This refers to the bulging or herniation of one or more of the pelvic organs into or out of the vagina, a shift into a displaced position. The pelvic organs include the bladder, bowel, uterus and vagina. Pelvic organ prolapse can occur for a number of reasons but the most common cause is weakening of the structures that support and maintain the position of these organs, including ligaments, fascia and the pelvic floor muscles.
Some Causes of Prolapse:
The pelvic organs are stabilised by a number of different structures – directly by a combination of fascia and ligaments, and indirectly by the pelvic floor muscles. These supportive components can become weakened, elongated or damaged by a number of different causes, such as: Childbirth (risk factors include large babies, long labours, assisted deliveries, poor postnatal exercise regimes), Aging and Menopause (hormonal changes can have an effect on collagen in the body, a major component of ligaments and fascia), Constipation (excessive bearing down or straining can place excessive pressure on the pelvic floor and Congenital causes (underlying medical conditions that affect the strength of connective tissue such as Ehlers-Danlos Syndrome or Marfan Syndrome can result in an inherited risk of prolapse).
There are non-surgical and surgical options available, depending on the degree and how bothersome your prolapse is. Addressing issues and activities that may be placing excessive pressure on the pelvic floor can assist. These include avoiding heavy lifting and straining and losing weight. If chronic constipation is contributing, dietary changes and increasing water intake can address this. There are different surgical approaches available for those whose prolapse is symptomatic and very bothersome. A device known as a pessary may be used to relieve symptoms by providing mechanical support. Your PhysioCare Chartered Physiotherapist will advise on the best course of action for you during your treatment session with them.
What we can do for you:
We can implement a supervised pelvic floor strengthening programme as this can help in the prevention or delay of prolapse and its symptomology. Your PhysioCare Chartered Physiotherapist can also assist in addressing any other issues that may be contributing such as chest infections, constipation, activity modification and obesity. Prolapse is included in our Women’s Health Physiotherapy service and is lead by female Chartered Physiotherapists across our clinics.