Vaginal prolapse

What is vaginal prolapse?

Vaginal prolapse, also called pelvis organ prolapse (POP), is when the muscles that support the organs in the pelvis weaken and one or more of the organs begins to bulge into and even out of the vagina. Organs that can prolapse in this way include:

• Bladder
• Uterus
• Urethra
• Rectum (end of the bowel)

Is vaginal prolapse life-threatening?

While not life-threatening, vaginal prolapse can be very uncomfortable or painful.

Symptoms of vaginal prolapse

Pelvic organ prolapse can cause the following symptoms:

• A heavy feeling in the pelvis
• A feeling of fullness in the vagina
• A lump protruding from the vagina
• Discomfort or numbness during intercourse
• Problems with urination – you may feel like you haven’t emptied your bladder or may need to go more often.
• Problems with bowel emptying, and needing to push around the vagina to help empty your bowel adequately.

How is vaginal prolapse diagnosed?

If vaginal prolapse has occurred, but hasn’t been serious enough to cause any symptoms, it may be picked up by chance during another internal examination, like a cervical screening.

If your doctor suspects a vaginal prolapse, he will need to perform an internal pelvic examination, which is done in a similar way to a smear test. Sometimes, additional tests such as an MRI are used to help define the areas and severity of your prolapse.

What are the causes of vaginal prolapse?

A group of muscles and tissues known as the pelvic floor sits above the vagina and supports the organs in the abdomen such as the bladder and bowel. Pelvic organ prolapse occurs when the pelvic floor weakens and can no longer hold up these organs. This weakening may be caused by:

• Pregnancy and childbirth – particularly if the baby was big, after a long and/or difficult birth or after a multiple birth
• Heavy lifting
• Pressure from being overweight or obese
• Chronic constipation
• Chronic lung disease or similar conditions that cause constant coughing
• Menopause

How is vaginal prolapse treated?

The first line of treatment is pelvic floor exercises designed to strengthen the muscles in the pelvic floor so that they can support the bladder, uterus, and other organs properly. This, combined with lifestyle changes, such as losing weight and giving up smoking can be enough for some patients.

Other patients may require a pessary – a device that is inserted into the vagina to hold the prolapse in position. If the prolapse is severe, surgical options may be considered. The ideal treatment depends on the case and should be discussed thoroughly and decided on by you and your doctor.

Which type of specialist treats vaginal prolapse?

Gynaecologists, colorectal surgeons and urologists specialise in dealing with conditions affecting the vagina, including pelvic organ prolapse.