Pelvic Organ Prolapse

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Do you leak a little urine when you cough laugh or sneeze?                              

Half of the women over the age of 50 with experience symptoms of pelvic organ prolapse, with 1 in 10 women by the age of 80 undergoing surgery. Worryingly, about a third of these women will need over one operation.  A mild prolapse often causes no symptoms and treatment is not always necessary. However, see your doctor if you think you may have a prolapse Please don’t be embarrassed, suffer on silence or rely on incontinence pads.

What causes a prolapse?

The organs within a woman’s pelvis (uterus, bladder and rectum) are held in place by ligaments and muscles known as the pelvic floor. If these support structures become weak, the pelvic organs can slip or bulge (prolapse) from their natural position into the vagina. Sometimes a prolapse may be large enough to protrude outside the vagina.


Prolapse can affect the quality of life by causing symptoms such as discomfort or a feeling of heaviness. It can cause bladder and bowel problems, such as frequency, urgency or leakage. Prolapse can also affect sexual activity.

Types of pelvic organ prolapse

There are several types of prolapse graded in severity; first, second or third-degree prolapse.

Uterine prolapse: the uterus and cervix slip down into the vaginal canal.  These all involve a weakening of the supporting structures resulting in a ‘dropping’ of organs or them pressing into the wall of the vagina.

Cystocele: The wall between the bladder and vagina  – resulting in part of the bladder and the vaginal wall

Urethrocele: The urethra (tube leading from the bladder to the outside of the body) is affected. Note occurs with a cystocele.

Rectocele: The wall between the vagina and rectum resulting in the rectum

Enterocele: Similar to a rectocele, but instead involves the area between the uterus and the rectum (Pouch of Douglas)

Vaginal vault prolapse: A vaginal vault prolapse occurs when the top of the vagina descends in women who have had a hysterectomy.

What can you do

  • Avoiding getting constipated or straining to open your bowels
  • Moderate exercise, running may not be advisable
  • Stopping smoking
  • Avoid activities that may make your prolapse worse such as heavy lifting

Treatment options

  • Mild cases, pelvic floor exercises are the first line (see next post for details)
  • Specialised women’s health physiotherapy
  • Using prescribed pessaries
  • Corrective surgery. Not everyone with prolapse needs surgery, but it may be something to consider if other options have not helped. Surgery for prolapse aims to support the pelvic organs and to help ease your symptoms, but sometimes, it cannot always offer a complete cure 

Still confused? Sign up for my “Pelvic floor explained workshop.”

Note: This is for guidance only, and should not be a substitute for medical advice, diagnosis or treatment given in person by a trained health professional.n by an appropriately trained health professional


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