Prolapse refers to the displacement or "falling down" of an organ or part of an organ from its normal position within the body. This condition typically occurs when the supporting structures that hold the organ in place weaken or become damaged. Prolapse can affect various organs, but it is most commonly associated with the following types:
- Uterine Prolapse: The uterus descends into the vaginal canal due to weakened pelvic floor muscles, often associated with childbirth, aging, or hormonal changes.
- Rectal Prolapse: The rectum protrudes through the anus, sometimes causing discomfort and difficulty with bowel movements.
- Bladder Prolapse (Cystocele): The bladder bulges into the vaginal wall, leading to problems with urination and discomfort.
- Vaginal Prolapse: The vaginal walls lose their support, resulting in the vaginal canal collapsing inward or protruding outside the body.
Prolapse Checklist
- Do you feel a lump or a bulge in your vagina?
- Does it get worse with heavy lifting, straining, or passing a bowel motion?
- Do you feel a blockage during sex or does sex feel loose? Do tampons fall out of your vagina?
If the answer is ‘yes’, you may have a prolapse. Prolapse happens when the womb, bladder or bowel drop down from their normal position causing a soft bulge to appear in the vagina.
The main risk factors for developing a prolapse are having children, getting older and being overweight especially after the menopause when the fall in hormones weakens the pelvic floor.
What type of prolapse do I have?
Cystocele
This is a prolapse of the bladder / front wall of the vagina. Sometimes this can be associated with bladder problems such as overactive bladder (running too often), difficulty emptying the bladder, or accidental leakage of urine.
Rectocele / Enterocele
This is a prolapse of the bowel / back wall of the vagina. Sometimes prolapse of the back wall of the vagina can be associated with bowel problems such as difficulty passing a bowel motion or accidental leakage of faeces.
Womb Prolapse
The strong ligaments that hold the womb in place can become weakened after childbirth or the menopause. This can result in the womb dropping down from its normal position.
Vault Prolapse After Hysterectomy
After hysterectomy, the top of the vagina can drop down into the vagina. This is more common if your hysterectomy was performed for prolapse.
Prolapse is very common and only needs treated if it bothers you.
What treatments are available?
Treatment for prolapse may involve pelvic floor exercises, lifestyle changes, or surgical interventions, depending on the severity of the condition and its impact on the individual's quality of life. If you suspect you have a prolapse or are experiencing related symptoms, it's essential to consult a healthcare professional for proper diagnosis and management.
Non-Surgical Treatment
Non-surgical treatment options such as pelvic floor exercises and vaginal pessaries (plastic rings or devices to support the prolapse), right through to complex pelvic floor reconstructive surgery.
Surgical Treatment
The following operations are available for prolapse:
- Vaginal hysterectomy
- Anterior & posterior repair
- Enterocele repair
- Perineorrhaphy
- Sacrospinous ligament fixation
- Laparoscopic sacrocolpopexy
- Laparoscopic sacrohysteropexy (womb-preserving key-hole surgery)
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