Pelvic Organ Prolapse · Patient guide
What Are the Different Types of Pelvic Organ Prolapse?
There are five main types of pelvic organ prolapse, named for the organ that drops: cystocele (bladder), urethrocele (urethra), uterine prolapse, enterocele (small bowel behind the cervix) and rectocele (rectum), plus vault prolapse of the vaginal top after hysterectomy. Most women have more than one type at once. Somssi Women's Clinic in Gangnam, Seoul maps each compartment and repairs uterine, enterocele and rectocele prolapse with native tissue.
Medically reviewed by Dr. Yoon Ho-joo, MD, PhD, OB/GYN specialist, Somssi Women's Clinic · Last updated October 2026
At a glance
Key facts
The essentials, based on how Somssi Women's Clinic performs this procedure or answers this question. Your plan is confirmed at consultation.
- Three compartments: anterior (bladder, urethra), apical (uterus or vaginal vault, enterocele), posterior (rectum, perineum)
- Most common pattern: several compartments together, typically uterine descent with a rectocele and a weakened perineum
- Staging: each compartment is graded with the POP-Q system from stage 0 to 4
- Repaired at Somssi with native tissue: uterine prolapse (hysteropexy), enterocele (culdoplasty), rectocele and perineum (posterior colporrhaphy, perineal reconstruction)
- Assessed and coordinated with hospital partners: large cystocele, advanced vault prolapse, stage 3 to 4 prolapse, stress incontinence surgery
- Diagnosis: examination at rest and bearing down, measurement of vaginal length and wall thickness, pelvic ultrasound
Pelvic organ prolapse is classified by which organ has dropped and which vaginal wall it pushes against: the bladder or urethra at the front, the uterus, vaginal vault or small bowel at the top, and the rectum at the back. Knowing the type matters because each needs a different repair, and because most women have more than one type at the same time.
Thinking in compartments
Gynecologists divide the vagina into three compartments. The anterior compartment is the front wall, with the bladder and urethra behind it. The apical compartment is the top, where the cervix and uterus sit (or the vaginal vault after hysterectomy), with the cul-de-sac and small bowel behind. The posterior compartment is the back wall, with the rectum behind it and the perineum at the opening. A prolapse in any compartment is graded with the POP-Q system from stage 0 (no descent) to stage 4 (complete eversion).
Somssi Women's Clinic is a surgical gynecology clinic in Gangnam, Seoul, founded in 2000 and led by Dr. Yoon Ho-joo, MD, PhD, a member of the Korean Society of Urogynecology. Mapping all three compartments is the first step of every prolapse consultation here.
The types of prolapse
| Type | What drops and where | Typical symptoms |
|---|---|---|
| Cystocele | Bladder bulges into the front vaginal wall | Front-wall bulge, frequency, incomplete emptying, weak stream, recurrent urinary infection |
| Urethrocele | Urethra sags with the lower front wall; usually with a cystocele | Stress leakage with coughing or exercise |
| Uterine prolapse | Uterus and cervix descend into the canal | Heaviness, lump felt low in the vagina, cervix bumped during intercourse, backache |
| Enterocele | Small bowel pushes into the cul-de-sac behind the cervix or vault | Deep pressure, a bulge high in the back wall, dragging that worsens by evening |
| Rectocele | Rectum bulges into the back vaginal wall | Back-wall bulge, needing to press on the vagina or perineum to empty, constipation |
| Vaginal vault prolapse | Top of the vagina descends after hysterectomy | Bulge or lump, heaviness, often with enterocele |
| Perineal descent | Perineal body stretched and lowered; wide opening | Laxity, air trapping, water entering, reduced sensation |
Anterior compartment: cystocele and urethrocele
A cystocele is the most common single finding on examination. The bladder base sags into the front wall, leaving urine behind and sometimes causing infections. When the lower front wall drops too, the urethra loses its support and stress incontinence appears. Interestingly, a large cystocele can kink the urethra and hide stress leakage, which only shows up once the prolapse is corrected.
Apical compartment: uterine prolapse, enterocele and vault prolapse
Uterine prolapse is the type most women have heard of. The cervix descends from near the top of an 8 to 9 centimeter vagina to within about 5 centimeters of the opening or beyond. An enterocele often accompanies it: the cul-de-sac behind the cervix opens up and small bowel pushes down, producing deep pressure. After hysterectomy the top of the vagina can itself fall, which is called vault prolapse. Apical support is regarded as the key to any lasting repair, because the walls hang from the top.
Posterior compartment: rectocele and perineal descent
A rectocele forms when the layer between rectum and vagina thins and the rectum bulges forward. Stool collects in the pocket, so women strain or press on the perineum to empty. Childbirth also stretches and shortens the perineal body, widening the opening; this perineal descent is often what women notice first as laxity. Our page on what vaginoplasty actually repairs explains the overlap between laxity and posterior prolapse.
Why most women have more than one type
The same forces, childbirth, menopause and chronic straining, weaken every compartment. In the clinic's experience, uterine descent rarely occurs alone: the posterior wall and perineum usually gave way first, the vagina widened and shortened, and the uterus followed. Treating one compartment and ignoring the others is a common reason prolapse seems to return, so the examination is done at rest and while bearing down, lying and sometimes standing, so that nothing is missed. See How Do I Know If I Have Pelvic Organ Prolapse?.
How each type is treated at Somssi
- Uterine prolapse: hysteropexy, in which the uterus is repositioned and fixed by tying its own supporting tissue, lifting it about 2 to 4 centimeters in the clinic's experience, without removing it.
- Enterocele: culdoplasty, closing the cul-de-sac so bowel cannot push down behind the cervix.
- Rectocele and perineal descent: posterior colporrhaphy with the mucosa peeled to under 1 millimeter, the pelvic floor muscles gathered and sutured, the wall closed in a second layer, a figure-8 suture at the opening and perineal reconstruction.
- Cystocele and urethrocele: the clinic does not operate on the anterior wall, to protect the urethra, bladder and sensation. Mild cystoceles and their symptoms often settle once the apex and posterior wall are restored; a large, dominant cystocele or stress incontinence needing a sling is discussed openly and coordinated with hospital partners.
- Vault prolapse: assessed individually; culdoplasty with posterior repair may suffice, while advanced vault prolapse usually needs a hospital-based suspension.
All clinic procedures use your own tissue with no mesh, take about an hour under sedation and allow same-day discharge. Stage 3 to 4 prolapse of any type may need a hospital-based approach, and we say so plainly. The pelvic organ prolapse repair page describes the operation compartment by compartment, and What Surgery Is Used for Pelvic Organ Prolapse? compares the options more widely.
Non-surgical options by type
For stage 1 and mild stage 2 prolapse of any type, supervised pelvic floor training, sometimes with an EMS device, lifestyle changes and vaginal estrogen after menopause are the first steps. A pessary can support a cystocele, uterine prolapse or vault prolapse well; it is less effective for an isolated rectocele. Our guide Can Pelvic Organ Prolapse Be Treated Without Surgery? covers these.
Bottom line
Pelvic organ prolapse comes in anterior, apical and posterior types, cystocele and urethrocele at the front, uterine, enterocele and vault prolapse at the top, rectocele and perineal descent at the back, and most women have a combination. An examination that maps and stages every compartment is the foundation of a good plan. At Somssi, uterine, enterocele and posterior prolapse are repaired with native tissue while keeping the uterus, and anterior or advanced prolapse is assessed honestly and coordinated with hospital partners when needed. Contact us to arrange an assessment, or read our international patients guide.
Private consultation
Talk it through with Dr. Yoon's team
English-speaking coordinators, a written treatment plan and a clear quote after your consultation. Same-day discharge for most procedures.
Mon, Tue, Wed, Fri, Sat 09:30–18:00 (KST). Closed Thu, Sun and holidays. 7F Sangkyung Building, 120 Teheran-ro, Gangnam-gu, Seoul.
Dr. Yoon Ho-joo, MD, PhD
OB/GYN specialist, Catholic University of Korea. Founder of Somssi Women's Clinic (2000). Published on female sexual function after reconstructive vaginal surgery; speaker at ESSM, ISSWSH, WAS and SMSNA.
Questions patients ask
Frequently asked questions
Short, honest answers. For anything personal, a consultation is the right place to ask.
Which type of prolapse is most common?
On examination, a cystocele (front wall) is the most frequently found, followed by uterine prolapse and rectocele, but the most common situation is a combination. Women often present with uterine descent plus a rectocele and a weakened perineum, because the same childbirth and aging changes affect every compartment.
How can I tell which type I have?
A bulge from the front wall with bladder symptoms suggests a cystocele; a firm, rounded lump (the cervix) low in the canal suggests uterine prolapse; a back-wall bulge with difficulty emptying the bowel suggests a rectocele. Only an examination while you bear down can confirm the type and stage, and it often finds more than one.
Is a rectocele the same as rectal prolapse?
No. A rectocele is the rectum bulging forward into the vagina. Rectal prolapse is the rectum itself protruding through the anus. They are treated by different specialists, and we refer rectal prolapse to colorectal colleagues.
Can prolapse happen after hysterectomy?
Yes. Without the uterus, the vaginal top depends on the ligaments that were attached to it, and if those were not suspended at the hysterectomy or weaken later, vault prolapse develops, often with an enterocele. This is one reason the clinic prefers to keep the uterus and suspend it rather than remove it.
Does the type of prolapse change the recovery?
Not much for the vaginal native-tissue repairs done at the clinic: same-day discharge, desk work within days, vigorous exercise at 6 weeks and intercourse after 7 to 8 weeks. Hospital-based operations for large cystoceles or advanced vault prolapse have their own timelines, which the treating team explains.
Do I need surgery if my prolapse is mild?
Usually not. Stage 1 and mild stage 2 prolapse with few symptoms is managed with pelvic floor training, lifestyle changes and sometimes a pessary. Surgery is for prolapse that affects daily life or is progressing. We review conservative treatment after a few months before suggesting anything further.
Keep reading
Related treatments and guides
- Pelvic Organ Prolapse Repair — compartment-by-compartment native-tissue repair
- Uterine Prolapse Surgery — treatment for the apical type
- What Are the Stages of Pelvic Organ Prolapse? — how severity is graded
- How Do I Know If I Have Pelvic Organ Prolapse? — symptoms by type
- What Surgery Is Used for Pelvic Organ Prolapse? — operations by compartment
- Can Pelvic Organ Prolapse Be Treated Without Surgery? — non-surgical options
- Perineoplasty — repair of perineal descent and a wide opening
Sources and medical review
- International Urogynecological Association (IUGA) / International Continence Society (ICS) — joint terminology for female pelvic floor dysfunction and POP-Q staging.
- American College of Obstetricians and Gynecologists (ACOG) — patient guidance on types of pelvic organ prolapse.
- Te Linde's Operative Gynecology (textbook) — anatomy of the anterior, apical and posterior compartments.
Next step
A consultation first. A decision only when you are ready.
Tell us what you are experiencing and what you hope to change. Dr. Yoon examines, measures and explains the options, including when no surgery is the right answer. International patients can start with an online consultation before travelling to Seoul.
