It’s been reported that 23.7% of women experience some form of pelvic floor disorder. Common issues range from urinary incontinence to several kinds of pelvic organ prolapse (POP). A “prolapse” is the slipping down or forward of a part or organ, often as a result of weakened or stretched connective tissue. Prolapses happen for both men and women, but women have several more types of prolapse that may affect the pelvic region of their bodies. This may cause pressure, pain during sex, incontinence, stretching sensations or lower back pain, an odd bulging sensation like sitting on a ball and in severe cases the prolapsed organ may sink so that parts are exposed outside of the body. Taking preventative measures, such as doing pelvic floor exercises, may help prevent these issues in women.
Types of Pelvic Organ Prolapse
These are the major types of pelvic prolapse that affect women.
A prolapsed bladder sinks into the anterior wall of the vagina.
Cystocele (or “dropped bladder”) is the most common type of female prolapse and one of the few types of bladder prolapse that may impact the body. Basically, the bladder’s supportive tissue stretches or detaches and sinks against the front (or anterior) vaginal wall at the top of the vagina. This may result in difficulty passing urine, incontinence, pain while having sex or general discomfort.
The prolapsed urethra sinks into the anterior wall of the vagina.
This is another prolapse that affects the anterior vaginal wall. This type of prolapse affects only the urethra, which is a tube that takes urine away from the body from the bladder. It may lead to incontinence and frequent or urgent urination.
Both the bladder prolapse (cystocele) and urethra prolapse (urethrocele) occur together.
This bladder prolapse affects both the bladder and the urethra, which sink into the anterior wall of the vagina together.
The uterus droops into the vaginal space and may even protrude outside of the vagina.
The uterus is a powerful, muscular organ that stretches during childbirth and pregnancy, but a dropped uterus can cause quite a few problems. It may lead to other prolapses on this list, as the weight of this organ puts pressure on other weakened organs, causing them to sink. A uterine prolapse, if it goes completely unaddressed and untreated, can painfully protrude outside of the vagina in a disorder called procidentia. A prolapsed uterus can feel like you’re sitting on a ball, lead to beading and may lead to pain during sex.
Vaginal Vault Prolapse
The top part of the vaginal wall droops towards the vaginal canal.
This type is common for women who have undergone a hysterectomy. Because the uterus has been removed, nothing is anchoring the top of the vagina or cervix in place, and it may sometimes sink. In very severe cases, the vagina may fall through the opening.
The vagina itself droops until it protrudes from the body.
A vaginal prolapse is slightly different than a vaginal vault prolapse. This is where the vagina and the ligaments, muscles and skin around it seem to sink and fall out of normal position. This is typically in combination with other types of prolapse on this list.
The small intestine prolapses into the upper wall of the vagina.
In some cases, the small bowel, or small intestine may sink into the lower pelvic cavity, affecting the top part of the vagina.
The rectum bulges into the posterior vaginal wall.
This type of rectum prolapse only affects women, in which the posterior wall of the vagina (a normally thick band of muscle between the vagina and rectum) is weakened. In severe cases, this bulge may tear into the vagina. Earlier stages may cause rectal pain, constipation, a feeling of pressure in the rectum or the feeling that the bowel hasn’t emptied even after finishing a bowel movement.
The rectum droops and protrudes through the anus.
Men and women can both experience this type of pelvic organ prolapse. The tissues and muscles around the rectal passage loosen, until the rectum may protrude through the anus. People may experience symptoms such as fecal incontinence, urgent bowel movements, or leaking blood or mucus from the anus.
Descending Perineum Syndrome
The perineum sinks down below its normal place on the pelvis.
Excessive trauma to the area may cause the perineum to sink. The perineum is the space between the vulva and the anus. This pelvic floor prolapse affects the whole region, which bulges down beyond its space, which is normally the bony part of the pelvis.
All these prolapses have a lot of potential causes. Pregnancy, childbirth, menopause, having a hysterectomy, excessive heavy lifting, smoking, weight, long-term health conditions that cause constipation, long-term conditions that cause frequent cough or strain, age and specific conditions (such as Marfan syndrome) all increase the risks of different forms of pelvic organ prolapse.
Many of these types of prolapses can be addressed with preventative measures, such as pelvic floor exercises, weight loss and lifestyle changes. More severe issues may be addressed with a type of surgery called sacrocolpopexy. A doctor also may use a pessary fitting, which are silicone rings inserted into the vagina to help address a prolapse. To talk about getting a diagnosis, prevention and the various procedures available, contact us at (678) 250-8451 or schedule an appointment with us.