Pelvic organ prolapse (POP) occurs when pelvic organs, such as the bladder, uterus, or rectum, descend from their normal position due to weakened support structures. For those experiencing this condition, a concerning symptom can be the presence of an unusual odor. Healthy, living tissue in a prolapse does not inherently produce a smell. However, the mechanical changes and complications associated with the descent of the organ frequently create an environment where odor-causing issues, like infection or leakage, develop. Understanding this distinction is important for seeking appropriate care.
What is Pelvic Organ Prolapse?
Pelvic organ prolapse is a mechanical condition resulting from the weakening or stretching of the pelvic floor muscles and connective tissues. This support system acts like a hammock, holding the pelvic organs in place. When this support fails, one or more organs can bulge or sag into the vaginal canal.
The specific type of prolapse depends on the organ involved. Examples include a cystocele (bladder descent), a rectocele (rectum bulge), or a uterine prolapse (uterus drop). This condition is a change in structural location, not a disease of the tissue itself.
The Prolapse Tissue and Odor
A prolapse consists of living, vascular tissue—the lining of the vagina, bladder, or rectum—that has simply shifted position. Healthy tissue, even when displaced, does not generate a foul smell. Therefore, a prolapse that is clean and free of secondary complications is odorless.
The odor concern arises when this displaced tissue is subject to irritation or external factors. Unlike conditions like tissue necrosis, where cell death creates an inherent smell, the presence of an odor in prolapse almost always indicates a secondary issue that is treatable.
Sources of Odor in Prolapse
The most frequent source of odor is related to the disruption of normal bodily functions, such as issues with urinary or bowel control, or secondary infections.
Urinary and Hygiene Issues
A prolapsed bladder (cystocele) can lead to urinary incontinence or prevent the complete emptying of the bladder, causing urinary stasis. Stagnant or leaked urine can break down, leading to a strong, ammonia-like smell. Difficulty maintaining hygiene is also common, especially when the prolapse protrudes outside the vaginal opening. This allows normal vaginal discharge to become trapped, leading to the growth of odor-producing bacteria.
Secondary Complications
Friction from clothing rubbing against a prolapsed organ can cause ulceration, creating open sores. These open sores are highly susceptible to bacterial colonization and infection, which often results in a distinct foul or fishy odor, commonly associated with conditions like bacterial vaginosis.
Other sources of odor include:
- Improperly cleaned vaginal pessaries, which can cause foul-smelling discharge if not removed and cleaned regularly.
- Severe complications like a rectovaginal fistula, which is an abnormal connection between the rectum and the vagina.
Warning Signs Requiring Immediate Care
While a mild odor can often be managed with improved hygiene or treatment for a minor infection, certain symptoms signal the need for immediate medical attention.
Seek prompt evaluation if you notice:
- A sudden, dramatic change in odor to one that is extremely foul or putrid, which may indicate a severe infection.
- Visible changes to the prolapsed tissue, including deep, open sores, significant bleeding, or a change in tissue color to dark purple or black.
- Systemic signs of infection accompanying the odor, such as fever, chills, or escalating pain.