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Symptoms & Causes

Pelvic Organ Prolapse

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What is Pelvic Organ Prolapse?

What is Pelvic Organ Prolapse?

Diagrams of pelvic organs

Pelvic organ prolapse is when pelvic organs drop out of their normal position. The pelvic organs include the bladder, uterus, vagina, and rectum. They can prolapse when the muscles and connective tissue that hold them in place weaken or tear.

Stages of Pelvic Organ Prolapse

Stages

After taking a complete medical history and performing a physical exam, your doctor may use a grading or staging system to describe how far your pelvic organ prolapse has advanced. Stages range from:

  • Least advanced, where pelvic floor muscles still support organs to some extent
  • Severe, where an organ prolapses until it is pushed out of the body

Types of Pelvic Organ Prolapse

Types

A prolapse can occur in the front or back wall of the vagina, the uterus, and/or the top of the vagina. More than one pelvic organ can move or prolapse at the same time.

Types of pelvic organ prolapse include:

  • Bladder prolapse (cystocele) - The bladder drops against the front wall of the vagina, the most common type of pelvic organ prolapse
  • Urethral prolapse (urethrocele) - The tube that empties urine from the bladder outside the body (urethra) drops against the front wall of the vagina. Bladder and urethral prolapse commonly occur together when the vaginal wall is weakened.
  • Uterine prolapse - The uterus bulges into or out of the vagina (dropped uterus)
  • Small bowel prolapse (enterocele) - A part of the small intestine moves from its normal position and presses into the weakened vaginal wall
  • Rectocele - The rectum (the end of the large intestine) shifts and presses against the weakened back wall of the vagina, also called posterior vaginal wall prolapse

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Causes of Pelvic Organ Prolapse

Causes

Any activity that puts pressure on your belly can weaken or damage the muscles and tissues that hold your pelvic organs in place, leading to pelvic organ prolapse. Age plays a role, too. Some women develop pelvic organ prolapse at a young age, but it is more likely to happen after menopause.

Common causes of pelvic organ prolapse include:

  • Pregnancy can weaken the vagina and supporting tissues
  • Vaginal childbirth can damage muscles and nerves; one in three women who deliver vaginally later develop prolapse  
  • Aging and menopause come with estrogen loss and other changes that can weaken the pelvic floor
  • Repeated pressure on the pelvic floor from obesity, constipation, chronic cough, or frequent heavy lifting
  • Inherited risk if prolapse runs in the family or with inherited diseases that affect connective tissue strength

Signs & Symptoms of Pelvic Organ Prolapse

Symptoms

Some women with pelvic organ prolapse have no symptoms. Others experience uncomfortable pain or pressure during physical activity.

Pelvic organ prolapse symptoms include:

  • Pressure, or a heavy or full feeling, in the vagina or lower back
  • Low back or pelvic pain that may interfere with daily activities
  • Pain or difficulty during intercourse
  • Frequent need to urinate, slow urinary stream, or feeling of incomplete emptying of the bladder
  • Seeing or feeling a bulge coming out of the vagina
  • Trouble having a bowel movement
  • Problems inserting a tampon

Risk Factors for Pelvic Organ Prolapse

Risk Factors

Some people are more likely to develop pelvic organ prolapse than others. Pelvic organ prolapse risk factors include:

  • Vaginal childbirth – Stretches the pelvic floor muscles
  • Family history - Having close relatives with pelvic organ prolapse
  • Hysterectomy - Surgical removal of the uterus
  • Long-term pressure on the abdomen - From obesity, chronic coughing, or straining during bowel movements
  • Aging - May weaken pelvic floor muscles and tissues
  • Menopause - May weaken the pelvic floor

Prevention

Prevention

You can take steps to reduce your risk of pelvic prolapse, including:

  • Maintain a healthy weight
  • Don’t smoke
  • Avoid heavy lifting
  • Do pelvic floor exercises regularly to strengthen your pelvic muscles (Kegel exercises), especially after having a baby
  • Exercise, eat high-fiber foods, and drink fluids to ease bowel movements
  • Ask your doctor about your chronic cough or trouble with constipation
 

This content has been reviewed by the following medical editors.

Helai Hesham, MD

Saya Segal, MD, MSCE, FACOG

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Get Pelvic Organ Prolapse Care from NewYork-Presbyterian

Pelvic organ prolapse is both common and treatable. Getting care from a specialist in pelvic floor disorders is the first step toward understanding treatment options and improving your quality of life.

At NewYork-Presbyterian, our board-certified urogynecologists are skilled in treating conditions that affect the pelvic organs and pelvic floor.