Vaginal prolapse is a condition in which structures such as the uterus, rectum, bladder, urethra, small bowel, or the vagina itself may begin to prolapse, or fall, out of their normal positions. Without medical treatment or surgery, these structures may eventually prolapse farther and farther into the vagina or even through the vaginal opening if their supports weaken enough.
The symptoms that result from vaginal prolapse commonly affect sexual functions and bodily functions such as urination and defecation. Pelvic pressure and discomfort are also common symptoms.
Common factors that may cause a vaginal prolapse include childbirth, menopause, or previous hysterectomy. Other risk factors of a vaginal prolapse include advanced age, obesity, dysfunction of the nerves and tissues, abnormalities of the connective tissue, strenuous physical activity, and prior pelvic surgery.
The symptoms associated with a vaginal prolapse depend on the type of vaginal prolapse present. The most common symptom of all types of vaginal prolapse is the sensation that tissues or structures in the vagina are out of place. The feeling can be described as “something coming down” or as a dragging sensation. This may involve a protrusion or pressure in the area of the sensation. Generally, the more advanced the prolapse, the more severe the symptoms.
The following are general symptoms you may experience when suffering from vaginal prolapse:
- Pressure in the vagina or pelvis
- Painful intercourse (dyspareunia)
- A lump at the opening of the vagina
- A decrease in pain or pressure when the woman lies down
- Recurrent urinary tract infections
The following are symptoms that are specific to certain types of vaginal prolapse:
- Difficulty emptying bowel – may indicate vaginal vault prolapse (when the upper part of the vagina loses its normal shape and sags into the vaginal canal), or prolapsed uterus. A woman with difficulty emptying her bowel may find that she needs to place her fingers on the back wall of the vagina to help evacuate her bowel completely.
- Difficulty emptying bladder – may indicate the dropping of either the bladder (cystocele), the vaginal vault (the upper part of the vagina), the small intestine (enterocele), the urethra (urethrocele), or uterus
- Constipation – this is the most common symptom of a rectocele, a bulge of the front wall of the rectum into the vagina. The rectal wall may thin, weaken and it may balloon out into the vagina when you push down to have a bowel movement
- Urinary stress incontinence – this is a common symptom of a bladder which has fallen out of place (cystocele)
- Pain that increases during long periods of standing – This may indicate small intestine prolapse (enterocele), vaginal vault prolapse, or a prolapsed uterus
- Protrusion of tissue at the back wall of the vagina – This is a common symptom of a rectocele, a bulge of the front wall of the rectum into the vagina.
- Protrusion of tissue at the front wall of the vagina – This is a common symptom of a prolapsed urethra (urethrocele) or bladder (cystocele)
- Enlarged, wide, and gaping vaginal opening – This is a common symptom of a vaginal vault prolapse (when the upper part of the vagina loses its normal shape and sags into the vaginal canal)