Although some women with POP have no symptoms, others may experience:
- A bulge near the opening of the vagina or have a pressure sensation in their pelvic region and or lower abdomen that worsens by the end of the day or during bowel movements.
- The feeling of “sitting on a ball.”
- Discomfort (usually pressure or fullness).
- Bleeding from the exposed skin that rubs on pads or underwear.
- Urinary symptoms of leakage, difficulty starting the stream of urine, frequent urinary tract infections.
- Difficult bowel movements—the need to strain or push on or around the vagina to have a bowel movement.
- Urinary frequency or the sensation that you are unable to empty the bladder well.
- Lower back discomfort.
- The need to lift up the bulging vagina or uterus to start urination.
- Urinary leakage with intercourse.
Types of Prolapse
Anterior Vaginal Wall Prolapse (Cystocele)
Anterior vaginal wall prolapse often occurs when there is a loss of support to the front wall of the vagina. The bladder drops down and vaginal tissue may bulge from the opening. Symptoms typically include:
- A bulge sensation
- Urinary symptoms
- The need to put your finger in or around the vagina to help empty the bladder
Posterior Wall Prolapse (Rectocele or Enterocele)
This type of prolapse occurs when there is a loss of support to the back wall of the vagina. With this loss of support, the rectum or intestines drops down and vaginal tissue may bulge from the opening. Symptoms typically include:
- A bulge sensation
- Problems having a bowel movement
- The need to put your finger in or around the vagina or rectum to help empty bowels
Apical Prolapse (Vaginal Vault Prolapse) or Uterine Prolapse
Apical prolapse occurs when there is a loss of support to the uterus and the top part of the vagina (called the cuff, apex or vault after a hysterectomy). Often, uterine or apical prolapse is associated with loss of anterior or posterior vaginal wall support.
Like the vagina and uterus, ligaments and muscles securely attach the rectum to the pelvis. Infrequently, the supporting structures stretch or detach from the rectal wall and the rectum comes out through the anus. This is different from a rectocele where the posterior wall of the vagina falls out through the vaginal opening. Early on, women may notice a soft, red tissue protruding from the anus after a bowel movement. Other symptoms may include:
- Pain during bowel movements.
- Mucus or blood discharge from the protruding tissue.
- Loss of control of bowel movements.
Risk factors for rectal prolapse include conditions associated with straining such as chronic constipation or diarrhea, nerve and muscle weakness (paralysis or multiple sclerosis), and advancing age.