Vaginal wall prolapse

Vaginal wall prolapse may occur independently of the uterus. Several types are described:

• cystocoele - descent or bulging of the bladder into the upper two thirds of the anterior vaginal wall. It denotes weakness in the investing fascia of the vagina.
  
  
• urethrocoele - bulging of the urethra into the lower one third of the anterior vaginal wall. It is more properly called urethral displacement, as the urethra is not dilated.
  
  
• enterocoele - herniation of the pouch of Douglas into the upper posterior vaginal wall. The peritoneal sac may contain loops of bowel
  
  
• rectocoele - prolapse of the rectum into the lower posterior vaginal wall. It is not to be confused with rectal prolapse.
  
  
• inversion of the vagina or vaginal vault prolapse indicates a failure of the supports around the upper vagina. It may be seen after vaginal or abdominal hysterectomy.