The cause of prolapse may be an increase in abdominal pressure, such as obesity. Other causes include childbirth, pregnancy and labor (the most common cause of POP), chronic coughing because of a respiratory problem, pelvic organ cancers, constipation or a hysterectomy in which the uterus is surgically removed.
Anterior Prolapse
Cystocele, or anterior prolapse, occurs when the bladder prolapses. The bladder bulges into the vagina because the supportive tissue between the woman’s bladder and vaginal wall weakens and stretches. Prolapse causes can include muscle strain, so those who have gone through vaginal childbirth are at risk as are those who have violent coughing fits, constipation or perform heavy lifting.
In mild cases of anterior prolapse, there may be few -- or no -- symptoms. But signs of cystocele include fullness or pressure in vagina or pelvis, the feeling of not completely emptying the bladder after urination, pain or urine leakage during intercourse, repeated bladder infections, and increased discomfort when straining or coughing. In severe cases, tissue may protrude from the vagina.
Some risks include obesity, one or more vaginal births and having a hysterectomy, but also include aging because of the pronounced reduction in estrogen production. Estrogen keeps this region’s connections strong and flexible, and with the advent of menopause, estrogen becomes scarce. And having a genetic predisposition to weaknesses in connective tissues allows an anterior or almost any kind of prolapse to take hold.
One form of treatment is with a supportive device, or pessary, a plastic tube or ring inserted into the vagina to support the bladder. There is also estrogen therapy. Estrogen helps make collagen, a protein that helps support pelvic tissues to stretch and return to shape. The lower the estrogen levels, the lower the collagen levels in the body. This condition is found more often in women with multiple sclerosis, muscular dystrophy and spinal cord injury.