Pelvic organ prolapse

A woman may experience different types of prolapse as different areas of pelvic floor muscle weaken. It's possible for the uterus, rectum, bowel or bladder to fall into the vagina. General symptoms of vaginal prolapse include:

• a heavy feeling in the pelvis
• feeling as though you're sitting on a small ball
• feeling as though something is coming out of the vagina
• difficulty passing urine and an increased need to visit the toilet
• numbness during sex
• passing urine when you sneeze or exert yourself
• constipation

If you can see a lump of bulge coming out the vagina, you may need to seek urgent medical help.

Your consultant will discuss your symptoms with you and help to make a diagnosis. You may ask to see a consultant for a physical examination. He or she will feel for any lumps in the pelvic area and vagina. They may also use a speculum — an instrument used during a smear test — to see inside the vaginal walls and check for signs of prolapse. A prolapsed rectum may involve a rectal exam. Your consultant may also suggest a urine test to check for infection.

Your consultant will discuss your treatment options and help to determine the best approach for you. If the prolapse is causing mild symptoms, they may recommend pelvic floor exercises to help strengthen the muscles in this area. They may order obliterative or reconstructive surgery if the prolapse is severe. The first closes off the vagina in order to support the trapped organs. The second reconstructs the pelvic floor using a woman's own soft tissue and returns organs to their original condition. This surgery is either performed through the vagina or through the abdomen, causing less pain during sex.