What Is Pelvic Organ Prolapse?

What Is Pelvic Organ Prolapse?

Pelvic organ prolapse is a common condition seen and treated by pelvic health physiotherapists.  Pelvic organ prolapse refers to the the drop of a pelvic organ(s) into the vaginal space or opening.  There are varying degrees/grades to which this can happen which are classified by the degree of protrusion of the pelvic organs.  Grade 1 is a minor prolapse and Grade 4 is severe. Your pelvic health physiotherapist can assess to determine if this is something you are suffering from and determine which grade you are if you do indeed have this condition.

Below are the symptoms, risk factors and different types of prolapse are outlined.  If it sounds like you are suffering from this condition see a pelvic floor physiotherapist for an assessment.

Symptoms of pelvic organ prolapse:

  • A feeling of pressure or pain near the vaginal opening
  • A noticeable protrusion in the vaginal opening
  • Typically symptoms are worse with increased intra-abdominal pressure (standing, walking, heavy lifting etc)
  • Symptoms are often relieved with gravity eliminated positions (i.e. laying on your back with legs up)

Cause/Risk Factors

Prolapse is usually due to weakness in the pelvic floor muscles.  These muscles act as a sling running from pubic bone to tailbone and one of their functions is to support the pelvic organs.  When they are weak they allow the pelvic organs to drop.  

  • common after being pregnancy/given birth as this puts a lot of strain and can alter the pelvic floor functionality.  The more children you have the more likely you are to have prolapse.  
  • increasing age  – our strength in general declines and is harder to maintain as we age.  
  • can also be caused by constant straining (repetitive heavy lifting, chronic constipation).

Common Types of prolapse:

1) Rectocele – rectal (end of large intestine/rectum) prolapse

2) Urethrocele – prolapse of the urethra into the vagina

3) Cystocele – drop of the bladder into the vaginal opening

Treatment:

Research has shown that conservative therapy (pelvic floor physiotherapy) should be the first line of defense in treatment of any prolapse grade 1-3.  Grade 4 is often surgical.  Treatment with a pelvic health physiotherapist for this condition will include education of safe/unsafe forms of recreational activities, specific strengthening exercises based on your grade and type of prolapse you have, recommendations/advice on potential supports (pessary) that may be helpful in some cases and communication/referrals to other medical professionals if needed.