Pelvic organ prolapse 

Introduction 

Women's health 40-60

Healthy living advice for women aged 40 to 60. Includes real stories on losing weight and alcohol dangers

Pelvic organ prolapse is bulging of one or more of the pelvic organs into the vagina.

These organs are the uterus, vagina, bowel and bladder.

Symptoms may include:

  • a sensation of a bulge or something coming down or out of the vagina, which sometimes needs to be pushed back
  • discomfort during sex
  • problems passing urine, such as slow stream, a feeling of not emptying the bladder fully, needing to urinate more often and leaking a small amount of urine when you cough, sneeze or exercise (stress incontinence)

Some women do not have any symptoms.

Read more about the symptoms of pelvic organ prolapse.

When to see your GP

Pelvic organ prolapse is not life threatening, but it can affect your quality of life.

See your GP if you have any of the symptoms of a prolapse, or if you notice a lump in or around your vagina that you have not felt before.

Your GP will often need to carry out an internal examination of your pelvis to diagnose a prolapse.

Read more about diagnosing pelvic organ prolapse.

Types of prolapse

Pelvic organ prolapse can affect the front, top or back of the vagina. The main types of prolapse are:

  • anterior prolapse (cystocoele), where the bladder bulges into the front wall of the vagina
  • prolapse of the cervix or top of the vagina, where the cervix or uterus drops, and can be the result of previous treatment to remove the womb (hysterectomy)
  • posterior wall prolapse (rectocoele or enterocoele), when the bowel bulges forward into the back wall of the vagina

It is possible to have more than one of these types of prolapse at the same time.

Why does prolapse happen?

Prolapse is caused by weakening of tissues that support the pelvic organs. This happens for a number of reasons.

In many women, the strain of childbirth weakens these tissues. Up to half of all women who have had children are affected by some degree of prolapse.

It is also more common as women get older, particularly in those who have gone through the menopause.

Things like being overweight, having a persistent cough and having long-term constipation can increase your risk of developing a prolapse.

Prolapse can also be caused by rare genetic conditions that affect your body tissues, such as Marfan syndrome.

Read more about the causes of pelvic organ prolapse.

Can a prolapse be prevented?

There are several things you can do to reduce your risk of prolapse, including:

  • doing regular pelvic floor exercises
  • maintaining a healthy weight or losing weight if you are overweight
  • eating a high-fibre diet with plenty of fresh fruit, vegetables and wholegrain bread and cereal to avoid constipation and straining when going to the toilet
  • avoiding heavy lifting

If you smoke, stopping smoking may also help reduce your risk of a prolapse.

How is prolapse treated?

Many women with prolapse do not need treatment as the problem does not seriously interfere with their normal activities.

Lifestyle changes such as weight loss and pelvic floor exercises are usually recommended in mild cases.

If the symptoms require treatment, a prolapse may be treated effectively using a device that is inserted into the vagina called a vaginal pessary. This helps to hold the prolapsed organ in place.

Surgery may also be an option for some women. This usually involves giving support to the prolapsed organ, but in some cases complete removal of the womb (hysterectomy) is required.

Most women experience a better quality of life after surgery, but there is a risk of problems remaining or even getting worse.

Read more about treating pelvic organ prolapse.

Page last reviewed: 26/02/2013

Next review due: 26/02/2015

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Comments

The 19 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Pinksam8591 said on 31 May 2014

I had prolapse surgery (and a TVT bladder repair and repair to my perineum) 4 weeks ago. I was terrified before I went in but I woke up to minimum discomfort - the worst part for me was the catheter! I stayed in hospital for 2 nights - the second night was by request as with a 2 year old at home I knew I would get no peace!
I would recommend this surgery to anyone that needs it - I can now sneeze without wetting myself! It isn't as bad as you think

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Dog Lady said on 24 May 2014

Hi folks
I'm six weeks post op both rectocoele and cystocoele repairs. The operation was simply a piece of cake. Hardly any after pain. Out of hospital on day three and took it easy for a good four weeks. I have revisited the surgeon because I was concerned. On occasion still experienced the heavy feeling. He told me everything was as it should be and possibly only a full bowel causing the discomfort. My concern is now I have become quite incontinent. I walk my dogs again every day. Not the long walk yet but if I bend to pick up the ball, cough and even just the walking causes my bladder to leak. I wasn't incontinent before the operation. Anyone having similar issues? I'm going to have to seek more advise but went through the cream, physio and pessary before op (none of which did any good whatsoever). I hope the op wasn't in vain....

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estellahart said on 22 March 2014

Hey Nickynoo, I'm just like you. Had both prolapses, totally terrified (of the anaesthetic, operation, being incontinent and peeing myself afterwards, of the surgeon damaging the bowel/other organis/vagina, everything! So scared I cried just before the surgery.) Now it"s all done! I waited 6 years and it got worse and worse. It felt like i was giving birth to a small inflated rubber balloon (yuk) - that was it protruding. Don't be afraid darling girl, do this: 1. Find a surgeon with a lot of experience and who does not use mesh (found to cut you on the inside, cause infections and later troubles). 2. Google any Reviews he/she may have. 3. Confess your fear to the receptionist (!) If you are lucky like me, they will tell you the surgeon is fabulous and has never failed anyone (if they say nothing, be suspicious!). 4. Lose weight if you need to and get healthy. See it as the beginning of a better life (it is, the damn thing hanging is not there any more!). 5. Eat vegetable soups, alkalizing food, no crap/junk/soft drinks/processed food/grains/sugar. Eat healthy grass fed meat with fat on it and get off alcohol and huff and puff everyday til your operation, doing anything you like.
Good luck! Tell me about it after. Go into the healing realms with a positive attitude and a good heart. Don't blame your wonderful body, you are blessed like me, with 3 children and bodies are like cars, they just need good repairs! I've been a fitness instructor for 20 years and still compete at Olympics for Oldies (Masters Games) and rank top 5 in the world for my age group, so fitness really means a lot to me! I'm 3 weeks out and would love to be in touch. Doing nothing (really hard), thanking my body, God (whatever or however you see this) and the universe (and still hoping I'm not incontinent when I've healed!). The double prolapse can stop this until it is fixed, so am still nervous about it.

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Nickynoo79 said on 17 March 2014

Hi im 34 and pretty sure im suffering with a rectocele and cystocele,symptoms started after the birth of my 3rd child 5yrs ago and are slowly getting worse..im petrified of going to get it all confirmed and having any kind of surgery incase it goes wrong or makes it worse..has anybody got any recent successful stories? Zara18 i would be interested to know if you went through with your surgery and how it went?

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HK50 said on 30 October 2013

I am 50 and had a hysterectomy and rectocele repair 7 years ago. The year after the surgery I felt that things weren't right and went for more surgery for a cystocele. This failed very shortly afterwards and I was eventually offered additional surgery. I ended up not taking this up - mainly because the time wasn't right. I coped with the problems - horrible feeling in vagina - for several years and then eventually the sensations subsided and I had little in the way of symptoms for 2 years. However, the symptoms have returned with a vengeance now and i have seen another consultant who has confirmed the presence of a rectocele and cystocele, which he believes have been holding each other up - hence no problems for a few years. Surgery is no longer an option for me really as it seems not to work for me. So, I'm back to searching out a pessary that stays in and is comfortable and allows me to forget about my vagina! It's been a long journey and I feel as if I've come full circle - right back to the beginning. I guess I'm sharing my experience because I want to add that this condition is so upsetting and really affects quality of life and people who don't have it tend not to be at all supportive, so it's quite a lonely path to walk really - if walking is at all possible! I wish I had been one of the 50% for whom the surgery works but, sadly, this was not to be. However, if my consultant can fit a suitable, effective pessary I will be delighted. So - not a life threatening condition of course but goodness me it affects quality of life - it is on my mind 100% of the time and I can't do things spontaneously anymore - even going upstairs is a calculated effort. Do hope you'll all get through this and that there is research going on to look for new (and safe) and very effective surgical solutions.

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pisces1963 said on 02 September 2013

i had surgery on 29.07.13 for a prolapsed utererus & bowel.. i was so scared of the surgery that i spent more than three years trying to come to terms with going into surgery. now for the first time in years i can laugh or sneeze without loosing water. the recovery from surgey is , as many will confirm not exactly a piece of cake, but as long as i take it really easy i am feeling better . sitting for any period of time still painful, and i am exhausted . my GP says this is normal and that a full recovery is anywhere from 6 weeks to 6 months depending on individul circumstances . i am hoping to be able to stand or sit without pain in the near future. @ Kam2481 i feel for you , ask your GP for Information about a household help ! even if you were to have surgery today you will not be able to lift your Baby, and certainly not a pram ! hope you feel better !!

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Vampirebirebite said on 14 August 2013

I have just been diagnosed with a prolapse of the bowel and bladder, I have had no children and a hysterectomy when I was 27. I am aboslutely terrified and so worried about any procedures I may have to have to correct the problem. I have had it for quite some time but have ignored it, when I first discovered something I went into a state of panic and ignored it!
I am feeling pretty miserable, there is always this constant feeling something is there in the way. I hardly have any sleep as constantly going to the loo throughout the night, very fed up :(

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kam2481 said on 24 July 2013

for a nhs hospital guide your description of prolapse not seriously interfering in a womans life is ridiculously wrong!! i take it no medical member of the nhs has ever suffered the devasting effects of a prolapse???
im 32 have an 11 monyh old baby and have a cystocele. i cant lift anything heavy like my baby shopping pushing/pulling pram up hills n stairs etc, i cant walk or dtsnd for long otherwise i get back ache stomache n a heavy dragging feeling like everythings gona fall out.
your article is patronising and basically brushes off prolapse as nothing serious...it might not be life threstening but it seriously affects the quality of your life...u cant run for a bus, jump about, lift heavy shopping furniture etc it limits the type of work you can do...you can be incontinent of feaces n urine or have urgency n cant get to the toilet on time.
the nhs should speak to women who actually have prolapse n ask how it affects their lives begore being so blaisey n brushing it off as nothing...its not nothing and i guaruntee if whoever wrote this had a prolapse then it would say it can seriously affect the quality of your life

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Dee57 said on 09 February 2013

Hi, I'm 57yrs old and I think I may have a prolapse(what kind I really don't know)I only know I have this feeling of something heavy hanging at the front of my vagina it's uncomfortable to sit and I looks like I have a heavy discharge. I also have problems going to the toilet to urinate as I feel this gets in the way.

I've looked at possible causes but wondered if a wire loop excision could have brought it on? after having problems with abnormal smears I was given the wire loop excision it wait took 3 new blades to cut through ,previous to this I have never had any trouble but when my next smear was due and I was examined the nurse informed me that I had a slight prolapse which has since gotten worse. I'm not complaining about the doctor who did this I'm just wondering how far do I let this prolapse go before I go back to see my doctor?

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hippyhop said on 11 October 2012

Water Lily, I was encouraged by your post. If your surgeon was in the Manchester or Cheshire area, could you let me have his name. I am being referred to our nearest hospital but know nothing of its reputation for this sort of operation and it is not generally held in high esteem!

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spocko said on 30 September 2012

I am having a hysterectomy in 6 weeks time and i'm so nervous, really worried about how long i will take to recover and whilst people keep telling me i will feel so much better for having one i'm still a bit scared.

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mummy21 said on 11 September 2012

I'm 21 and had a prolapse of the womb last year very worried as I think its happened again . having sex with my partner is a no no bleed every time again . I'm worried I'll need an operation x

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sarah 23 said on 10 September 2012

Tozzie i feel the same(I hate the stress incontinence and can't bear to think of being a "smelly old woman".) or in my case smelly young woman as I'm 23. And as you said Zara18 (I just can't beleive that at my age I have to put up with the symptoms that I have).

I have these problems caused by a condition from birth and worry very much about if I am able to have children and have more surgery how this will affect my partener and child or children if this is even possible.

If anyone could give me any advice on this, it would be greatly appreciated i.e. Has it created family problems? Is it fair to try to have children when I know what I am facing?

Has anyone tried anything that has been successful? Any positive out look would be appreciated as I have a lot of years ahead of me to deal with this and try things, any help lines or service that could be recommended to me?

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Darrenliam32 said on 26 July 2012

I am 68 and have suffered from IBS for a long time but now due to another med. is infinitely better but today I have been diagnosed with the dreaded severe prolapse and this only came to light due to bladder incontinence. I think in my case that it will probably have to be surgery and in the meantime pelvic floor exercises. I am retired and live quite an active life going abroad quite a lot. One of my worries is that I shall not be eligible for holiday insurance which may seem petty to some but it is the life we are now leading .The IBS was so bad that I could not go out sometimes all day but now it's a little better. How does one cope with a double "wammy" - will the op if I go down that route be successful? No way do I was the entrance of my virgina closed I have lost enough of my body what with sterilisation and the "microwave abilation" so don't want that option. I shall be seeing my own GP tomorrow who I hope be able to assist with my worries. However I feel quite bad because a very dear friend of mine is very poorly with a nasty cancer whilst my problem does not even compare to hers. I don't how long we have to wait for these ops but perhaps someone can enlighten me. Thanks

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Neens said on 06 July 2012

In reply to Tozzie (april 11th 2012)
Please do not be afraid to have the surgery done. I am 48 and had mine done 4 days ago ( total hysterectomy with a cystocele repair) I feel fantastic. If you do as you are told and take it easy, no walking the dog or lifting anything, get plenty of rest and keep your feet up you will be absolutely fine. I am so glad I did it. I was absolutely terrified going into theatre, my BP went up to 238/118!! I woke up in recovery in no pain at all, I stayed in hospital for 2 days and am now home enjoying the freedom of discomfort and pain. Don't change your mind .... go for it, it's the best decision you will ever make xx

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Zara18 said on 21 June 2012

I'm 34 and due to go into hopsital in two weeks to have prolapse, rectocele and cystocele repair. I'm really worried that i'm doing the right thing but I just can't beleive that at my age I have to put up with the symptoms that I have. It has taken me 3 years of battling to get where I am now and just want to get my life back. The surgeon has said that if this procedure doesn't work then I can always come back to have a more serious op but its taken alot of organisation to get the time off work not to mention sorting out support with my children. I'm encourgaed by Water Lilly's comments and hope that my op goes well. I have to try and believe that it'll be ok otherwise i'm not going to go through with it! I just want to have a normal life again and hope this is the last step towards that goal. Fingers crossed (rather than my legs!).

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Water Lily said on 17 June 2012

Really sorry Hillytilly had such a bad time, but I think her experience was not normal. I'm a 71-year old who had a vaginal hysterectomy and repair to prolapse of bladder and bowel on May 28. I have been pleasantly surprised at how well my recovery is going. There was very little pain afterwards and I was given plenty of pain relief in hospital. I was in for 3 days and it was a good experience, the nurses were excellent and everything was very clean. It did take me at least a week to come round properly from the anaesthetic but once that had cleared I felt so much better, able to walk the dog and get up and about around the house earlier than I thought I would. Now nearly 3 weeks, yes I still get tired but I'm enjoying the need to rest, read and catch up on demand TV on my I-pad. Still some discharge but this is normal-just get in a supply of pads beforehand! I'm still full of stitches inside, going all up the front, across the top, and down the back, but I look in wonder at my new outline, without that awful lump hanging out down below. Wonderful to pee normally too, no incontinence problems. I do have problems with constipation ATM but can sort that out with laxatives as well as diet and water consumption.
I was lucky to have a very experienced surgeon who I think has done an excellent job on my quite complicated and radical repair. I'm just being careful to do justice to his work by doing my part towards a full recovery, not doing anything silly for the next few weeks.
In my case there really was no option, I was just grateful the operation existed, and I'd say go for it, get yourself sorted, nothing in life is certain, but your prolapse will only get worse if you don't do anything about it. Good luck Tozzie, and let us know how you get on.

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Tozzie said on 11 April 2012

Oh my word! I'm due to have a full hysterectomy in a couple of months becase of a prolapsed womb/bladder/bowel and now, reading what HillyTilly has written about all that she has suffered has frightened me to death! I don't know if I'm doing the right thing now having it done. I can't bear to think of going through it if it's going to cause yet more problems. I was thinking along the lines of "Get it out and it'll be worth 6 weeks of recovery time to get back to normal". I hate the stress incontinence and can't bear to think of being a "smelly old woman".
I don't know what to do now... watch this space!

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HillyTilly said on 08 September 2011

This would have been helpful before I had my hysterectomy but it doesn't help me now. My hysterectomy was followed by 7 months of passing pus, taking antibiotics and having my wound cauterized , I now have a rectocele, cystocele and urethracele as well as incisional hernias, with consequent difficulties emptying my bowel and bladder.
I have been offered a vaginal pessary but the info about those is very discouraging and I dread another operation because surgeons are so reluctant to give antibiotics as a preventive measure.
Why is there no mention of- and separate info about- vaginal prolapse and its remedies?

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