Prolapse

Also known as POP (pelvic organ prolapse)….When organs sag down into the vaginal canal. Pelvic floor muscles are designed to help hold these in place, but the system can become compromised and prolapse is the result.

It occurs most commonly with vaginal deliveries, however, you are not guaranteed to be clear if you had a C-section because the weight of the growing baby can be enough to cause this, as well as pushing before a C-Section was eventually performed.

There are actually 3 types:

Cystocele: bladder prolapse and the most common type

Rectocele: rectal prolapse

Uterine prolapse: uterus prolapse

These can be graded just like a sprain, but grading doesn’t have great reliability between practitioners & the grading may not necessarily correlate with severity of symptoms. Grade 1 is the lowest with slight distention and grade 4 can be one of these protruding all the way out of the vaginal canal.

Symptoms: most often described as heaviness, dragging, “bulge” feeling, pain during intercourse, urinary retention, leaking of urine, fecal retention or constipation, pulling of the pelvic floor muscles.

Causes: pregnancy, delivery complications or prolonged & improper pushing, post-menopause, in conjunction with drastic hormonal changes, heavy lifting, improper muscle engagement, straining during bowel movements, chronic coughing, muscular atrophy conditions, past pelvic surgeries or operations

What can be done? Mild to moderate cases: treating and preventing chronic constipation, avoid heavy lifting for a time, properly engaging different muscle groups when lifting is necessary, (kegels are not always the answer), treating chronic cough, exercise modification, diet changes, during menopause, considering hormonal therapy, and of course surgery can be the end route.

There is great research that POP can be improved conservatively, by addressing posture, breathing, pressure management, body mechanics, muscle strength and length, which are individually dependent. Assessment by a pelvic floor PT will be able to tell what areas need addressing before going down the route of no return with surgery- which is not necessarily a guaranteed fix- or if you don’t learn the proper techniques first, could inadvertently damage what is corrected for during surgery.

Contact if you have further questions about these common, but not normal conditions!