Understanding 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 pelvic organs include the vagina, uterus, bladder, urethra, and rectum. These organs are held in place by muscles of the pelvic floor.
The main cause of pelvic organ prolapse is pregnancy and childbirth, especially vaginal childbirth. Other causes can include aging and obesity. This problem also runs in families.
The following videos show the different types of prolapse that can occur. Prolapse happens 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. Sometimes several organs can be affected at once. There also are videos showing treatment with pessaries.
Types of Prolapse
The uterus drops down into the vagina. In severe uterine prolapse, the uterus may protrude from the vagina.
Anterior Vaginal Wall Prolapse
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. Another name for bladder prolapse is cystocele.
Posterior Vaginal Wall Prolapse
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. Another name for this condition is rectocele.
In some cases, several organs can drop. Here the bladder, uterus, and rectum are shown shifting down.
Prolapse After Hysterectomy
Pelvic organ prolapse also can occur after hysterectomy (an operation to remove the uterus). The following videos show the different types of prolapse that can occur without a uterus.
Anterior Vaginal Wall Prolapse (After Hysterectomy)
Bladder prolapse can occur in a person without a uterus. Another name for bladder prolapse is cystocele.
Vaginal Vault Prolapse (After Hysterectomy)
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 also may occur with small intestine prolapse (shown here), anterior vaginal wall prolapse, or posterior vaginal vault prolapse.
Posterior Vaginal Wall Prolapse (After Hysterectomy)
The rectum can drop downward, creating a bulge into the back wall of the vagina. It may occur with prolapse of the vaginal vault. Another name for this condition is rectocele.
Treatment with Pessaries
Pessaries are a nonsurgical 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.
This pessary is used to treat uterine prolapse.
Ring with Knob Pessary
This pessary is used to treat urinary incontinence caused by bladder prolapse.
Published: April 2021
Last reviewed: April 2021
Copyright 2021 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.
This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.