The Facts
Pelvic Organ Prolapse is a common condition, occuring in 1 in 3 women aged 45 years. By the age of 80, approximately 1 in 10 women will have undergone surgery for the condition.
What is Pelvic Organ Prolapse?
Pelvic Organ Prolapse (POP) or Genital Prolapse is the herniation of pelvic organs through the urogenital diaphragm into the vagina.
Download the Pelvic Organ Prolapse Quick Reference Guide (PDF 1601Kb)
What are the symptoms?
- Loss of bladder or possibly bowel control
- Difficulty voiding
- Urinary frequency
- Problems with bowel movements
- Feelings of pelvic or vaginal heaviness, bulging, fullness and/or pain
- Recurrent bladder infections
- Excessive vaginal discharge
- Discomfort or lack of sensation with intercourse
A patient may complain of backache, a sensation of something pulling down, increased frequency of micuration, stress incontinence, coital problems and difficulties in voiding urine and defecating.
Types of Pelvic Organ Prolapse
There are a number of different types of prolapse, which include:
Anterior Prolapse
Cystocele - when the upper part of the anterior wall prolapses, which is the result of an underlying failure in the investing fascia. The bladder base also falls downwards, towards the vagina resulting in a bulge at the front of the vaginal wall.
Urethrocele - when the lower part of the vaginal wall prolapses and the urethra descends. A urethrocele indicates stretching of the urogenital disphragm which holds the urethra and pubic bone.
Posterior Prolapse
Enterocele - occurs in the upper part of the posterior vaginal walls and often results in the Pouch of Douglas becoming elongated with a drop in the small bowel or omentum. This will then slide down between the rectum and the back wall of the vagina. Enterocele is often known as 'Vault Prolapse' due to its usual occurence with uterine prolapse. This is more common in patients who have had a hysterectomy and is a condition that presents difficulties in treatment.
Rectocele - If the prolapse occurs at the middle third of the vagina the recto-vaginal septum is often involved and the rectum prolapses with vaginal wall. This is known as a Rectocele. If the lowest part of the vaginal prolapses then perineal body is involved as opposed to the rectum.
Top Vaginal Prolapse
Uterine Prolapse occurs when the uterus drops down into the vagina. Uterine Prolapse is the second most common form of prolapse in women and is classified into grades. The uterus gradually descends in the axis of the vagina taking the vaginal wall with it. It may present clinically at any level, but is usually classified as one of three degrees:
- 1st Degree - cervix still inside vagina
- 2nd Degree - the cervix appears outside of the vulva. The cervical lips may become congested and ulcerated
- 3rd Degree - complete prolapse
Vaginal Vault Prolapse (when the vagina falls in on itself) - can only occur in women who have had a hysterectomy and only occurs in approximately 15% of women who had a hysterectomy for uterine prolapse.
Treatment Options
In patients for whom conservative therapy has failed, surgery may be an option. There are many minimally invasive treatment options that can help patients gain control over this condition and improve their quality life. ETHICON™ Women's Health & Urology UK offers two different solutions for treating Pelvic Organ Prolapse using mesh, which are listed on the right hand side at the top of this page.
