Pelvic organ prolapse occurs when a pelvic organ – such as your bladder, womb (uterus) or bowel – drops from its normal position in your lower belly and presses against the walls of your vagina.

More than one pelvic organ can prolapse at the same time. Organs that can be involved when you have pelvic prolapse include the:

  • Urethra/bladder
  • Uterus/cervix
  • Rectum/small intestine

How common is pelvic organ prolapse?

Up to 40 per cent of women have a mild prolapse with minimal or no symptoms. Overall, about one in 9 women will ever need surgery in their lifetime.

What causes a pelvic organ to prolapse?

Vaginal birth

"Pelvic organ prolapse is most often related to a history of vaginal childbirth," according to doctors from the Department of Obstetrics & Gynaecology at Singapore General Hospital, a member of the SingHealth group. Normally your pelvic organs are kept in place by the muscles and tissues in your lower belly. During childbirth, these muscles and tissues can get weakened or stretched. If they don't recover, the pelvic organ support may be affected.

Increased abdominal pressure/straining

Pelvic organ prolapse can be made worse by anything that puts pressure on your belly, such as:

  • Being very overweight
  • Prolonged cough
  • Frequent constipation
  • Pelvic tumours

Postmenopausal hormonal changes

Older women are more likely to have pelvic organ prolapse. This is because a reduced level of the female hormone oestrogen after menopause, causes thinning and weakening of the pelvic connective tissue.

Genetic factors

Some women may have an inherited risk for prolapse, while others have some conditions that affect the strength of connective tissue, leading to pelvic organ prolapse.

What are the symptoms of pelvic organ prolapse?

With mild prolapse, there may be no symptoms. Symptoms in more severe cases of pelvic organ prolapse may include:

  • A heavy dragging feeling in the vaginal region
  • Feeling a pull in the groin area or pain in the lower back
  • Noticing a lump outside the vaginal opening
  • Releasing urine without meaning to, needing to urinate a lot or incomplete bladder emptying
  • Having problems with bowel movement, such as constipation or incomplete emptying
  • Having vaginal discomfort during sexual intercourse.

How is pelvic organ prolapse diagnosed?

Your doctor will ask questions about your symptoms and assess your risk factors for prolapse. Your doctor will need to perform a general examination and a pelvic examination to look for any pelvic organ prolapse.

Learn more about the management and treatment of pelvic organ prolapse on the next page.

Ref: R14