Women's Health Matters

Text Size
Jump to body content

Medical Description

The pelvic floor is a layer of muscles that stretches like a hammock from the pubic bone at the front of the pelvis to the base of the spine in the back. These muscles support the weight of the pelvic organs and enable everyday activities like walking and sitting. Ligaments within the pelvis hold the organs in place.

The pelvic floor muscles also play a crucial role in the functioning of pelvic organs. For example, bands of muscle encircle the urethra (the opening you urinate through) and bowel. These bands are called sphincters. Sphincters control the release of urine and feces. Other muscles surrounding these organs control the filling and emptying of the bowel and bladder.

Muscles throughout the pelvis also work when a woman gives birth. Some of these same muscles contribute to the enjoyable sensations of female orgasm.

Damage or weakness in these muscles can interfere with all of these functions. One of the most obvious signs of damage is a prolapse.

Think of the pelvic floor as a mesh of muscles, like a nylon stocking. When these muscles are weakened or damaged, runs or even holes appear in the mesh and it can no longer support the pelvic organs. A prolapsed organ is an organ that has shifted position and begun to protrude through this mesh. Most commonly, prolapsed organs press down against the vagina, since this is the largest opening to the pelvic floor. This causes a bulge in the wall of the vagina. In severe cases, a prolapse can push part of the vaginal wall out through the vaginal opening.

Types of Prolapse

There are several types of prolapse. Prolapse can affect one or more of the muscles and organs in the pelvis. These include the bladder, urethra, uterus, vagina, small bowel and rectum.

Cystocele
Rectocele If the muscles in front of the vagina are weakened, the bladder will begin to bulge into the vagina. This is called a cystocele. The most common symptoms of cystocele are:

  • difficulty emptying your bladder
  • leaking of urine, especially when you cough, sneeze or laugh
  • pain during sexual intercourse

Rectocele
If the muscles behind the vagina are damaged, the rectum will begin pressing into the vagina. This is called a rectocele. The most common symptoms of rectocele are:

  • a bulge in your vagina
  • constipation and difficulty completing bowel movements
  • a feeling of rectal pressure
  • painful sexual intercourse

Enterocele
If the muscles and tissues that hold your small bowel (or small intestines) in place stretch or weaken, the small intestines press down on the vagina. This is called an enterocele. The most common symptoms of an enterocele are:

  • a feeling of heaviness or fullness in the vagina
  • constipation or difficulty completing bowel movements
  • lower back pain that gets worse when you’ve been standing for a long time and eases when you lie down
  • a bulge in your vagina
  • vaginal discharge
  • vaginal bleeding
  • painful sexual intercourse

Uterine Prolapse
If the muscles and ligaments of your pelvic floor stretch or weaken, the uterus can drop down into the vagina. This is called a uterine prolapse. The most common symptoms of a uterine prolapse include:

  • menstrual-like cramps
  • a feeling of heaviness or pulling in your pelvis
  • constipation
  • urinary incontinence
  • lower back pain

Vaginal Vault Prolapse
When the upper part of the vagina sags or drops down into the vaginal canal or (in severe cases) outside the vagina, this is called a vaginal vault prolapse. This type of prolapse usually affects women who have had a hysterectomy. This is usually due to muscle damage that occurred during surgery.

The most common symptoms of a vaginal vault prolapse are:

  • a feeling of pressure in the abdomen and vagina
  • painful intercourse
  • back pain
  • vaginal bleeding
  • urinary incontinence

 

The pelvic floor is a layer of muscles that stretches like a hammock from the pubic bone at the front of the pelvis to the base of the spine in the back. These muscles support the weight of the pelvic organs and enable everyday activities like walking and sitting. Ligaments within the pelvis hold the organs in place.

The pelvic floor muscles also play a crucial role in the functioning of pelvic organs. For example, bands of muscle encircle the urethra (the opening you urinate through) and bowel. These bands are called sphincters. Sphincters control the release of urine and feces. Other muscles surrounding these organs control the filling and emptying of the bowel and bladder.

Muscles throughout the pelvis also work when a woman gives birth. Some of these same muscles contribute to the enjoyable sensations of female orgasm.

Damage or weakness in these muscles can interfere with all of these functions. One of the most obvious signs of damage is a prolapse.

Think of the pelvic floor as a mesh of muscles, like a nylon stocking. When these muscles are weakened or damaged, runs or even holes appear in the mesh and it can no longer support the pelvic organs. A prolapsed organ is an organ that has shifted position and begun to protrude through this mesh. Most commonly, prolapsed organs press down against the vagina, since this is the largest opening to the pelvic floor. This causes a bulge in the wall of the vagina. In severe cases, a prolapse can push part of the vaginal wall out through the vaginal opening.

Jump to top page

This website proudly supported by:


Pelvic Prolapse

Medical Description

Diagnosis

Coping

Treatment

FAQs


Discussion Groups

Share knowledge and talk about your gynecological health-related experiences with other women.

Gynecological Health Discussion Forum

  • A publication of:
  • Women's College Hospital