Pelvic organ prolapse

 

The organs within a woman’s pelvis (uterus, bladder and rectum) are held in place by connective tissue and muscles which form the pelvic floor.

If these support structures are weakened (which can occur when you deliver a baby), the pelvic organs can bulge or descend (prolapse) into the vagina.

Sometimes a prolapse may be felt as a bulge inside or at the vaginal opening. It is possible that a prolapse may be large enough to protrude outside the vagina.

Why does this occur?

There are a number of risk factors that contribute to the development of a prolapse. All of these factors contribute to weakening of the in-built pelvic support mechanisms (connective tissue and muscle tissue).

  • Genetic predisposition

  • Excessive weight gain (high BMI)

  • Constipation and straining

  • Repeated heavy lifting

  • Childbirth (especially instrumental delivery, baby over 4kg and more than 1 vaginal birth)

  • Chronic coughing

  • Previous prolapse surgery

  • Previous hysterectomy

What are the signs and symptoms?

Women with mild prolapse may have no symptoms or discomfort at all.

Symptoms that may occur are:

  • A heavy sensation or dragging in the pelvis or vagina

  • You may be able to see or feel a lump or bulge coming from the vagina when you are in the shower or having a bath

  • Lower back pain that eases when you lie down.

  • Your bladder might not completely empty or your urine stream might be weak

  • Urinary tract infections might be reoccurring

  • It might be hard for you to empty your bowel.

  • Pain or lack of sensation during sex.

What can be done to help me?

We know 50% of people are performing their pelvic floor exercises incorrectly, 30% are causing further damage.

However, evidence shows a correct technique assessed by a Pelvic Floor Physiotherapist combined with individualised pelvic floor program can significantly reduce prolapse symptoms.

We can also provide expert advice regarding reducing aggravating factors and modifying general exercise programs.

Pelvic floor physiotherapists specialise in conservative management of prolapse however we have a thorough knowledge of other treatment methods such as medications, pessaries and prolapse surgery and therefore we can help to guide you towards the most appropriate interventions for your condition.