Prolapse is when pelvic organs are dropping down into the vaginal space. Women may be aware of a bulge or lump in the vagina and a feeling of heaviness. It is caused by a stretching of the ligaments and muscles that support the pelvic organs. The word prolapse literally means to ‘fall out of place’.
Types of prolapse
Uterine prolapse: This is when the uterus (womb) and cervix drop down towards the vaginal opening. In severe cases, it may protrude outside the vagina
Bladder prolapse: The bladder causes a bulge to occur in the front vaginal wall. Also known as a cystocoele
Bowel prolapse: The bowel bulges forward into the back vaginal wall. Also known as rectocoele
Rectal prolapse: This is when part of the rectum, falls and protrudes out of the anus
What causes pelvic organ prolapse?
A prolapse can result from anything that puts pressure on the organs in the pelvis. Risk factors can include:
Pregnancy and childbirth
Regularly straining on the toilet to pass bowel motions or urine
Repetitive lifting of children/grandchildren
Repetitive lifting of heavy weights at work or in the gym
Excess weight, especially around the abdomen
Smoking and chronic lung diseases with coughing
Pelvic surgery such as hysterectomy
Symptoms of pelvic organ prolapse
A bulge or swelling felt in the vagina
A sensation of fullness or pressure inside the vagina
A sensation of vaginal heaviness or dragging
Lower back ache
Bladder or bowel urgency or incontinence
An inability to completely empty the bladder or the bowel
Straining to get urine flow started, or to empty the bowel
In severe cases, the vaginal wall or cervix may protrude outside the vaginal entrance.
What can I do to prevent pelvic organ prolapse?
Do regular pelvic floor exercises to improve pelvic floor muscle strength and endurance
Avoid constipation and try to relax when defecating
Minimise coughing by managing illnesses well
Have good lifting technique, including no breath holding and tightening the pelvic floor prior to lifting
Discuss your birth plans carefully with your medical team
Avoid running and high impact exercises for three months after pregnancy and birth
How can I manage a pelvic organ prolapse?
Lifestyle changes including modifying lifting, coughing and impact exercise
Pelvic floor physiotherapy to learn the best exercise technique to strengthen the pelvic floor muscles
Management of bowels and avoiding straining and constipation
Vaginal support pessary to stop the bulge falling out of the vagina
Surgery may be required in severe cases, where the bulge is out of the vagina and is impacting bladder and bowel function
What is a vaginal support pessary?
A vaginal support pessary is a device that can be inserted into the vagina, which helps to hold the walls in place to support the internal organs. They come in various types and sizes and need to be fitted by a gynaecologist or specially trained pelvic health physiotherapist.
Who can I see to fit a vaginal support pessary?
At Life Ready, we have two pelvic health physiotherapists who are trained to fit vaginal support pessaries and teach you to self-manage them.
We recommend you book an initial women’s health physiotherapy appointment to discuss your symptoms, obtain a diagnosis and discuss the best management strategies for your prolapse symptoms.
Please note: To make an appointment concerning pelvic organ prolapse physiotherapy, please book a women’s health physiotherapy consultation. If you would like to discuss your appointment agenda before you visit the clinic, please give our friendly team a call on 9440 3443.