Pelvic Organ Prolapse

Your pelvic organs; the bladder, uterus, and bowel are supported within the pelvis by muscles, ligaments and connective tissue.

If there are any changes or damage to support structures these organs can rest lower against the vagina and can present as heaviness or a bulge within the vagina. When there is descent into the vagina to a particular level and this creates symptoms, we call this as pelvic organ prolapse.

***Please note in the case of your bladder and bowels, these organs do not come through into the vagina but rest against it, so the vaginal wall sits lower.*** 

Some movement and lowering is considered normal and not a sign to panic!

So why does this happen?

Prolapse will occur if there have been changes to the supporting structures (connective tissue or ligaments) that support the pelvic organs.  

This can occur:

  • Following childbirth

  • For those with persistent increase pressure on the pelvic floor i.e. chronic constipation or chronic cough

  • For those who are repeatedly lifting heavy loads

  • After some pelvic surgeries i.e hysterectomy or previous prolapse surgery

Common symptoms:

  • A bulge within the vagina

  • A heaviness or dragging sensation

  • Needing to apply support into the vagina or pressure to the perineum to empty bowels

  • Lower back ache that is relieved by resting and taking weight off feet.

  • Difficulty emptying your bladder or bowel and a sensation of incomplete emptying

  • A lack of sensation or discomfort during intercourse

Treatment may include:

  • Optimising your pelvic floor. We want your pelvic floor muscles to be able to contract and relax and provide good support from underneath to support your pelvic organs. Especially to minimise/soften any pressure downwards with a cough or sneeze or repeated heavy lifting

  • Improving your bowel habits, including education to help you comfortably poo and avoiding straining

  • Providing tips on how to fully empty your bladder

  • Tailoring your exercise program to ensure that you are strong enough to cope with the demands you are placing on your body and your pelvic floor

  • Optimising your breathing pattern and ensure your rib cage can expand and move freely

  • Referring onwards for pessary or discussions with uro/gynaecologist or colorectal surgeon as necessary. Even if you opt for surgery we would recommend working on the above to ensure that your pelvic floor is working well and you have minimised any risk factors to help improve the chances of successful outcomes