On This Page


What is pelvic organ prolapse? and bowel

A pelvic organ prolapse happens when the ligaments and muscles that support pelvic organs stretch, causing the organs to drop down. There are different types of pelvic organ prolapse, including uterine prolapse, and bladder and bowel prolapse (vaginal prolapse). A uterine prolapse is when the uterus (womb) and cervix (the opening to the uterus) drop down towards the vaginal entrance and may even protrude outside the vagina.

Bladder prolapse (cystocele) is when the bladder bulges into the front wall of the vagina. is when the rectum bulges into the back of the vaginal wall. Bladder and bowel prolapses usually happen together, but they can happen separately.

This type of prolapse is also known as ‘vaginal prolapse’ because the walls of the vagina become overstretched and bulge down towards the vaginal entrance. The symptoms of a prolapse depend on the severity of the prolapse and your general health. Symptoms can include: a sensation of vaginal ‘dragging’ or ‘heaviness’.

There may also be: lower back ache. In severe cases, the vaginal wall or cervix may protrude outside the vaginal entrance.

What causes a prolapse? can cause a prolapse

For example: squatting for long periods of time. The risk of prolapse increases: after menopause when oestrogen levels drop, causing pelvic floor muscles to lose elasticity. Note that being sexually active does not cause or worsen prolapse.

Prolapse is usually diagnosed by your doctor after discussing your symptoms and medical history. They will also do a physical pelvic examination to check: which organs are involved in the prolapse. You may also need other tests, including: a midstream urine test.

The severity of prolapse is measured using the POP-Q system to understand the stages of prolapse. Stages one to 4 are defined by how far the prolapse comes down into the vagina.

Without intervention, symptoms of prolapse will usually get worse over time

Treatment and management will depend on the severity of the prolapse and how much it interferes with your daily life.

If you have a mild or moderate prolapse (stages one and 2), regular sessions with a pelvic floor physiotherapist will help. If the prolapse is more severe you may need to try different approaches, including devices that support the pelvic organs (pessaries) or surgery.

There are practical things you can do to reduce the risk of prolapse.

These may also help you to recover well after a prolapse or surgery

For example you can: make lifestyle changes, like quitting smoking.

You can also do pelvic floor exercises every day.

For example, squeeze up pelvic floor muscles before lifting, coughing, laughing or sneezing. A pelvic floor physiotherapist can show you how to do this.

The pelvic organs include the vagina, uterus , bladder Uterine prolapse Bladder and bowel prolapse (vaginal prolapse) Bowel prolapse (rectocele) Symptoms of a prolapse inability to completely empty your bladder or bowel when going to the toilet straining to wee or poo a slow flow of wee that may stop and start a feeling of fullness or pressure inside the vagina a feeling of swelling or a lump at the vaginal opening needing to go to the toilet quickly inability to control your wee or poo ( incontinence ) Anything that puts pressure on your pelvic floor muscles pregnancy and childbirth constipation or regularly straining when trying to go to the toilet being overweight or obese coughing due to smoking or chronic lung disease repetitive lifting of heavy weights at work, home or the gym with previous pelvic or gynaecological surgery Diagnosing prolapse the degree of prolapse how well the pelvic floor muscles are working Other tests a pelvic ultrasound a bladder function test (urodynamics) a bladder scan Stages of prolapse Treatment and management Mild and moderate prolapse What you can do manage constipation by eating a balanced diet and drinking enough water do regular physical activity avoid heavy lifting More information For more detailed information, related resources, articles and podcasts, visit Jean Hailes Women’s Health Where to get help Your GP (doctor) Gynaecologist Pelvic floor physiotherapist Continence Foundation of United States Helpline Jean Hailes for Women’s Health .

Key Points

  • symptoms of a prolapse depend on the severity of the prolapse and your general health
  • Symptoms can include: a sensation of vaginal ‘dragging’ or ‘heaviness’
  • What causes a prolapse? can cause a prolapse
  • risk of prolapse increases: after menopause when oestrogen levels drop, causing pelvic floor muscles to lose elasticity
  • Note that being sexually active does not cause or worsen prolapse