PEV001, November 2012


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Pelvic Organ Prolapse

Pelvic organ prolapse is a disorder in which one or more of the pelvic organs drop from their normal position. It is caused by injury to the muscles or tissues that support the pelvic organs. The main cause of this injury is pregnancy and childbirth, especially vaginal childbirth. Other causes include prior pelvic surgery, menopause, and aging. This problem also runs in families.

Pelvic organ prolapse is a disorder in which one or more of the pelvic organs drop from their normal position. It is caused by injury to the muscles or tissues that support the pelvic organs. The main cause of this injury is pregnancy and childbirth, especially vaginal childbirth. Other causes include prior pelvic surgery, menopause, and aging. This problem also runs in families.

The following videos show the different types of prolapse that can occur. Keep in mind that often more than one organ can be affected at the same time. Prolapse occurs in stages. Mild cases are those in which the organs have dropped only a short distance. Severe cases are those in which the organs have dropped a greater distance.

Labeled Pelvic

Uterine prolapse

The uterus drops down into the vagina. In severe uterine prolapse, the uterus may protrude from the vagina. Uterine prolapse can occur with bladder prolapse (shown here), small intestine prolapse, or rectal prolapse.

Bladder prolapse (cystocele)

The bladder drops down and creates a bulge into the front wall of the vagina. In severe cases, the bulge can protrude outside the vagina. It can occur with uterine prolapse (shown here). Bladder prolapse may cause stress urinary incontinence (involuntary loss of urine while coughing, sneezing, or laughing).  

Rectal prolapse into the vagina (rectocele)

The rectum drops down and creates a bulge into the back wall of the vagina. In severe cases, the bulge can protrude outside the vagina. It can occur with uterine prolapse (shown here).

Pelvic organ prolapse also can occur in women who have had a hysterectomy (an operation to remove the uterus). The following videos show the different types of prolapse that can occur in women without a uterus:

Vaginal vault prolapse

The top of the vagina drops down, creating a bulge. In severe cases, the top of the vagina may protrude outside of the vagina. It may occur with bladder prolapse (shown here), small intestine prolapse, or rectal prolapse.

Bladder prolapse (cystocele)

Bladder prolapse can occur in a woman without a uterus. It may occur with prolapse of the vaginal vault. Bladder prolapse may cause stress urinary incontinence (involuntary loss of urine while coughing, sneezing, or laughing).

Small intestine prolapse (enterocele)

The small intestine can drop downward, creating a bulge into the vaginal vault. Small intestine prolapse may occur with bladder prolapse (shown here) or rectal prolapse.

Rectal prolapse into the vagina (rectocele)

The rectum can drop downward, creating a bulge into the back wall of the vagina. It may occur with prolapse of the vaginal vault.

Pessaries are a non-surgical treatment option that can relieve prolapse symptoms. A pessary is a device that is inserted into the vagina to provide support for prolapsed organs. Three types of pessaries are shown in the following videos:

Gelhorn pessary

This pessary is used to treat uterine prolapse.

Dish pessary

This pessary is used to treat bladder prolapse.

Ring pessary

This pessary is used to treat urinary incontinence caused by bladder prolapse.

 

Animations ©2010-2012 Tim Peters and Company, Inc. All Rights Reserved. Developed in consultation with Patrick Culligan, MD, FACOG, FACS.

No part of these videos may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission of the copyright holder.