The ‘drooping’ or ‘sagging’ of a structure or an organ

A prolapse is the ‘drooping’ or ‘sagging’ of a structure or an organ. When this drooping or sagging involves one or more organs within the pelvis, it is called a ‘pelvic floor prolapse’.

The main structures and organs within the pelvis are the bladder, womb (uterus), bowel and the roof (or ‘vault’) of the vagina.

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Different types of prolapse


The vagina has a front wall and a back wall. If the front wall sags, it usually pulls the bladder down with it and so this type of prolapse is called a ‘cystocoele’.


If the back wall sags, it usually pulls down the rectum (lower part of the bowel) with it and so this type of prolapse is called a ‘rectocoele’.


If the highest corner of the back wall of the vagina sags, it can pull down the intestines and this is called an enerocoele.

Apical prolapse

If the roof (or ‘vault’) of the vagina sags, it can pull down the womb and neck of the womb (cervix) with it and so this is called an ‘apical prolapse’.

Symptoms of a prolapse

A prolapse can affect any of the structures and organs in the pelvis.

The classic symptoms are the feeling of a ‘lump or swelling down below’, or ‘something coming down’, or a ‘dragging sensation’ especially towards the end of the day. It may get worse when coughing or walking.

There are other symptoms that are commonly associated with a prolapse:

A prolapse involving the bladder, can cause urine-related symptoms, commonly:

  • Bladder leaks
  • Frequent passing of urine
  • Urgency
  • Difficulty passing urine (weak or longer stream of urine or feeling that you haven’t completely emptied your bladder)

A prolapse involving the rectum can cause:

  • Leakage of faeces
  • Feeling that you haven’t completely emptied your bowels
  • Straining to pass stools
  • Urgency to pass stools

A prolapse often affects the walls of the vagina and so can cause discomfort during sex, and reduced sensation or reduced arousal.

Managing a Prolapse

The following measures can help manage symptoms of a prolapse.

Since a weak pelvic floor can lead to a prolapse, it makes sense that strengthening of the pelvic floor muscle can improve symptoms of a pelvic organ prolapse, particularly in the early stages. Studies show that supervised pelvic floor exercises for 6 months significantly improve bladder, bowel and sexual function. It does require good motivation, but is absolutely worth it!

Check out the Squeezy App at to learn more about pelvic floor muscle exercises.

  • Try to lose weight if you have a BMI of over 30
  • Treat constipation
  • Treat a chronic cough (get help to stop smoking!)
  • Avoid excessive heavy lifting

This is a device that is used to support the prolapsing structure. It’s a suitable option for all women and is usually well tolerated. It is particularly recommended for those who have not yet completed their family or older women who would not want surgery.

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HRT may improve the quality of tissue by improving levels of pelvic organ collagen. It may not necessarily rectify a prolapse but it may prevent symptoms from getting worse.

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If you have a significant prolapse or one which does not respond to the above measures, you can be referred to a specialist for surgery. There are quite a number of surgical procedures used for the correction of a pelvic organ prolapse. You will be able to discuss these options with your specialist to decide on the procedure that is most suitable for you.

Please get in touch to speak about any of the above issues

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