Pelvic & vaginal health

Pelvic Organ Prolapse: The Four Main Types

Save

Pelvic organ prolapse is grouped by which organ drops: cystocele involves the bladder, rectocele the rectum, uterine prolapse the uterus, and vaginal-vault prolapse the top of the vagina after hysterectomy. Many women have more than one type together. Mild prolapse is common and often silent, while bulging or pressure warrants evaluation.

Last updated: July 2026

Talk to a clinician

Gale can help you find a clinician in your state and request a visit.

Find care →

What is pelvic organ prolapse?

Pelvic organ prolapse is a loss of support, not a growth or a tumor. A hammock of muscles, ligaments, and connective tissue normally holds the bladder, uterus, and rectum in place above the vagina. When that support weakens, mainly from vaginal childbirth, aging, and the estrogen drop of menopause, one or more organs can sag into the vaginal space 1. According to ACOG, some degree of prolapse is found on examination in up to 1 in 2 women who have given birth, yet fewer than 1 in 10 notice bothersome symptoms 2. The four types describe which organ has lost support, and mixed prolapse, with more than one organ involved, is common in real bodies.

What are cystocele and rectocele?

Cystocele and rectocele are the two most common types, and both involve the vaginal walls. A cystocele, sometimes called a dropped or fallen bladder, occurs when the front vaginal wall weakens and the bladder bulges downward, which often brings a sense of fullness and can affect how completely the bladder empties 1. A rectocele is the mirror image at the back wall, where the rectum presses into the vagina, sometimes making bowel movements harder to pass and occasionally linked to bowel leakage. According to ACOG, these two account for a large share of prolapse, and both can coexist with urinary incontinence 2. Symptoms often worsen by day's end or with prolonged standing.

What about uterine and vaginal-vault prolapse?

Uterine and vaginal-vault prolapse involve the top of the vaginal canal rather than its walls. Uterine prolapse is descent of the uterus and cervix into the vagina, and in advanced cases the cervix can reach or pass the vaginal opening, a stage women often describe as feeling like they are sitting on a ball. Vaginal-vault prolapse occurs after a hysterectomy, when the top of the vagina, no longer anchored by the uterus, drops 1. According to ACOG, vault prolapse follows a small percentage of hysterectomies and may appear years later 2. Both are graded by how far the organ descends, and both can pull on the bladder or rectum, blurring the neat four-type picture. Knowing which compartment is involved guides which treatment is likely to help.

Why does prolapse happen and who gets it?

Prolapse develops when lifetime demands outpace pelvic support. Vaginal birth is the biggest single factor, and risk rises with the number of deliveries, larger babies, and instrumental births. Aging and the fall in estrogen after menopause thin the tissues further, which is why symptoms so often begin or worsen in midlife, while prolapse is uncommon in adolescence and before childbirth. According to ACOG, chronic strain from constipation, heavy lifting, a long-standing cough, and higher body weight all add load, and about 1 in 8 women will have surgery for prolapse or incontinence by age 80 2. Pelvic floor exercises and, in some cases, a pessary can slow or ease mild prolapse 3.

When pelvic organ prolapse needs a gynecologist

A gynecologist's assessment is worth seeking once prolapse causes a noticeable bulge, pressure, or trouble with the bladder or bowels. A visible or palpable bulge at the vaginal opening, difficulty emptying the bladder or rectum, or symptoms that interfere with daily life all merit evaluation. Rarely, a prolapse that cannot be pushed back, along with severe pain or an inability to urinate, needs urgent attention. A clinician can stage the prolapse, identify which organs are involved, and lay out options from pelvic floor therapy and pessaries to surgery. Gale can help you prepare for that visit and describe what you are feeling. Bringing a note on which symptoms bother you most helps the visit focus on what would actually improve your day.

Common questions

They are cystocele (the bladder pressing into the front vaginal wall), rectocele (the rectum pressing into the back wall), uterine prolapse (the uterus descending), and vaginal-vault prolapse (the top of the vagina dropping after a hysterectomy). Many women have more than one at the same time.

Common sensations include a bulge or pressure in the vagina, a feeling that something is falling out, or fullness that worsens through the day. Depending on the type, it can also affect emptying the bladder or having a bowel movement.

It is usually not dangerous, though it can be uncomfortable and affect daily life. Mild prolapse often needs no treatment. Rarely, a prolapse that cannot be reduced or that blocks urination needs prompt care, but most cases are managed without urgency.

Often, yes. Pelvic floor exercises and a pessary, a removable support device, can ease mild to moderate prolapse for many women. Surgery is one option when symptoms are significant, but it is not the only path, and a clinician can outline the choices.

Related

Say it back

How would you explain this to someone you love?

Two or three sentences, just as you’d say it. Gale reflects back what you focused on — a mirror, not a quiz.

Talk to a clinician

Gale can help you find a clinician in your state and request a visit.

Find care →

Prolapse symptoms that need timely care

  • —A prolapse bulge that cannot be pushed back in, with pain or new trouble urinating, is a reason to seek same-day care.
  • —Difficulty emptying the bladder, or a sudden inability to urinate, is a reason to seek urgent care.
  • —Vaginal bleeding, sores, or discharge from exposed prolapsed tissue is a reason to seek clinician review.
  • —A bulge or pressure that interferes with daily life is a reason to seek clinician review.

If a prolapse cannot be pushed back in and you cannot urinate or have severe pain, seek care right away; go to urgent care or the nearest emergency room the same day.

This article is general health education, not medical advice. Diagnosing the type and stage of prolapse and choosing treatment is a decision to make with a gynecologist or urogynecologist.

References

  1. 1.Office on Women's Health (U.S. HHS) (2025). Pelvic organ prolapse. Office on Women's Health (womenshealth.gov), U.S. HHS. link ✓Patient-facing overview of pelvic organ prolapse and its main types, describing cystocele, rectocele, uterine, and vaginal-vault prolapse in plain language
  2. 2.American College of Obstetricians and Gynecologists (2019). Pelvic Organ Prolapse: ACOG Practice Bulletin, Number 214. Obstetrics & Gynecology. doi:10.1097/AOG.0000000000003519 ✓Prolapse is frequently found on examination while fewer women have bothersome symptoms, vault prolapse can follow hysterectomy, and about 1 in 8 women undergo surgery for prolapse or incontinence by age 80
  3. 3.Hagen S, Stark D (2011). Conservative prevention and management of pelvic organ prolapse in women. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD003882.pub4 ✓Conservative measures including pelvic floor muscle training and pessaries can prevent progression and ease symptoms of mild pelvic organ prolapse

3 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — every citation independently verified. Editorial policy

← Back to the health library