INFORMATION SHEET ON PROLAPSE
What is prolapse?
Prolapse is a condition where the womb or vaginal walls drop down from their normal position. You may feel that ‘something is coming down’ in the pelvis or have symptoms of a lump or bulge in the vagina. This lump might even come out of the vagina. It is rarely a cause of pain.
Prolapse can sometimes affect how your bladder or bowels work, although it is important to realise that the prolapse does not necessarily cause your bladder or bowel problems. If your prolapse is repaired, it may not necessarily be the case that your bladder or bowel symptoms will improve. For many women they do, but for a small number of women they may even worsen.
What causes prolapse?
The main cause is damage to the ligaments and muscles that help to keep the womb and the vaginal walls in place. Pregnancy and childbirth are considered to be the biggest cause of prolapse, although other factors are recognised:
• Heavy lifting, straining, persistent coughing, or constipation.
• Ageing and the menopause can cause further weakness.
• Some genetic conditions may cause prolapse, such as those that affect the connective tissues.
Prolapse is very common and around half of women over 50 years old may experience some symptoms. It also is quite common in younger women. Around one in ten women will have surgery for prolapse in their lifetime.
What are the different types of prolapse?
Prolapse can affect the vaginal walls or the womb. If you have a vaginal wall prolapse, the prolapse might affect the front wall or the back wall of the vagina. Although prolapse can affect the front or back vaginal walls, or the womb, it is common to have a combination of problems.
If you have had a hysterectomy for prolapse of the womb before, you can still develop vaginal wall prolapse. This might affect the front or back walls of the vagina, or the very end of the vagina. The very end of the vagina is called the vaginal vault.
What can be done to help?
You could carry on as you are, and although your symptoms might be distressing, you are very unlikely to come to any harm.
If you would prefer to have treatment, you have three options:
• Pelvic floor muscle training with a physiotherapist.
• The use of a vaginal support pessary.
• An operation to repair the prolapse.
There are separate information sheets explaining the benefits and risks of treatments. If you decide to have surgery, there are detailed information sheets explaining each operation. If you wish more information,or if anything is not clear, then please ask your surgeon
Where can I get more information?
The British Society of Urogynaecology
Telephone: 020 7772 6211
Fax: 020 7772 6410
The International Urogynecological Association