What is prolapse? Should I be worried?
- Have you been experiencing heaviness in the pelvic region, continence problems or pelvic pain?
- Have you been told you have a prolapse and are worried about needing surgery?
What is prolapse?
Pelvic organ prolapse describes when one of the pelvic organs (the bladder, rectum or uterus), hangs and descends into the vaginal space. When the bladder descends it is termed ‘cystocele’. When the rectum descends it is termed ‘rectocele’, and when the uterus descends it is termed uterine prolapse.
Prolapse can develop when the following 2 things happen:
- The ligamentous and fascial tissue which hold the organs up start to weaken, stretch and lengthen.
- When the pelvic floor muscles, which support the organs from beneath, weaken.
These problems can occur as a result of pregnancy, delivery and also as a result of changes in hormones throughout menopause.
What are the symptoms?
Mild prolapse is usually asymptomatic, but as the prolapse worsens in severity symptoms develop. The symptoms experienced depend on the type of prolapse present but generally can include:
- A ‘heavy’, ‘dragging’ sensation in the vagina
- The feeling of ‘something coming out’ the vaginal passage or an observable bump/lump bulging out of the vagina
- Pain with intercourse
- Bladder symptoms including: weak urine stream, feelings of incomplete bladder emptying and recurrent urinary tract infections
- Bowel symptoms include: constipation, and straining to completely empty the colon.
Prolapse is very common. Approximately 1 in 5 women who have had a baby experience pelvic organ prolapse.
What If I never had a vaginal delivery, can I still develop prolapse?
Yes. Development of prolapse has a large genetic component and does seem to ‘run in families’. Prolapse is more common in women who are post-menopausal and overweight. Prolapse also commonly occurs in women who have a respiratory disease who cough a lot, women who lift heavy loads or in women who strain to toilet.
Prevention is better than cure for prolapse!
To prevent prolapse it is important to keep the pelvic floor muscles strong. Pelvic floor muscles are like every other muscle in the body and can be made stronger with exercise, despite your age!
It is important to have your pelvic floor muscle technique examined by a women’s health trained physiotherapist to ensure you are doing them correctly. Like other exercises, they can be done incorrectly and may cause harm. For example, if you do squats incorrectly you can develop knee and back pain. Likewise if pelvic floor exercises are done incorrectly you can develop pain or make symptoms of prolapse or incontinence worse.
Common errors can be ‘pushing down’ or breath holding when trying to exercise the pelvic floor. This can result in downward pressure and a worsening of prolapse symptoms! So a simple check with your women’s health physio can set you on the right path for accurate muscle strengthening and prevent you making problems worse.
As well as ensuring you are using your pelvic floor muscles correctly, it is also helpful to lose weight and avoid constipation- both of which can increase pressure or strain on the pelvic floor muscles. Ensuring a healthy diet and plenty of water can assist with this.
Along with exercises, did you know that a trained women’s health physio can help by fitting you with a pessary? A pessary is a silicon device (often a ring but there are many shapes and sizes available) that can be inserted to provide internal support the pelvic organs. Many women manage pelvic floor symptoms from prolapse with a pessary and avoid surgery! Not all women are suited to pessary support and it is important to seek assessment with a trained women’s health physio who is qualified in pessary fitting. The added benefit of pessary is that they can allow your pelvic floor muscles the chance to strengthen after pregnancy, which means once you have regained your strength you no longer require the support.
Surgery is the other treatment option for pelvic organ prolapse. For a successful surgery, it is important to still develop strong pelvic floor muscles. 1 in 3 surgery’s result in the prolapse re-occurring! But a strong pelvic floor helps improve surgical outcomes.
Don’t despair! If you do suffer from pelvic organ prolapse there are many treatment options available which can cure symptoms! These treatment options are individually tailored to each patient based on their age, type of prolapse and specific goals. Speak to a women’s health physiotherapist today! You don’t need to suffer in silence.
Like to read more? Learn more about women’s health physiotherapy
- You are concerned you have prolapse
- You have a family history of prolapse
- You do have prolapse
- Would like to know more about pessary support
- Or would like to PREVENT prolapse from occurring
About Rebecca- Rebecca Reiss is passionate about caring for women’s health concerns during and after pregnancy and also into menopause. She has expertise in the management for pelvic floor problems and brings a wealth of knowledge to the Synergy Physio team. She is qualified in pessary fitting for women. Her caring and professional nature will support you toward improving your health, your pelvic floor function and help you get back to doing the things you love. Don’t suffer in silence- contact us today.