Imaging is pretty cool, isn’t it? The primary complaint of patients is that symptoms of pelvic organ prolapse get worse when they stand up. That makes sense, right? There are gravity, positional, and pressure changes. Symptoms may vary, but are often described as “bulge feeling down there” or “I feel like I have a golf ball or bowling ball between my legs”.
Here’s a view of comparing lying down vs. standing vs. standing with straining.
Educational piece for patients: * Due to the anatomy, the uterus can actually “fall” so far down that it can protrude outside of the vagina. The bladder is in a separate space. It can also “fall” and cave toward the vaginal wall, but you can’t see the actual bladder falling (just the vagina bulging). However, it is common that the urethra will also descend down along with the bladder. This can be seen vaginally.
Fancy terms: Bladder Prolapse = Cystocele. Bladder + Urethra = Cystourethrocele