What does pelvic organ prolapse mean?

The pelvic organs, which include the bladder, vagina, uterus and bowel, are held in place by the pelvic floor muscles and supporting tissues such as ‘fascia’ and ‘ligaments’. These help to join the pelvic organs to the bony side walls of the pelvis and keep them in place.

Your pelvic floor muscles also work to support the pelvic organs from underneath. If the supporting tissues are torn or stretched, and you’re the pelvic floor muscles are weak, then the pelvic organs may not be held in their right place.

Pelvic organ prolapse (POP), occurs when one of the pelvic organs sags and may bulge or protrude into the vagina.

Signs and symptoms will depend on the type and level of prolapse.

Early on, you may not notice the signs of prolapse, but your doctor or nurse may be able to see it when you have your routine pap smear test.

When a prolapse is further down, you may notice things such as:

  • A lump bulging out of your vagina that you can see or feel
  • A heavy sensation or dragging in the vagina
  • Something ‘coming down’ or a lump in the vagina
  • Difficulty emptying your bladder or bowel
  • Lower back pain
  • Sexual problems (pain or less sensation)
  • Weak urine stream
  • Recurring urinary tract infections

These signs and symptoms can be worse at the end of the day and may improve after lying down. If the prolapse bulges right outside your body, you may feel sore and bleed as the prolapse rubs on your underwear.

What are the causes of prolapse?

Childbirth is the main cause of a prolapse. On the way through the vagina, the baby can stretch and tear the supporting tissues and pelvic floor muscles. The more vaginal births you have, the more likely you are to have a prolapse.

Other causes of prolapse can include:

  • persistent coughing with a chronic lung condition, such as smoker’s cough, bronchitis or asthma
  • lifting very heavy weights
  • chronic constipation with persistent straining to empty the bowel