Pelvic Organ Prolapse

What?  That can happen?  Yes it can, and it does…..Often.  In fact 1 in 3 women have a prolapse, and 1 in 5 will have surgery for it one day.  And that’s not even the shocking thing…..the shocking thing is that even after surgery 1 in 3 will prolapse again!  This is certainly one area where the saying “prevention is better than cure” rings true!!

What is it?  It is when one or more of the organs that sit in the pelvis descend.  The organs that often do so are the bladder, bowel and uterus.

Why does it happen?  It happens if there has been pressure from above down……like during a vaginal delivery, from lifting weights, chronic coughing or even if you have been straining at the toilet for many years.

What do you normally feel?  Often a heaviness or dragging feeling vaginally, usually worse at the end of the day.  Sometimes you can feel a bulge at the entrance of the vagina.  Sometimes it makes emptying your bladder difficult; you may need to lean forward or back.  Often it makes sex painful/uncomfortable.  It can even cause a lower back ache.

What in the world can a physio do about it?  Lots!  Granted every case is different; but at the very least we can stop it from getting worse.

What’s particularly exciting though is that we can pick those who are at risk for prolapse in the future and prevent it!! Just another reason why we always look at your whole body no matter what you come in for!

How we can help:

– By boosting your pelvic floor – making it stronger, but above all making it shorter.  You see, your pelvic floor sits like a sling below your organs and helps to hold them up.  If this sling is too long and is sagging, then it will let your organs sag down as well!  Generally, the stronger a muscle becomes the shorter it gets.  The shorter your pelvic floor becomes, the more it will help lift your organs up and stop them from descending any further.  Sometimes this even helps reduce the symptoms of the prolapse.

– We also use things called pessaries – little gadgets we insert into the vagina (like a tampon) which helps to hold all of the organs up and in.  Think of it like scaffolding. There are many different types and in many cases they can make a world of difference.

– Advice on lifestyle (ideal weight, fluid intake, bowel habits, etc).

– Advice on exercise. What’s a good idea and what is not.

– Advice on best positions to reduce discomfort with sex

– Advice and rehabilitation post surgery (if it is required to support your prolapse)

For more information on prolapse go to the continence foundation at: