Your gynecologist or urogynecologist diagnosed you with pelvic organ prolapse. What does this mean?
Pelvic organ prolapse is defined by Haylen et al. as “the descent of one or more of the anterior vaginal wall, posterior vaginal wall, the uterus (cervix), or the apex of the vagina (vaginal vault or cuff scar after hysterectomy).”
We can think about structures “relaxing” back into the front of the vaginal wall (anterior wall) or falling forward into the back of the vaginal canal (posterior wall).
The American College of Obstetricians and Gynecologists has animations of the different types of prolapses that help illustrate what happens internally. The American Urogynecologic Society offers a beautifully designed pelvic organ prolapse fact sheet with illustrations.
What are the types of pelvic organ prolapse?
The type of prolapse is named for the organs that “fall down” and cause the vaginal walls to bulge and descend.
Cystocele, urethrocele, and urethrocystocele
Also in the front, a woman might be diagnosed with a urethrocele (urethra) or urethrocystocele (both urethra and bladder desend back toward the vaginal wall).
Symptoms of a cystocele
Since a cystocele is an architectural change where the bladder has relaxed into the anterior (front) vaginal wall, your urinary function might be altered. You might feel a bulge, or feel like there is something stuck in your vagina. You may also experience sexual dissatisfaction.
Some women will experience a slower trickle during urination, which results in a longer stream duration. Sometimes it might be hard to start the flow of urine or be able to stop midstream. (Note: stopping midstream is confusing for the bladder and should not be practiced as a way of strengthening your pelvic floor.)
Some women experience a urine stream that starts and stops a few times while voiding. This can lead to incomplete bladder emptying or urinary retention. This can also lead to increased urinary frequency because your bladder has not emptied it’s capacity, and the woman will feel the first urge to urinate sooner than normal. Cystocele may also lead to urinary incontinence.