Vaginal wall bulge: causes and next steps

You may notice pressure, dragging, a lump at the vaginal opening, or tissue that is more obvious after standing, coughing, or bowel movements. Pelvic organ prolapse happens when support for the bladder, bowel, uterus, or vaginal wall becomes less effective. Symptoms can include difficulty emptying the bladder, constipation, discomfort during sex, or a feeling of incomplete emptying.

The appearance of a bulge does not show which structure is involved. A clinician can examine you while lying and standing, ask about bladder and bowel function, and assess how the symptoms affect daily activities.

Book an assessment if the bulge is new, increasing, painful, or interfering with urination, bowel movements, exercise, or sex. Preventing constipation, avoiding repeated heavy straining, treating a persistent cough, and using safe lifting technique may reduce pressure on the pelvic floor. A pelvic health specialist can teach tailored exercises through [Pelvic Floor Physiotherapy](/treatments/pelvic-floor-and-rehabilitation/pelvic-floor-physiotherapy/).

Depending on the examination and your preferences, options may include observation, pelvic-floor rehabilitation, or a removable support device. [Vaginal Pessary Fitting](/treatments/pelvic-floor-and-rehabilitation/vaginal-pessary-fitting/) helps select and check such a device.

Seek urgent help if you cannot pass urine, have severe pelvic pain, heavy bleeding, fever, or tissue that becomes very swollen, dark, ulcerated, or suddenly much more painful. Arrange prompt review for a bulge that is rapidly changing or associated with new loss of bladder or bowel control. Do not try to push painful or injured tissue back forcefully.

Ask: Which pelvic organ is contributing to the bulge? How advanced is the prolapse? Would physiotherapy help? Is a pessary suitable for me? How should it be cared for, and which bladder or bowel symptoms need urgent attention?