Urogenital prolapse occurs when pelvic organs (bladder, uterus, rectum, or small bowel) slip from their normal position and bulge into the vagina due to weakened pelvic floor muscles and ligaments. It’s not life-threatening but can affect daily life and comfort. Think of your pelvic floor as a supportive hammock—when it weakens, organs may “sag.”
Common Symptoms
- A bulge or pressure in the vagina (may feel like sitting on a ball).
- Heaviness or dragging sensation in the pelvis.
- Bladder issues: Leaking urine, frequent urination, or difficulty emptying the bladder.
- Bowel issues: Constipation or difficulty passing stool.
- Discomfort during sex or reduced sensation.
Causes & risk factors
- Childbirth: Vaginal delivery (especially multiple or traumatic births).
- Aging & menopause: Reduced oestrogen weakens tissues.
- Chronic pressure: Obesity, heavy lifting, chronic coughing (e.g., asthma, smoking).
- Genetics: Family history of prolapse.
- Hysterectomy: Previous surgery removing the uterus.
Diagnosis
- Pelvic exam: To assess the prolapse.
- Questionnaire: Discuss symptoms and how they impact your life.
- Imaging (rarely): Ultrasound or MRI to evaluate severe cases.
Treatment options
Non-surgical management
- Pelvic floor physiotherapy: Strengthen muscles with guided exercises (Kegels).
- Pessary: A removable silicone device inserted into the vagina to support organs.
- Topical oestrogen: For postmenopausal women to improve tissue health.
Surgical options
- Repair surgery: Reinforce pelvic floor tissues (e.g., anterior/posterior repair).
- Hysterectomy: Remove the uterus if prolapsed (often combined with repair).
Prevention & self-care
- Pelvic floor exercises: Daily Kegels (ask for a referral to a physiotherapist).
- Avoid heavy lifting or straining.
- Maintain a healthy weight and treat chronic coughs.
- Quit smoking (reduces coughing and tissue damage).
eGynaecologist Advice
- Prolapse is common and manageable. Non-surgical options (pessaries, physio) work for many and surgery effective for severe cases.
- You should seek gynaecological consultation if you develop sudden inability to urinate or pass stool and if you notice signs of infection (fever, foul-smelling discharge).
- You should seek urgent gynaecological consultation if you have severe pain or the prolapsed organ protrudes outside the vagina.
Frequently Asked Questions
Is prolapse linked to cancer?
No, but report any unusual bleeding to rule out other conditions.
Can I still get pregnant?
Yes, but prolapse may worsen during pregnancy. Discuss plans with your gynaecologist.
Will prolapse return after surgery?
Recurrence is possible (10–30% risk). Pelvic floor care reduces this risk.
Can I exercise?
Yes! Low-impact activities (swimming, walking) are safe. Avoid heavy lifting.
Does menopause worsen prolapse?
Yes – low oestrogen weakens tissues. Topical oestrogen may help.
