OVERVIEW

Pelvic floor muscles support the pelvic organs, including the bladder, vagina, and rectum. If pelvic floor muscles are weak, your organs may drop and bulge into the vagina.

There are several types of prolapse:

Cystocele--tissues between the vagina and bladder weaken, and the bladder falls into the vagina
Rectocele--tissues between the vagina and rectum weaken, and the rectum falls into the vagina
Enterocele--the small bowel falls through the apex of the vagina, often after a hysterectomy
Uterine prolapse--the uterus descends into the vaginal vault, or in severe cases, outside of the vagina

Risk factors include previous childbirth (usually more than one vaginal delivery), chronic constipation, coughing, as from chronic bronchitis or smoking, obesity, age, hysterectomy, and menopause. There also may be a slight genetic risk.

Symptoms

If pelvic floor muscles are weak, your organs may drop and bulge into the vagina. When that happens, you may feel like something is falling out of your vagina or you may have a sensation of fullness or pain. It can also become difficult to hold urine or have a bowel movement.

Diagnosis

You may have a single prolapse or a combination. We can determine this through a pelvic examination.

Treatment

Because prolapse is associated with aging and low estrogen levels, topical estrogen creams or vaginal tablets may be prescribed. They can strengthen tissues and promote surgical healing, without entering your bloodstream in significant quantities. If you have total prolapse, surgery may be necessary.