The main types of pelvic support problems include:

• Cystocele (SIS-tow-seel)-bladder
• Enterocele (en-TARE-oh-seel)-small intestine
• Rectocele (REK-tow-seel)-rectum
• Uterine prolapse-uterus
• Vaginal prolapse-vagina

Although each problem occurs in different pelvic organs, they often occur at the same time.

Cystocele
A cystocele occurs when the bladder drops from its normal place into the vagina. Some cystoceles cause urine to leak when you cough, sneeze, lift objects, or walk. Large cystoceles may kink the urethra and cause problems with the passing of urine. If this occurs, you may have to strain or push the bladder up by reaching into the vagina to pass urine. If there is a very large cystocele and if the bladder loses some of its ability to contract, it may not completely empty. Small cystoceles are common. In most cases, they do not cause problems with urination and do not need surgery. If a cystocele is causing symp-toms, your doctor can suggest ways to relieve them. The place where the bladder joins the urethra is called the bladder outlet or bladder neck. When the tissues that support the bladder neck are damaged, it may drop and push against the vaginal wall. A dropped bladder neck is called a cystourethrocele. It may cause urine to leak. Urine is more likely to leak when there is a sudden increase in abdominal pressure caused by walking, jumping, coughing, sneezing, laughing, lifting, or making sudden movements. The amount of urine lost may be only a few drops. In other cases, it may be enough to require changing clothes or wearing pads. You should tell your doctor if you cannot con-trol the leakage of urine. Sometimes leakage is not caused by a cystourethrocele. It may be caused by a urinary tract infection, bladder problems, or other medical conditions.

Enterocele
An enterocele forms when the intestine bulges into the upper vagina. To diagnose an enterocele, a doctor may place a finger in your vagina and a finger in your rectum while you are standing.

Rectocele
When the rectum bulges into or out of the vagina, it is called a rectocele. It is caused by a weakness of the back wall of the vagina. A large rectocele may make it hard to have a bowel movement, especially if you have constipation. Some women must push the bulge back into the vagina to have a bowel movement.