Pelvic Organ Prolapse

Woman with pelvic organ prolapse

Pelvic organ prolapse (POP) is a very common condition effecting the female population that is not very well known.  This is due to the fact that it is not talked about a whole lot.

There can definitely be adverse effects on women’s quality of life who are affected by this condition.

Pelvic organ prolapse is a condition in which there is a failure in the support of the uterus, bladder and bowel.  This lack of support leads to the sagging of these organs from their usual position within the body towards, into or through the vagina.

30% to 40% of women will be affected by POP.

Pelvic Organ Prolapse Female Pelvis

There are five types of pelvic organ prolapse:

  1. Rectocele, also known a posterior vaginal prolapse, is a type of pelvic organ prolapse. In rectocele, there is a bulging of the front wall of the rectum into the back wall of the vagina.
  2. Entrocele is a type of POP in which the small intestine prolapses into the vaginal canal.
  3. Cystocele is the term used for when the bladder prolapses.
  4. Uterine Prolapse
  5. Vaginal wall prolapse occurs when the walls of the vagina itself can sag and descend into the vaginal canal.


The two most important risk factors for POP are vaginal childbirths and the loss of estrogen due to menopause.  In terms of vaginal childbirths, multiple vaginal childbirths and instrument interventions add to the risk of developing POP.

Other risk factors for POP include:

  • age
  • vaginal childbirths that required instrument (forceps, suction) intervention
  • hysterectomy
  • chronic constipation
  • straining during bowel movements
  • obesity
  • smoking
  • high impact exercise
  • strenuous physical occupation (heavy lifting)
  • family history
  • genetics (Caucasians and Asians more suscepible)
  • urinary incontinence when coughing, laughing or sneezing
  • fecal incontinence

There is some belief that pelvic floor muscle training can help to reduce the risk of POP.  Results of studies though are not conclusive that there is any benefit.

In POP the ligaments and muscles that support the normal biological position of the pelvic organs become weakened.  It is proposed that supplementation of estrogen (hormone therapy) may help to maintain or improve the strength of ligaments and muscles.

It is believed that local estrogen therapy (e.g. topical vaginal estrogen) may provide better results than oral or systemic estrogen therapy.

Pessaries for Pelvic Organ Prolapse

Vaginal pessaries are another excellent treatment option that work very well for some women.  There is a wide variety of available pessaries.

Pessaries are broadly divided into two types; support or space-occupying.  Support pessaries include ring pessaries, Gehrung pessaries and Hodge pessaries.  Space-occupying pessaries include Cube pessaries, Donut pessaries and Gelhorn pessaries.

Many specialists utilize pessaries as first line therapy.

To learn more about other embarrassing health issues please visit our Conditions page.