Patient Information

Types of Prolapse

The main types of prolapse are:

• Cystocele (bladder prolapse)
• Enterocele (small bowel prolapse)
• Rectocele (rectum prolapse)
• Uterine prolapse (prolapse of the uterus)
• Vaginal vault prolapse

Cystocele

Occurs when the front of the vaginal wall weakens, allowing the bladder to herniate into the vagina. 

This condition changes the angle of the urethra (tube that carries urine from the body) and often results in stress incontinence. 

When a cystocele occurs, the urethra also may prolapse into the vagina (called urethrocele). 

When prolapse of both the bladder and the urethra occurs, the condition is called cystourethrocele.

Enterocele

Is a condition that occurs when the front and back vaginal walls separate, allowing the small bowel to press against or herniate into the vagina. This condition is more common following removal of the uterus (hysterectomy).

Rectocele

May also be called proctocele, occurs when the back of the vaginal wall weakens and the rectum presses against or prolapses into the vagina. This condition may create a bulge that is more noticeable during a bowel movement.

Uterine Prolapse

Weakening of the ligaments that support the top of the vagina (called the uterosacral ligaments) may cause the front and back of the vaginal walls to weaken as well, resulting in prolapse of the uterus (womb). 

There are 3 stages of this condition, which is called uterine prolapse:

• First-degree uterine prolapse (the bottom portion of the uterus enters the vaginal canal)
  
• Second-degree uterine prolapse (the uterus enters the lower portion of the vagina)
  
• Third-degree uterine prolapse (the uterus protrudes through the vaginal opening)

Vaginal Vault Prolapse

The uterus, or womb, helps to support the top of the vagina. Following removal of the uterus (hysterectomy), the upper portion of the vagina (vaginal vault) may drop toward the vaginal opening. This condition, which is called vaginal vault prolapse, occurs in about 10 percent of women who have had a hysterectomy. Vaginal vault prolapse often occurs with enterocele. It is possible to have more than one of these at the same time.

Causes of Pelvic Organ Prolapse

Pelvic organ prolapse happens when the group of muscles and tissues that normally support the pelvic organs, called the pelvic floor, becomes weakened and can't hold the organs in place firmly.

A number of things can weaken your pelvic floor and increase your chance of developing pelvic organ prolapse, including:

• Pregnancy and childbirth – especially if you had a long, difficult birth, or if you gave birth to a large baby or multiple babies
  
• Getting older and going through the menopause
  
• Being overweight or obese
  
• Having long-term constipation or a long-term condition that causes you to cough and strain
  
• Having a hysterectomy
  
• A job that requires a lot of heavy lifting