Pelvic organ prolapse means that one or more of the pelvic organs has moved downward in the pelvis, out of its correct position.
Prolapse may involve
- Bladder
- Bowel
- Rectum
- Uterus
- Vaginal vault (Top of the vagina – after hysterectomy)
Prolapse can be very uncomfortable. It may be noticed as heaviness or dragging in the pelvis, or as a lump or bulge at the entrance to the vagina or anus. Sometimes prolapse can cause problems with fully emptying the bladder or bowel.
What causes pelvic organ prolapse (POP)?
There are a number of factors that may lead to development of POP.
- Being overweight – Body Mass Index (BMI ) – over 25. Check your BMI using the calculator to the right.
- Chronic coughing or sneezing – due to respiratory conditions (asthma, bronchitis etc), smoking or allergies.
- Repetitive heavy lifting – at work, at home, in the garden, on the farm or in the gym.
- Constipation and straining to empty your bowels (if you do this a lot).
- Vaginal birth of big babies, greater than 4000g (about 9lb).
- Difficult childbirth – requiring forceps.
- Genetic factors – some people report a family tendency to develop POP.
How can physiotherapy help?
One of the roles of the pelvic floor muscles is to support the pelvic organs. Improving pelvic floor muscle control can help to support these organs more effectively – meaning that you will be more comfortable.
Exercises can’t reverse an advanced prolapse, but may help reduce how much bother it causes.
Some women benefit greatly from using a vaginal pessary to support their prolapse. Women are often able to manage the pessary themselves, after instruction, and this gives them total control over when to use it. Some women need the support most of the time, others only need extra support on some occasions (e.g. when they go to work or the gym, or when lifting young grandchildren). A pessary is the pelvic equivalent of needing a knee brace or a back brace – only it’s your secret, and no-one else will know it’s there!
Lifestyle advice, education and correct bracing with pelvic floor muscles can help you to avoid making the situation worse. Pelvic floor muscles are not the only structures responsible for pelvic organ support. Sometimes the physical changes indicate that surgery may be required at some point. Improving pelvic floor control and learning how to use these muscles in a protective way is excellent preparation for surgery.
Pelvic organ prolapse is one of the many conditions that can be treated by a suitably trained Pelvic Health Physiotherapist.