Pelvic organ prolapse is a very common condition, particularly among older women. It's estimated that half of women who have children will experience some form of prolapse in later life, but because many women don't seek help from their health care provider the actual number of women affected by prolapse is unknown. Prolapse may also be called uterine prolapse, genital prolapse, uterovaginal prolapse, pelvic relaxation, pelvic floor dysfunction, urogenital prolapse or vaginal wall prolapse. Pelvic organ prolapse occurs when the pelvic floor muscles become weak or damaged and can no longer support the pelvic organs. The womb (uterus) is the only organ that actually falls into the vagina. When the bladder and bowel slip out of place, they push up against the walls of the vagina. While prolapse is not considered a life threatening condition it may cause a great deal of discomfort and distress.
Uterine prolapse is a condition that develops when muscular support for the uterus is lost and the uterus has fallen or dropped from its normal location, causing it to bulge into the vagina. The uterus is normally held in place by the pelvic muscles and supporting ligaments. When these muscles become weakened or injured, uterine prolapse can occur. In mild cases, a portion of the uterus descends into the top of the vagina. In more serious cases, the uterus may even protrude through the vaginal opening and outside the vagina. A prolapse can be associated with or accompanied by a urethrocele and cystocele (urethra and/or bladder bulge along the front wall of the vagina) and rectocele (rectal wall bulges into the back wall of the vagina).
TYPES OF PELVIC PROLAPSE
There are a number of different types of prolapse that can occur in a woman's pelvic area and these are divided into three categories according to the part of the vagina they affect: front wall, back wall or top of the vagina. It is not uncommon to have more than one type of prolapse. Prolapse of the Anterior (Front) Vaginal Wall
Cystocele (Bladder Prolapse): When the bladder prolapses, it falls towards the vagina and creates a large bulge in the front vaginal wall. It's common for both the bladder and the urethra (see below) to prolapse together. This is called a cystourethrocele and is the most common type of prolapse in women.
Cystocele (Bladder Prolapse): When the bladder prolapses, it falls towards the vagina and creates a large bulge in the front vaginal wall. It's common for both the bladder and the urethra (see below) to prolapse together. This is called a cystourethrocele and is the most common type of prolapse in women.
Urethrocele (Prolapse of the Urethra): When the urethra (the tube that carries urine from the bladder) slips out of place, it also pushes against the front of the vaginal wall, but lower down, near the opening of the vagina. This usually happens together with a cystocele (see above).
Prolapse of the Posterior (Back) Vaginal Wall
Enterocele (Prolapse of the Small Bowel): Part of the small intestine that lies just behind the uterus (in a space called the pouch of Douglas) may slip down between the rectum and the back wall of the vagina. This often occurs at the same time as a rectocele or uterine prolapse (see below).
Rectocele (Prolapse of the Rectum or Large Bowel): This occurs when the end of the large bowel (rectum) loses support and bulges into the back wall of the vagina. It is different from a rectal prolapse (when the rectum falls out of the anus).
Enterocele (Prolapse of the Small Bowel): Part of the small intestine that lies just behind the uterus (in a space called the pouch of Douglas) may slip down between the rectum and the back wall of the vagina. This often occurs at the same time as a rectocele or uterine prolapse (see below).
Rectocele (Prolapse of the Rectum or Large Bowel): This occurs when the end of the large bowel (rectum) loses support and bulges into the back wall of the vagina. It is different from a rectal prolapse (when the rectum falls out of the anus).
Vaginal Vault Prolapse: The vaginal vault is the top of the vagina. It can only fall in on itself after a woman's womb has been removed (hysterectomy). Vault prolapse occurs in about 15% of women who have had a hysterectomy for uterine prolapse, and in about 1% of women who have had a hysterectomy for other reasons.
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