Causes and Symptoms

Symptoms of Pelvic Organ Prolapse may include: pelvic pressure or pain, urinary symptoms, recurrent pain with intercourse, a visible bulge in the vaginal area that often worsens with lifting or straining, constipation, and having to push down on the vagina to move your bowels. Urinary symptoms may include: frequent urination, sudden urges to go, loss of urine control, and recurrent urinary tract infections.

Several things can “drop” within the vagina and they all have different possible symptoms and treatments. A cystocele (pronounced cysto-seal) is a loss of bladder support allowing the bladder to push into the vaginal canal. A rectocele (pronounced recto-seal) is when the rectum bulges into the lower part of the vagina. A prolapsed uterus refers to the loss of ligament support to the uterus and leads to the uterus dropping into the vaginal canal.  Apical prolapse refers protrusion of the “cuff” at the top of the vagina. This “cuff” is present after having a hysterectomy. Finally, an enterocele (pronounced entero-seal) refers to small intestine protruding around the “cuff.”


A detailed history and examination is the first step in evaluation of all forms of POP. Your doctor may ask you to keep a brief diary of any urinary symptoms and adjunctive testing may be indicated. A cystoscopy is a look inside the bladder. This is an excellent way to determine the extent of the problem because the prolapse can be visualized with both an empty and full bladder. The procedure is done in the office and only takes a few minutes. Some numbing jelly is placed on the urethra. An urodynamics assesses the function of your bladder. This is important to do prior to intervening on POP to see what effects lifting the bladder into place may have on urination. It is a test done in the office and takes about an hour to complete. On rare occasions an MRI of the pelvis may be ordered to image the pelvic organs and their movement.

At Alpine Urology, we care about you and your urological needs. We encourage you to make an appointment to discuss your treatment options.