Breaking the Silence around Pelvic Organ Prolapse

Organ descent, or prolapse, affects nearly one in three women during their lifetime¹, but remains too often a taboo subject.
This condition, which affects the uterus, bladder, or rectum, manifests as a feeling of heaviness, pelvic discomfort, or even urinary or digestive disorders, which can affect daily life.

Fortunately, there are now several effective solutions: pelvic rehabilitation, pessary, surgical intervention, and even innovations like the Pelvinity support underwear, designed to gently support the pelvic organs without discomfort.

This article guides you transparently, with simple illustrations to better understand the mechanisms of prolapseits symptoms, its causes, and especially, the concrete options to regain well-being and confidence.

What is an organ descent (prolapse)?
How do we know if we have a prolapse?
Photos of organ descent: what does it look like?
What are the 3 causes of a prolapse?
What solutions exist to treat a prolapse?
FAQ

What is an organ descent (prolapse)?

Medical definition of prolapse

Prolapse, also called organ descent, refers to the abnormal slipping of one or more pelvic organs through the vagina, due to a weakening of the supporting tissues such as muscles, ligaments, and connective tissue of the pelvic floor. This condition occurs when the structure that holds the organs in place is altered, often after a childbirth, with age or related to aggravating factors such as chronic constipation or repeated effort (chronic cough, heavy lifting...).

This phenomenon can cause a sensation of "lump" in the vagina, persistent discomfort when standing, or even pelvic pain and urinary disorders. There are several stages of severity, from simple internal sagging up to partial or total externalization through the vulvar opening.

The affected organs: uterus, bladder, rectum

Three main organs can be affected by a prolapse:

The uterus: referred to as uterine prolapse or hysterocele
The bladder: called cystocelee
The rectum: in the case of a rectocele

Other forms of prolapse, rarer but possible, include urethrocele (prolapse of the urethra) and enterocoele (hernia of the intestine into the vagina).

How do we know if we have a prolapse?

The most common symptoms

The signs of a prolapse vary depending on theorgan concerned and the severity of the stage. Among the most common symptoms:

Feeling of heaviness in the pelvis or vagina
Feeling of a "lump" or foreign body in the vagina
Discomfort in prolonged standing, relieved when lying down
Urinary leaks, frequent urges to urinate, or on the contrary, difficulty in
emptying the bladder
Constipation or a feeling of obstruction during defecation
Pain during sexual intercourse
Discomfort or chronic pain in the lower back.

These symptoms may fluctuate depending on the time of day, physical activity or position. It is important to consult a doctor or gynecologist as soon as these symptoms appear.

How to differentiate from other pelvic disorders?

Prolapse is often confused with other pelvic disorders, such as isolated urinary incontinence or recurrent urinary infections. However, the sensation of "falling" or a lump in the vagina remains quite specific.

Only a gynecological examination can provide an accurate diagnosis. During this examination, the healthcare professional assesses the stage of the prolapse (from 1 to 4) according to the Baden-Walker classification or POP-Q. A stage 1 prolapse is mild and may go unnoticed, while stage 4 corresponds to the complete externalization of the organ.

Photos of organ descent: what does it look like?

Visual examples of different types of prolapse

It is often difficult to imagine what a prolapse looks like without a clear illustration. However, visualizing things helps to better understand the nature of the problem and to break taboos.

Here are some examples of prolapse:

Cystocele (bladder): The cystocele corresponds to a hernia of the bladder into the anterior wall of the vagina. Under normal circumstances, the bladder rests just above the vagina, supported by the pubovaginal fascias and ligaments.
When these tissues are stretched or torn, the bladder begins to push down, bulging the anterior vaginal wall.
Hysterocele (uterus): In this case, it is the uterus itself that descends vertically along the axis of the vagina. This type of prolapse is axial: the organ gradually slips down, pulling with it the tissues that form the vaginal vault.
Rectocele (rectum): A rectocele is a hernia of the rectum into the vagina through the posterior vaginal wall. It occurs when the rectovaginal fascia is damaged or weakened, often after childbirth or chronic constipation.

What do the stages of a prolapse look like?

Prolapse is classified into several stages:

Stage 1: slight descent of the organ, with no visible passage at the level of the vagina.
Stage 2: the prolapse reaches the entrance of the vagina, without exceeding it.
Stage 3: the organ partially protrudes from the vagina, causing discomfort important.
Stage 4: complete descent, with externalization of the organ.

Each stage corresponds to a different level of discomfort, pain, and functional disorders. The more advanced the stage, the more management will likely be directed towards a surgical solution.

What are the 3 causes of a prolapse?

Pregnancies and deliveries: main triggers

Vaginal deliveries, especially those requiring the use of instruments (forceps, vacuum), are one of the primary causes of descent of organs.

During expulsion, the ligaments and supportive tissues may undergo excessive stretching or even tearing, compromising their ability to keep the pelvic organs in place.

The baby's weight, the duration of labor, prolonged pushing efforts, or even an episiotomy can increase this risk.

In some women, the first signs may appear very early, within weeks or months following childbirth.

Aggravating factors: menopause, heavy lifting, constipation…

In addition to pregnancies, several factors increase the risk of prolapse:

Menopause: hormonal decline weakens the tissues of the pelvic floor.
Repeated heavy lifting (professional or domestic).
Chronic constipation: regular straining increasing pressure on the pelvis.
Chronic cough, especially in smokers or asthmatics.
Overweight and obesity: abdominal weight pressing on the pelvic floor.

All these elements create downward pressure, gradually weakening the structures that support the pelvic organs.

Genetic background or tissue fragility?

Some women are naturally at higher risk due to a tissue looser or less resilient connective tissue.

This hereditary factor would explain why some develop a prolapse even without childbirth or obvious triggering factors.

Studies² have also shown a link between certain collagen abnormalities (a major component of supportive tissues) and genital prolapse.

Age, for its part, remains a major factor³: with the years, the muscles and ligaments naturally relax.

What solutions exist to treat a prolapse?

Perineal rehabilitation: the first essential step

The pessary is a soft silicone medical device, inserted into the vagina to keep the organs in place.

There are different shapes (ring, cube, perforated disk…) and sizes depending on the patient's morphology and the type of prolapse (uterine, cystocele, rectocele…).

This solution is:

Reversible and adjustable
Suitable for women who do not wish to or cannot undergo surgery
Often used in waiting for an intervention or during menopause

The pessary must be placed by a gynecologist or a trained healthcare professional, and checked regularly. It is compatible with normal sexual life and can effectively relieve daily discomfort.

The pessary: a non-surgical alternative

Perineal rehabilitation is the first response to consider when a prolapse is detected, especially at stages 1 and 2. This non surgical approach consists of strengthening the pelvic floor muscles that support the organs such as theuterus, the bladder or the rectum. It is often prescribed after childbirth, but can also be useful for menopausal women or as prevention.
Different methods can be used:

Kegel exercises
Biofeedback with vaginal probe
Muscle electrostimulation
Postural and respiratory work

These techniques aim to restore better support of the vagina and reduce symptoms such as pelvic discomfort, incontinence, or a feeling of heaviness. If done well, rehabilitation can be enough to avoid intervention, or even stop the progression of the prolapse.

Surgical intervention: when and how?

When the prolapse is advanced (stage 3 or 4), or in case of failure of the treatments conservatives, surgical intervention may be considered. There are several techniques depending on the nature of the prolapse, the woman's age, her maternity plans, and her overall medical situation. The most common surgeries include:

Colporrhaphy: reinforcement of the vaginal wall (anterior or posterior)
Uterine fixation: suspension of the uterus or vagina on the ligaments or sacral bone
Hysterectomy: removal of the uterus, sometimes necessary in cases of severe uterine prolapse
Placement of slings or meshes (note: some methods with mesh are controversial). Their use is now strictly regulated.

Hospitalization is often short (1 to 3 days) with a recovery period of several weeks.

Surgery can be performed via the lower route (vaginal), upper (abdominal or laparoscopic), depending on the cases. It generally offers an excellent improvement in quality of life.

Pelvinity: the compression panty

Among non-invasive solutions, the Pelvinity panty is an innovationrecent, CE certified medical device, designed for active women suffering from mild to moderate prolapse. This solution is ideal for those troubled by the ring or cube pessary.

Designed specifically for women suffering from prolapse or vulvar varices, it provides effective support and relief thanks to a compression hammock.