Pelvic organ prolapse

Pelvic organ prolapse occurs when pelvic structures protrude into or outside the vagina. It is caused primarily by pregnancy, labor, and childbirth. It may also occur in women who have never been pregnant, especially in the presence of problems that increase pressure in the abdomen such as obesity, chronic cough, and constipation. Pelvic organ prolapse can also occur after surgical removal of the uterus (hysterectomy).

The sites of pelvic organ prolapse are:

• Vagina (vaginal vault prolapse, after hysterectomy)
• Uterus (uterine prolapse)
• Bladder (cystocele)
• Rectum (rectocele)
• Small bowel (enterocele)

Factors other than pregnancy that may increase your risk for pelvic organ prolapse are:

• Age (due to decreasing estrogen levels in older women)
• Obesity (causes increased pressure in the abdomen)
• Smoking (due to increased cough and effects of smoking on the collagen in the tissues)
• Constipation (straining increases pressure on the vaginal wall)
• Certain occupations (jobs that involve heavy lifting will cause an increased pressure in the abdomen)
• Previous pelvic surgery

There are both nonsurgical and surgical treatment options available for pelvic organ prolapse. Treatment is usually not required if the prolapse is not causing symptoms.