Pelvic organ prolapse (POP) is a pelvic floor disorder that up to 50% of women will experience in their lifetime. Despite it being an extremely common condition, pelvic organ prolapse isn’t talked about very much, partially because many women feel embarrassed.

If you’ve been diagnosed with POP or have reason to believe you are experiencing it, there is nothing to be ashamed of. Pelvic organ prolapse happens to women of all ages and for a variety of reasons, not just because of childbirth.

In this complete women’s guide, we will discuss pelvic organ prolapse in depth, including the two most common types (bladder and uterine.) We will tell you what they are, why they are often confused, and what you can do to manage, treat, and even help prevent pelvic organ prolapse from occurring.

What is Pelvic Organ Prolapse

The pelvic floor is made up of muscles, ligaments, connective tissues, and nerves that support the bladder, uterus, vagina, small intestine, and rectum. This supportive structure functions kind of like a hammock that keeps these organs securely in place.

However, for many reasons, pelvic floor muscles can lose strength and elasticity. When this happens, the organs they support can begin to shift downward or bulge into the vaginal canal— medically known as pelvic organ prolapse (POP).

While POP is most commonly caused by changes during pregnancy and childbirth that weaken the pelvic floor, women who have never given birth can also develop POP. It can also occur from aging, obesity, and even repeated heavy lifting.

Types of Pelvic Organ Prolapse

Because the pelvic floor supports several organs, different types of pelvic organ prolapse can occur. Bladder prolapse (cystocele) and uterine prolapse are the two most common types of POP. Because their symptoms often overlap and share similar causes, they can be easily confused. It’s also possible for both conditions to co-occur.

We will discuss these two most common types of POP in depth for the rest of this article; however, we should note that there are other types of POP that women can experience and should be aware of.

  • Rectal Prolapse (Rectocele): A condition where the rectum bulges into the vaginal wall. This can cause symptoms such as a sensation of fullness or pressure in the pelvic area, difficulty with bowel movements, or the feeling of incomplete emptying after a bowel movement. In some cases, women may experience constipation or rectal incontinence.
  • Vaginal Vault Prolapse: A type of POP that can occur in women who have had a hysterectomy. In this condition, the top of the vagina (the vaginal vault) collapses or sags into the vaginal canal. Symptoms may include pelvic pressure, vaginal bulging, urinary issues, or even sexual dysfunction, depending on the severity of the prolapse.

While these types of prolapse are less common than bladder and uterine prolapse, they can still cause discomfort and require attention. As you can see, they share many of the same symptoms as bladder and uterine prolapse.

The only way to know the exact type of pelvic organ prolapse you might be experiencing is through a thorough evaluation by your OBGYN. A pelvic exam and discussion of your medical history and any relevant symptoms will help your doctor determine the specific condition and recommend the best next steps.

What is Bladder Prolapse (Cystocele)

The bladder is a hollow, muscular organ that stores urine until it’s ready to be expelled from the body. Positioned in the pelvis, it relies on surrounding muscles and tissues for support.

Bladder prolapse, also called a cystocele, occurs when the bladder loses this support and begins to shift downward. Instead of remaining in its normal position, it presses against the vaginal wall, creating a bulge. This doesn’t mean the bladder “falls out”. It moves into an area where it isn’t supposed to be, which can feel uncomfortable.

It most commonly occurs due to age, childbirth, and hormonal changes after menopause, but can also result from heavy lifting or being overweight. These factors increase pressure on the pelvic floor, weakening its ability to hold the bladder in place.

Common symptoms of bladder prolapse include pelvic pressure, frequent urination, difficulty emptying the bladder, or urinary incontinence.

What is Uterine Prolapse

The uterus is an organ in the female reproductive system that sits in the pelvis and is held in place by supportive muscles, ligaments, and tissues. Its primary role is to house and nourish a developing fetus during pregnancy.

Uterine prolapse happens when the support structures around the uterus weaken or stretch, often due to childbirth, aging, or hormonal changes after menopause. When this occurs, the uterus may begin to shift downward, pressing into the vaginal canal. In more advanced cases, it can protrude outside the vaginal opening.

Like bladder prolapse, this doesn’t mean the uterus suddenly falls out. The condition develops gradually as the pelvic floor’s ability to hold the uterus in place diminishes.

Uterine prolapse most often occurs as a result of factors like aging, multiple vaginal births, and hormonal changes after menopause. The pelvic floor muscles may also weaken due to excessive strain from activities such as heavy lifting or obesity, which increases pressure on the pelvic area.

Women with uterine prolapse typically notice symptoms such as a heavy feeling in the pelvis, bulging tissue in the vagina, or difficulty with bowel movements.

What Causes Bladder and Uterine Prolapse?

Both bladder prolapse and uterine prolapse are often caused by weak pelvic floor muscles that support the pelvic organs.

Several factors contribute to this weakening, the three most common: age, childbirth, and menopause.

  • Childbirth: Vaginal delivery, especially multiple births, can stretch and damage the pelvic floor muscles, increasing the risk of prolapse.
  • Menopause: The decrease in estrogen during menopause can lead to the weakening of pelvic tissues, which makes prolapse more common in postmenopausal women.
  • Aging: As we age, the pelvic muscles naturally weaken, which can lead to prolapse.

Activities such as heavy lifting or obesity can also increase pressure on the pelvic area and cause pelvic organ prolapse. Chronic constipation or severe coughing can also put added pressure on the pelvic floor. Over time, this could also potentially lead to pelvic organ prolapse.

Similarities and Differences Between Bladder Prolapse and Uterine Prolapse

While bladder and uterine prolapse are both forms of pelvic organ prolapse, they involve different organs and often present unique symptoms.

Similarities:

  • Both conditions share common risk factors, including childbirth, menopause, and weakened pelvic floor muscles.
  • Symptoms often overlap, such as pelvic pressure, vaginal bulging, and urinary issues.

Differences:

  • Bladder prolapse specifically involves the bladder slipping into the vaginal wall, leading to urinary problems like incontinence or incomplete bladder emptying.
  • Uterine prolapse involves the descent of the uterus into the vaginal canal, which may cause issues such as vaginal protrusion or difficulty with bowel movements.

Although these conditions are different, they can occur simultaneously. If you notice any symptoms, you will need to have a pelvic exam to properly diagnose prolapse, determine the specific type of prolapse, and create the most effective treatment plan.

Symptoms: How Can You Tell the Difference Between Bladder Prolapse and Uterine Prolapse?

Although both bladder prolapse and uterine prolapse can cause a sensation of pelvic pressure
or heaviness, their symptoms can vary:

Symptoms of Bladder Prolapse (Cystocele)

  • Frequent urination
  • A feeling of incomplete bladder emptying
  • Urinary incontinence
  • Pain during intercourse
  • A bulge in the vaginal wall

Symptoms of Uterine Prolapse

  • Pelvic pressure
  • Vaginal bulging
  • Urinary problems
  • Difficulty with bowel movements
  • In more severe cases, the uterus may protrude outside the vaginal opening.

Because symptoms can be very similar, it’s often difficult to know for sure what type of pelvic organ prolapse you might be experiencing. The only way to know is for your OBGYN to perform a pelvic exam.

Can Bladder and Uterine Prolapse Occur Together?

It’s possible for both bladder and uterine prolapse to happen at the same time, as they share similar risk factors like childbirth, aging, and weakened pelvic floor muscles. However, they are distinct conditions, and one does not automatically lead to the other.

If you do have both bladder and uterine prolapse, treating one form of prolapse may sometimes help reduce symptoms of the other, especially if both are mild to moderate.

More commonly, these two types of pelvic organ prolapse are confused due to their overlapping symptoms, such as pelvic pressure or a vaginal bulge. It’s important for women experiencing symptoms to consult with their OBGYN for a thorough evaluation.

Proper diagnosis ensures the most effective treatment plan for addressing the specific type—or types—of prolapse.

Treatment Options for Bladder and Uterine Prolapse

Treatment for bladder and uterine prolapse depends on the severity of the condition and individual needs. There are both more conservative, non-invasive approaches and minimally invasive surgical procedures that can correct pelvic organ prolapse.

Treatment choice depends on factors like the severity of symptoms, your overall health, and personal preferences. Your OBGYN can help guide you in selecting the most appropriate approach for your specific situation.

Conservative Treatments

Pelvic floor exercises (Kegels)

Strengthening the pelvic muscles through targeted exercises can improve support for the pelvic organs, particularly in the early stages of prolapse. This simple practice can help prevent further progression and alleviate mild symptoms.

Pessary

This small, removable device is inserted into the vagina to provide structural support for prolapsed organs. Pessaries are effective for both bladder and uterine prolapse and are often used as a non-surgical solution.

Lifestyle modifications

Addressing factors that strain the pelvic floor—such as managing constipation, avoiding heavy lifting, and maintaining a healthy weight—can help reduce pressure on the pelvic organs and prevent the prolapse from worsening.

Surgical Treatments

If you have experienced bladder prolapse, surgery may involve repairing the vaginal wall or repositioning the bladder to restore its proper alignment. These procedures are typically minimally invasive and focus on strengthening the support structures around the bladder.

For uterine prolapse, surgical options often include a hysterectomy, which removes the uterus. This procedure is generally more invasive and requires a longer recovery time but may be recommended in severe cases or when other treatments are not viable.

Alternatively, uterus-preserving surgeries, such as a uterine suspension procedure, may be an option. These surgeries are often minimally invasive and aim to lift and secure the uterus back into place, offering a solution for women who wish to retain their uterus.

How to Prevent Pelvic Organ Prolapse: Can Pelvic Floor Exercises Help?

While pelvic organ prolapse is very common, there are proactive steps you can take to strengthen and protect the pelvic floor, reducing your risk of developing or worsening prolapse.

Yes, Kegels are one of them, but several other exercises and lifestyle changes can complement your pelvic health routine.

Small, consistent habits can have a significant impact on long-term well-being. By incorporating a few preventative measures into your daily life, you can strengthen your pelvic floor and support your pelvic health.

Kegels

Kegels are one of the most effective ways to strengthen your pelvic floor. These exercises involve contracting and relaxing the muscles that support the bladder, uterus, and other pelvic organs. With consistent practice, these muscles grow stronger, helping to maintain proper alignment and provide better support for the pelvic organs over time.

Kegels are simple to learn and can be done virtually anywhere. Consistency is key—aim to perform a few sets daily to see and maintain the benefits

Yoga

Certain yoga poses can help release tension, improve posture, and support overall pelvic health. Poses like Child’s Pose, Happy Baby, and Cat-Cow can help strengthen the pelvic floor and improve flexibility in the lower back, hips, and pelvis.

Breathing Exercises

Focusing on diaphragmatic breathing—where you breathe deeply into your abdomen—helps to naturally engage the pelvic floor muscles. This can promote relaxation and alignment, encouraging the muscles to function more effectively in supporting the pelvic organs.

Specific Body Exercises

Staying active, in general, can help improve circulation and muscle tone, which both contribute to overall pelvic health. However, there are some specific exercises you can do that are known to specifically strengthen the pelvic floor. Here are a few examples:

  • Squats
  • Clam Shells.
  • Pelvic Tilts
  • Bridge with Knee Taps:
  • Lunges

If you need help with any of these exercises, there are many resources online with proper how-to videos and step-by-step guides.

Maintain a Healthy Weight

Extra weight puts added pressure on the pelvic floor, increasing the risk of prolapse. Adopting a balanced diet and regular exercise can help maintain a weight that supports pelvic health.

Prevent Excessive Straining

Straining during bowel movements, heavy lifting, or high-impact activities can weaken the pelvic floor over time. If you struggle with constipation, increasing fiber and drinking plenty of water can help. If it continues, you should see a doctor.

When lifting or exercising, use proper form to prevent unnecessary strain. Also, limit high-impact activities, such as running, when possible to give the pelvic floor muscles a break.

Address Chronic Coughs

Persistent coughing or other chronic conditions that put pressure on the pelvic floor should be treated promptly to minimize strain. Conditions like allergies, asthma, or a lingering cold can lead to frequent coughing, which increases pressure on the pelvic floor.

Managing these conditions and speaking with your doctor to address the underlying issues can help protect the pelvic floor muscles from unnecessary stress.

Final Thoughts

Learning that you have pelvic organ prolapse can be a frightening and emotional experience.

But there is nothing to be embarrassed about, and while POP can seem scary and affect your daily life, it is treatable.

As difficult as it may be, it’s crucial to discuss your concerns with your doctor. If you believe you are experiencing symptoms of pelvic organ prolapse, don’t hesitate to book an appointment for a pelvic exam at Cool Springs OBGYN. Early detection and treatment can help you maintain your pelvic health and improve your quality of life.