Pelvic organ prolapse (POP) is a condition where one or more pelvic organs descend from their normal position and bulge into the vagina. This is a common occurrence after childbirth, affecting up to 50% of women. Understanding the visual indicators of this condition is a practical step for individuals navigating the postpartum period. This article clarifies what prolapse can look like following delivery.
What Pelvic Organ Prolapse Is
Pelvic organ prolapse develops when the muscles and connective tissues that form the pelvic floor weaken. This supportive structure, often described as a hammock, holds organs such as the bladder, uterus, rectum, and small intestine in their proper places within the pelvis. When this support system is compromised, these organs can shift and descend, creating a bulge into the vaginal canal.
Childbirth is a significant factor contributing to pelvic floor weakening. The pressure and stretching endured during pregnancy and vaginal delivery can damage these muscles and ligaments. Hormonal changes during pregnancy, such as increased relaxin, also soften ligaments. This combination of physical strain and hormonal influence can lead to a loss of pelvic floor integrity, allowing organs to move out of alignment.
How Different Types of Prolapse Appear
The appearance of pelvic organ prolapse varies depending on the organ that has descended and the condition’s severity. A common sign is a bulging sensation or visible tissue at the vaginal opening. The degree of protrusion can range from a slight internal bulge to tissue extending outside the body.
A cystocele, or bladder prolapse, occurs when the bladder pushes into the front wall of the vagina. This often appears as a smooth, rounded bulge on the anterior (front) vaginal wall. In more advanced cases, this bulge may extend to or even protrude through the vaginal opening.
A rectocele occurs when the rectum bulges into the back wall of the vagina. This type of prolapse presents as a soft bulge of tissue on the posterior (back) vaginal wall. Its size can vary from a small internal protrusion to a more noticeable mass that emerges from the vaginal opening.
Uterine prolapse involves the uterus descending into the vagina. The cervix, the lower part of the uterus, may be seen or felt at or outside the vaginal opening. The entire uterus can drop, appearing as a mass protruding from the vagina.
An enterocele, or small intestine prolapse, occurs when a section of the small intestine pushes into the upper back wall of the vagina, creating a bulge. Enteroceles often occur alongside other types of prolapse, so their visual presentation may be combined with a cystocele or rectocele.
Distinguishing Prolapse from Normal Postpartum Changes
The postpartum period involves many natural physical changes as the body recovers from childbirth. Immediately after delivery, the perineum, the area between the vagina and anus, commonly experiences swelling, bruising, and tenderness. This normal swelling and general vaginal soreness are a standard part of recovery due to increased blood flow and fluid accumulation during pregnancy and birth.
This typical postpartum swelling is usually most noticeable in the first week and generally subsides within a few days to several weeks as the body eliminates excess fluids. Many individuals describe a feeling of fullness or pressure, or even a sensation like a “golf ball” in the vagina. However, a persistent or defined bulge that does not diminish over weeks, or one that worsens with standing or activity, is more indicative of a prolapse.
Unlike the temporary nature of postpartum swelling, prolapse involves a structural shift of organs. While normal tissue healing progresses and discomfort lessens, a prolapse will remain or may become more apparent over time. The visible signs of prolapse, such as a distinct bulge of tissue from the vaginal walls or cervix, are different from the diffuse swelling associated with normal recovery.
When to Consult a Healthcare Professional
If you observe any persistent bulging tissue at or near your vaginal opening after childbirth, consult a healthcare professional. This includes any visual signs resembling cystocele, rectocele, uterine prolapse, or enterocele. Individuals should also seek medical attention if they experience discomfort, such as a feeling of heaviness or pressure in the pelvis, or difficulties with urination or bowel movements.
A medical professional can diagnose the type and severity of any prolapse through a physical examination. While visual information can be concerning, only a healthcare provider can confirm whether the observed changes are pelvic organ prolapse and discuss appropriate steps. Early assessment can lead to effective management.