lead to a thinning and weakening of muscles, physical activity can prevent this decline, including exercising the pelvic floor muscle.
Types of prolapse
There are four categories of prolapse, each relating to the organ involved.
- Vaginal Prolapse. The vaginal wall can over-stretch and fall downwards towards the opening. It’s usual to diagnose if the prolapse is the front or back wall of the vagina as each can have different symptoms.
- Uterine Prolapse. The cervix or uterus drops out of place, sometimes even protruding from the vagina.
- Bladder Prolapse. Usually caused by a weakened pelvic floor muscle, the shifted bladder position can create a bulge in the vagina. It’s not uncommon for a bladder prolapse to occur in conjunction with other prolapses.
- Bowel Prolapse. When the bowel shifts, putting pressure on the back wall of the vagina.
Symptoms of prolapse
Prolapses can happen gradually and may not start with noticeable symptoms. Your doctor might be the first to notice during a routine gynaecological examination, such as a pap test.
Noticeable symptoms can vary in both type and severity depending on which organ or organs are involved and how far they’ve shifted but include:
- Difficulty passing urine or being able to completely empty the bladder
- Difficulty or discomfort when emptying bowels
- Reoccurring UTIs
- Uncomfortable, even painful sexual intercourse, or a loss of sensation
- A distinct bulge inside or protruding from the vagina
- Feelings that have been described as ‘heavy’, ‘dragging’ or ‘pressure’ in the vagina or pelvis
Prolapse and incontinence
Prolapse can cause stress incontinence as well as blockages and difficulty establishing and maintaining urine flow when voiding.
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Diagnosis of a prolapse
You must see a health care professional to obtain a diagnosis that will identify the organs involved and the severity. This will usually start with a physical examination and may also include an ultra-sound and tests of the bladder function.
Your doctor will be able to discuss treatment options for your specific case, but these could include:
- Lifestyle changes (losing weight, quitting smoking, improving diet)
- A régime of pelvic floor exercises
- A vaginal insert, or pessary, to hold things in place. You can read more about these on
Reducing the risk of prolapse
Preventative steps such pelvic floor exercises, improving bowel regularity, quitting smoking, improving core strength (with Pilates for example) and reducing weight will all help avoid a prolapse and may even assist in improving mild cases.
However, in more extreme examples, surgery may be required to rectify the issue so if a prolapse is suspected, it’s best to see a doctor.
Asaleo Care makes no warranties or representations regarding the completeness or accuracy of the information. This information should be used only as a guide and should not be relied upon as a substitute for professional, medical or other health professional advice.