Coping with a Prolapse

Prolapse of the posterior (back) vaginal wall

Rectocele (prolapse of the rectum) - This type of vaginal prolapse involves a prolapse of the back wall of the vagina (rectovaginal fascia). Rectoceles and enteroceles develop if the lower pelvic muscles become damaged by pregnancy, labour, childbirth, or a previous pelvic surgery or when the muscles are weakened by aging. When this wall weakens, the rectal wall pushes against the vaginal wall, creating a bulge. This bulge may become especially noticeable during bowel movements. Rectocele and enterocele formation may occur together, especially in women who have had a hysterectomy (removal of the uterus or womb). There are many different kinds of Pelvic Floor Exercises that you can use to combat these symptoms.
• Enterocele (prolapse of the small bowel) - Part of the small intestine that lies just behind the uterus (in a space called the pouch of Douglas) may slip down between the rectum and the back wall of the vagina. This often occurs at the same time as a rectocele or uterine prolapse.
• Rectocele (prolapse of the rectum or large bowel) - This occurs when the end of the large bowel (rectum) loses support and bulges into the back wall of the vagina. It is different from a rectal prolapse (when the rectum falls out of the anus). A rectocele or an enterocele may become large or more obvious when a woman strains or bears down during a bowel movement.

Pelvic Organ Prolapse

Prolapse is when the pelvic floor muscles become weak or damaged and can no longer support the pelvic organs. The movement of the vaginal wall from its normal position along with the bladder, bowel or womb is caused by damage to the ligaments in the pelvis. These ligaments act as guy ropes supporting the womb and the strength giving layers overlying the bowel and bladder.

The main causes of prolapse are childbearing and any condition leading to chronic straining (constipation, smokers cough or being overweight). The womb (uterus) is the only organ that actually falls into the vagina. When the bladder and bowel slip out of place, they push up against the walls of the vagina.

While prolapse is not considered a life threatening condition it may cause a great deal of discomfort and distress. Some degree of prolapse affects up to 30% of women who have had children. It is more common as women age, and is rarely seen in women without children, or those who have not gone through the menopause. If you are in any doubt whether or not you are going through the menopause, there are lots of over-the-counter menopause tests that you can now buy. Its better you know than to worry about this.

There are a number of different types of prolapse that can occur in a woman's pelvic area and these are divided into three categories according to the part of the vagina they affect: front wall, back wall or top of the vagina. It is not uncommon to have more than one type of prolapse.

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