You have been told about rectocele, cystocele, organ prolapse… all terms that may be unfamiliar to some and, unfortunately, all too familiar to others. Today, in this article, we explain the main symptoms of an organ prolapse and how they relate to the pelvic floor.
No, this word should not be taboo — quite the opposite. We need to talk about this condition, which affects more than 10 % of women at some point in their lives.
How do you detect a prolapse?
A prolapse is the descent of one or more pelvic organs (bladder, uterus or rectum) into the vagina. These organs, normally located in the pelvic cavity, are held in place by fibres, muscles and ligaments.
The link between the pelvic floor and organ prolapse
And it is this famous pelvic floor that supports these organs from below (when we told you this pelvic floor needed looking after, there was a reason!). However, a woman's pelvic floor is fragile because of the openings that pass through the pelvic diaphragm.
What is more, the muscles and ligaments holding these organs can slacken. This creates pressure on the vaginal wall, sometimes leading to part or all of the organs sliding towards the vagina.
The different types of prolapse
There are several types of prolapse, but the three main ones are:
- Cystocele (or bladder prolapse): this is the descent of the bladder into the vagina. It is the most common form of prolapse, accounting for 4 cases out of 5.
- Hysterocele (or uterine prolapse): this is the descent of the uterus into the vagina.
- Rectocele: as you will have gathered, this is the descent of the rectum into the vagina.
How do you know if you have an organ prolapse?
Depending on the stage of your organ prolapse, certain signs can suggest a prolapse and should alert you. Here are some typical symptoms of an organ prolapse to watch for.
Symptoms frequently associated with a prolapse
When the prolapse is not at a very advanced stage, it is entirely possible to feel no discomfort at all. It is worth noting that only 10 % of women affected by an organ prolapse experience discomfort.
You therefore need to be very attentive to any other symptom that might appear in the lower abdominal area and be connected to an organ prolapse.
For example, if urine leaks, urinary infections, anal incontinence, constipation or discomfort during sexual intercourse appear, do not hesitate to discuss it with a healthcare professional so they can carry out an overall assessment of the situation and rule an associated condition in or out.
Detecting a low-grade prolapse
Often, the discomfort may only appear during physical activity, such as sport or an effort like carrying a heavy load. If you feel a sensation of heaviness at the pelvic floor or vagina, or a weight on your bladder, a gynaecological examination with a healthcare professional is strongly advised.
With a cystocele, you may have difficulty urinating (weak stream) and the feeling of not managing to empty your bladder. You may also frequently and suddenly feel an irresistible urge to urinate.
With a descent of the rectum (rectocele), you may feel difficulty passing stools and not manage to empty your bowels completely.
Detecting an advanced-stage prolapse
When the organ prolapse is at an advanced stage, the genital prolapse will come outside. You may then see a "bulge" emerging from your vagina. This bulge can cause a sensation of discomfort at the vulva.
Depending on its position, it may suggest a cystocele if it is towards the front, or a rectocele if it is further back. In every case, the prolapse can worsen if it is not treated in time. Surgery then becomes unavoidable.
The aggravating factors of an organ prolapse
A prolapse can occur at any point in a woman's life. But the risk does increase with age and the slackening of tissues.
Other factors also increase the risk of a prolapse occurring, for example:
- pregnancy;
- vaginal delivery;
- intensive sporting activity;
- a situation of excess weight;
- constipation;
- a digestive disorder requiring straining;
- carrying heavy loads;
- a chronic cough;
- the onset of menopause…
Indeed, without you even realising it, all these factors are closely tied to the health of your pelvic floor!
Looking after your pelvic floor throughout your life and toning it as a preventive measure is therefore essential to avoid an organ prolapse. If you are among the women at risk, preventive pelvic floor rehabilitation sessions may be prescribed for you.
Toning your pelvic floor to ease the symptoms of a prolapse
If you have symptoms or are at the start of a prolapse, pelvic floor rehabilitation is always strongly advised before considering surgery.
A prolapse managed in time is not irreversible. Thanks to pelvic floor rehabilitation, you can strengthen your pelvic muscles and reduce the risk of your prolapse worsening.
This is exactly what happened to Eve, who was able to avoid a second organ prolapse thanks to pelvic floor rehabilitation (testimonial originally collected in French). However, if the prolapse is at too advanced a stage, surgical treatment will most likely still need to be considered.
In any case, if after reading this article you have a doubt about having a prolapse, book an appointment with a healthcare professional who will be able to help you and recommend a suitable treatment.
How do you tone your pelvic floor?
To tone your pelvic floor and keep it in good shape, you can go to a healthcare professional (physiotherapist or midwife) for pelvic floor rehabilitation sessions.
Once these are finished, it is important to keep contracting your pelvic floor regularly to maintain the benefits of the sessions over the long term. You can continue to tone it at home on your own thanks to the Emy app, which lets you do playful exercises based on medical protocols.
And for even more effective training, you can use the Emy connected biofeedback probe to see your contractions in real time on your smartphone. This solution lets you genuinely track your development and progress over time.
Sources
- The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction, R C Bump, A Mattiasson, K Bø, L P Brubaker, J O DeLancey, P Klarskov, B L Shull, A R Smith, July 1996, American Journal of Obstetrics and Gynecology 175(1):10-7 – link
- Pelvic Organ Prolapse: ACOG Practice Bulletin, Number 214, American College of Obstetricians and Gynecologists, November 2019, Obstetrics and Gynecology 134(5):e126-e142 – link
- Evaluation and Management of Pelvic Organ Prolapse, Rubin Raju, Brian J Linder, December 2021, Mayo Clinic Proceedings 96(12):3122-3129 – link
- Clinical assessment of pelvic organ prolapse by consecutive cough maneuver, S Pacquée, H P Dietz, May 2022, International Urogynecology Journal 34(1):185-190 – link
- Epidemiology and outcome assessment of pelvic organ prolapse, Matthew D Barber, Christopher Maher, November 2013, International Urogynecology Journal 24(11):1783-90 – link
- Conservative prevention and management of pelvic organ prolapse in women, Suzanne Hagen, Diane Stark, December 2011, Cochrane Database of Systematic Reviews 2011(12):CD003882 – link
