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Prolapse

Pelvic organ prolapse is a condition where the bladder, uterus, or rectum slips down or pushes into the vaginal walls due to weakened pelvic floor muscles and tissues.

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Pelvic organs (bladder, uterus and rectum) are supported by a “hammock” of muscles, ligaments and tissues that attach to the bony anatomy of the pelvic from and front (pubic bone) to the back (tail bone).

The “hammock” is designed to stretch but still be supportive. If the “hammock” is damaged or weakened, it may “sag”, lose support and strength and may not be able to support all the organs. These organs may start to drop into or through the vaginal walls; this drop of the organs is called  pelvic organ prolapse.

Causes and Symptoms of Prolapse

Causes

  • Pregnancy and childbirth, especially if the birth process was long, difficult, the baby was large or you gave birth to multiples.

  • Getting older, being menopausal and/or being overweight

  • Having many years of constipation 

  • Having a health condition that causes you to cough and strain

  • Having a job that requires a lot of heavy lifting

Symptoms

  • A feeling of pressure, bulging, discomfort, aching, or fullness in the vagina, rectum 

  • Pelvic pressure that gets worse with standing, physical activity, coughing or as the day goes on

  • Urinary leakage, urgency, frequency, incomplete emptying or problems having a bowel movement

  • Low back/pelvic pain that worsens with standing or exercising and is relieved with laying down

HOW DOES PHYSICAL THERAPY HELP?

Recent high quality studies show pelvic floor physical therapy to be an effective intervention for improving feelings of heaviness, bulging and lessening urinary and fecal problems. 


Accurate pelvic floor and lower abdominal exercises to improve supportive functions of the pelvic floor.  Studies have shown that most women are doing pelvic floor exercises (or Kegels) incorrectly and that vigorous supervision and instruction is necessary for good clinical results. 


Hypopressive exercises involve creating a vacuum or “suction” in the abdominal cavity to draw up the pelvic organs
We may use manual/hands-on therapies, biofeedback, stimulation and other interventions as needed.


Even if you are scheduled for surgery to correct the prolapse, or have already had a  repair surgery, remember that the “hammock” cannot be fixed surgically.  Strengthening these muscles will enhance the success of your surgery.

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Education and Resources


Even if you do not have any symptoms or your prolapse is mild and not bothersome, you may still benefit from strengthening your pelvic floor muscles (correctly!).  

 

Making some lifestyle changes will help; losing excess weight, avoiding heavy lifting and/or lifting correctly to avoid strain on your pelvic floor, treating constipation.
 

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