Pelvic Prolapse

What is pelvic prolapse?

Pelvic prolapse occurs when the ligaments, muscles and tissues that support the pelvic organs (bladder, uterus, rectum, vagina, bowel) become stretched, damaged or weakened, causing one or more organs to drop down. There are different types of prolapse including vaginal, uterine, bladder and bowel and is often caused by excessive pressure on the pelvic floor. Although not life threatening, pelvic prolapse can cause pain and discomfort and have a substantial effect on a woman’s quality of life and well being.

What are the symptoms of a prolapse?

Symptoms can vary depending on the type and severity of the prolapse as well as individual factors and level of physical activity. 

  • Difficulty or inability to completely empty the bladder or bowel. 
  • Discomfort or difficulty when emptying the bladder or bowel
  • Bowel or bladder incontinence or urgency
  • A ‘heavy’, ‘dragging’ or ‘fullness’ sensation in the vagina.
  • A bulge or swelling in the vagina
  • Lower back ache/pain.
  • Recurring UTI’s

Are you at risk of a prolapse?

Anything that put pressure on the pelvic floor can cause a prolapse, risk factors include1:

  • Pregnancy and childbirth
  • Persistent constipation
  • Repetitive lifting heavy weight that causes excessive strain on pelvic floor 
  • Being overweight or obese
  • Chronic coughing from lung disease or smoking
  • Women who have had pelvic surgery

How is pelvic prolapse diagnosed?

When consulting with your doctor or gynaecologist, they will discuss your medical history and then perform a physical examination to confirm a diagnosis. Additional tests such as a pelvic ultrasound, MRI or bladder test may be needed to confirm type of prolapse and severity of symptoms. Doctors can classify your prolapse severity as mild, moderate or severe and understanding your prolapse diagnosis allows you to make informed decisions about managing and treating your prolapse.

How to treat and manage pelvic prolapse?

There are many treatment options that play a vital part in managing pelvic prolapse, but depending on the severity, some may be more beneficial than others. For women with mild or moderate prolapse, research shows pelvic floor strengthening exercises are effective in reversing and reducing prolapse symptoms2. However, if your pelvic floor muscles are weak, exercises such as running, jumping or high impact activities may worsen your symptoms, so consulting with an exercise physiologist or physiologist before you begin exercising is important. For women with severe prolapse, surgery may be required or long term pessary management however this should be discussed with your doctor or gynaecologist. 

Other ways to manage prolapse2:

  • Avoid straining or downward pressure when lifting heavy objects 
  • Stay within a healthy weight range 
  • Eat recommended daily fibre intake (30g/day)
  • Drink enough water each day (2-3L)
  • Avoid straining while going to the toilet 
  • Medication (seek medical advice) 

As physiotherapists and exercise physiotherapists, we are able to prescribe safe and effective strengthening exercises and assist you in making appropriate lifestyle changes to help reduce and manage symptoms.