Types of Incontinence and Prolapse

Pelvic floor conditions are problems that affect women's pelvic organs: the uterus, vagina, bladder, rectum and the muscles that surround and support them.

The three most common problems are:

  • Difficulties with bladder control
  • Difficulties with bowel control
  • Pelvic organ prolapse

Difficulties with Bladder Control (Urinary Incontinence)

Bladder control problems are very common, especially among older adults. Incontinence can be a short-term problem caused by a urinary tract infection, use of medications, or illness. But when bladder control becomes an ongoing problem, it is considered a chronic condition that may require medical or surgical treatment.

There are two main kinds of chronic incontinence. Some women have both.

  • Stress incontinence is the most common type among women. It occurs when you sneeze, cough, laugh, jog, or do other things that put pressure on your bladder.
  • Urge incontinence, also called overactive bladder, is the inability to hold urine long enough to reach a restroom. It can happen even when your bladder is holding only a small amount of urine. Some women may have no warning before they accidentally leak urine. Other women may leak urine when they drink water or when they hear or touch running water.

Pelvic Organ Prolapse

Pelvic organ prolapse occurs when a pelvic organ drops (prolapses) from its normal spot in the lower belly and pushes against the walls of the vagina. This can happen when the muscles that hold the pelvic organs in place are stretched or weakened, often as a result of surgery or childbirth.

Prolapse is not dangerous, but can cause symptoms of pressure and difficulty emptying the bladder and/or bowels. Prolapse can often be managed conservatively with exercises and the use of a pessary. Pessaries can be managed at home or in the office by a nurse. If these conservative measures are not successful, there are a variety of surgical options available.

Surgery can often fix pelvic organ prolapse and treat any stress incontinence that has occurred as a result of the prolapse. Some of the common types of prolapse and their surgical treatments include:

  • Bladder prolapse (cystocele): This is when the bladder sags into the vagina. To fix this, the bladder is moved back into its normal position. It is then sewn into place
  • Uterine prolapse: This is when the uterus sags into the vagina, sometimes as far as the opening of the vagina. To fix this, the uterus is often removed (hysterectomy) or sewn back into place.
  • Vaginal vault prolapse: This is when the walls of the vagina fall in on themselves. It can happen if the uterus has been surgically removed. In this case, another surgery can be done to lift the vagina and hold it into place.
  • Rectocele or enterocele: A rectocele occurs when the rectum bulges into the vagina. An enterocele (much less common) is when the small intestine bulges into the vagina. During surgery, the bulge in the rectum or small intestine can be fixed.


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