Pelvic Organ Prolapse

Of all the pelvic floor symptoms I have treated as women’s health physio, pelvic organ prolapse is often the one that creates that most fear and worry for my patients.

So what is pelvic organ prolapse?

Pelvic organ prolapse is the symptomatic descent of one of more of the pelvic organs against the walls of the vagina.

Note that it is not the pelvic organs coming out of the body, but the organs sitting lower and resting against the vagina.

Also note that the definition has the word symptomatic in it. That is because some movement or descent of the vaginal wall is normal. The bladder and bowels need to fill and at some stage a baby might be grown in the uterus so the vaginal walls need to be mobile to allow for this.

What the symptoms of pelvic organ prolapse?

  • A feeling of heaviness or something coming down the vagina

  • A bulge feeling or a feeling of a tampon being stuck

  • A feeling of incomplete emptying of bladder or bowels

  • Lower back pain (particularly at the sacrum)

  • Occasionally painful sex (if this cervix is sitting lower)

Symptoms can be felt throughout the duration of the day or sometimes people find that they are worse towards the end of the day after spending a period of time on their feet.

What are the risk factors for pelvic organ prolapse?

  • Genetics: some people have more mobile tissues and more predisposed to prolapse

  • Childbirth: particularly where forceps have been used

  • Chronic Constipation

  • Chronic cough or vomiting

  • Increase in weight (through pregnancy or increased abdominal weight)

  • Work where heavy lifting is involved

How can women’s health physio help prolapse?

Pelvic floor strengthening is considered first line treatment for pelvic organ prolapse.

There is new evidence emerging that pelvic floor strengthening can help improve the grade of mild prolapse if it is a prolapse of the anterior wall (cystocoele). However, we need a lot more evidence to support this. There is evidence to show it can improve symptoms for mild prolapse for all different types (cystocoele, uterine and rectocoele).

Women’s health physio’s can also help to improve tips on how to best empty bladder or bowels when you have prolapse. Recommend supportive wear to limit pressure downwards. Prescribe general strengthening to help support the pelvis and more.

Other options for prolapse management include using pessary or surgical options. At Kin Physio, we aren’t anti-surgery. However, if you decide to go down the path of surgery we would recommend getting your pelvic floor as strong as possible as well as helping to reduce risk factors for recurrence.