Overview

Pelvic prolapse or Vaginal prolapse is the term used to describe a weakness in one or more sides of the vaginal wall, allowing one or more pelvic organs to fall into the vagina. Vaginal prolapse is a broad term used to describe the following: 

• cystocele or weakness in the front wall of the vagina allowing the bladder to fall into the vagina, 
• rectocele is a weakness in the back wall of the vagina allowing the rectum to fall into the vagina, 
• enterocele is a weakness in the top or roof of the vagina allowing small bowel to fall into the vagina, 
• Uterine prolapse is when the uterus and cervix descend from its normal position deep in the pelvis at the top of the vagina, towards the vaginal opening and sometimes  through and outside the vaginal opening. Vaginal vault (or vaginal cuff) prolapse is when the top of the vagina, (after hysterectomy) which is usually deep in the pelvis, descends into the bottom of the vagina or completely outside of the opening of the vagina. 

Women often have more than one type of prolapse. The prolapse is staged according to how severe it is, meaning how much the prolapse has descended into the vagina and sometimes outside of the vaginal opening.

Symptoms

Women complain of a bulging or pressure inside the vagina. Some women can see or feel a bulge from the vagina. Women with a rectocele might need to push the prolapse back inside the vagina to defecate (or have a bowel movement) properly. They may also have difficulty emptying their rectum completely and might leak stool after having a bowel movement. Conversely, women with a cystocele might need to push the prolapse back inside to empty their bladder completely. 

Women with an enterocele might complain of low abdominal or back pain.

Diagnosis

Vaginal prolapse is diagnosed during a vaginal exam by a physician, usually a primary care physician or gynecologist. Some physicians who specialize in treating prolapse and urologic conditions, such as a urologist, or urogynecologist, might recommend a urodynamic test (evaluation of bladder function) or defecography (evaluation of lower bowel function) to determine if there are associated bladder or bowel conditions that need to be addressed concurrent to the prolapse, such as urinary incontinence, constipation.

Treatment

Observation, Pessary, Surgery

Self Care

Additional Reading

Physicians