A vaginal prolapse is the protrusion of an organ into the vagina, caused primarily by gravity. A uterine prolapse occurs when the uterus (womb) moves down the vagina and completely fills it. Occasionally the cervix, which is the lowest part of the uterus, may protrude through the vulva to the outside. Part of the bladder which is in front of the vagina, may push back into the vagina causing a bladder prolapse (cystocoele). The rectum (last part of the large intestine) may push forward into the vagina as a rectal prolapse (rectocoele). Occasionally there is a combination of all three types of prolapse.
During childbirth, the vagina becomes very stretched, and does not always return to its original size. The muscles around the vagina become weakened and the ligaments supporting the uterus may become stretched and sag. All these factors may lead to vaginal prolapse years later.
A cystocoele may cause difficulty in passing urine, urinary infections and incontinence. A rectocoele causes difficulty in passing faeces and other bowel problems. A uterine prolapse causes discomfort and pain, and ulceration of the cervix may result in infections and bleeding.
The vaginal prolapse may be repaired by an operation that uses strong natural material in the pelvis and artificial slings to support the prolapsing organ. In elderly women, a ring inserted into the vagina may be used to hold prolapse in the correct place. Younger women can prevent the problem by pelvic floor exercises under the guidance of a physiotherapist both before and after the delivery of their babies. The results of surgery are reasonable, but recurrences are possible.