Genital prolapse occurs when pelvic organs (uterus, bladder, rectum) slip down from their normal anatomical position and either protrude into the vagina or press against the wall of the vagina. The pelvic organs are usually supported by ligaments and the muscles, connective tissue and fascia which are collectively known as the pelvic floor. Weakening of or damage to these support structures allows the pelvic organs to slip down.
The condition is most common in postmenopausal women who have had children, but can also occur in younger women and women who have not had children. It is estimated that at least half the women who have had more than one child have some degree of genital prolapse (although only 10-20% complain of symptoms)
Types of prolapse
There are a number of different types of prolapse. The prolapse of a pelvic organ may occur independently or along with other pelvic organ prolapses. Prolapses are graded according to their severity; first, second or third degree prolapse.
A uterine prolapse involves the descent of the uterus and cervix down the vaginal canal due to weak or damaged pelvic support structures.
A cystocele occurs when the tissues supporting the wall between the bladder and vagina weaken, allowing a portion of the bladder to descend and press into the wall of the vagina.
A urethrocele occurs when the urethra (tube leading from the bladder to the outside of the body) descends and presses into the wall of the vagina. A urethrocele rarely occurs alone, instead usually accompanying a cystocele. The term cystourethrocele is used to refer to the prolapse of both part of the bladder and the urethra.
A rectocele occurs when the tissues supporting the wall between the vagina and rectum weaken allowing the rectum to descend and press into the wall of the vagina.
An enterocele is similar to a rectocele, but instead involves the Pouch of Douglas (area between the uterus and the rectum) descending and pressing into the wall of the vagina.
Vaginal vault prolapse
A vaginal vault prolapse occurs when the top of the vagina descends in women who have had a hysterectomy.