What is Pelvic Organ Prolapse

A pelvic organ prolapse is a bulging of the pelvic organs such as the bladder, bowel, rectum or uterus downward into the vagina. The pelvic floor muscles provide support to the pelvic organs, and control the bladder and bowel to prevent incontinence. If either the pelvic floor muscles or the supporting structures weaken, the pelvic organs can bulge into the vagina in what is known as a prolapse.

What Causes Prolapse

• Pregnancy and Childbirth: This is the most common cause and occurs more often when there has been a vaginal delivery. The extra weight of the growing baby puts strain on the pelvic organs and pelvic floor muscles. Pregnancy hormones cause relaxation of the supporting ligaments in preparation for delivery. In addition, an episiotomy or vaginal tear may weaken the supporting structures. All of these issues combined can cause the pelvic floor muscles to weaken and result in a prolapse.
• Obesity: The more weight your body is carrying, the more pressure there is on your pelvic organs, causing strain on your pelvic floor muscles, thus increasing the likelihood of a prolapse.
• Heavy Lifting: Heavy lifting on a daily basis can increase the abdominal pressure pushing downwards. This combined with weak pelvic floor muscles can increase the likelihood of a prolapse.
• Family History: A strong family history of prolapse can increase your chances of developing one.
• Age: The older you are, the more likely you are of developing a prolapse. This is due to the fact that muscle strength and vaginal supports tend to weaken as you age.
• Constipation: The strain from chronic constipation can increase the likelihood of prolapse. This is due to the increased intra-abdominal pressure which can put strain of the pelvic floor muscles.
• Chronic Cough: Having a persistent cough perhaps as a side effect of bad asthma could make a prolapse more likely. Again this is due to the increased intra-abdominal pressure which tends to weaken pelvic floor muscles.
• Previous Pelvic Surgery: If you have previously had surgery to repair a prolapse, or a hysterectomy, your chances of developing a subsequent prolapse increase.

How to Recognise a Prolapse

There are a number of different types of prolapse and accompanying symptoms, distinguished by which pelvic organ has moved. They can be mild causing very little to no discomfort, or it can be severe causing many problems and affecting your overall quality of life. The most common type of prolapse is the front vaginal wall prolapse. This occurs when the wall supporting the bladder bulges downward into the vagina. However there are different types of prolapse that can occur. The most common symptoms of pelvic organ prolapse are:

• A feeling of vaginal fullness, heaviness, or even pain
• Loss of bladder and/or bowel control
• Involuntary urination or inconsistent urinary stream
• Difficulty with bowel movements
• Recurrent urinary or bladder infections
• Pain or discomfort during intercourse

Physiotherapy for Pelvic Organ Prolapse

Physiotherapy can help reduce the symptoms caused by pelvic organ prolapse and help improve your pelvic floor support. Treatment is often focused around strengthening pelvic floor muscles through pelvic floor exercises. This will help improve bladder and bowel control and can be very beneficial for treating and preventing future problems. In other cases, the pelvic floor muscles can be too tight, in which case muscle relaxation exercises will be prescribed. Muscles take time to become strong so you will need to persevere with your home exercise programme. In addition, your chartered physiotherapist can advise you on habits for keeping your bladder healthy. This will include tips on keeping hydrated and eating enough fibre to avoid constipation.

Here at Ballsbridge Physiotherapy Clinic, our clinic director Aileen Maguire specialises in treatment for pelvic organ prolapse, and accompanying bladder and bowel conditions. If you have any questions regarding prolapse and symptoms, or wish to have an assessment, please get in contact with us here.