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What is Pelvic Organ Prolapse and What Can You Do About It?

By Dr. Brooke Meinema PT, DPT, FAFS

While many people might not exactly talk about it often, a pelvic organ prolapse is quite common with studies estimating that 23.7% of women have had one. Having a prolapse means that the structures of the pelvic floor may begin to lower into a space they are not supposed to occupy. The structures of the pelvic floor are in place to support the organs within the pelvis (uterus, bowels, bladder, vagina, and cervix). When this structure is no longer able to perform this job, whether it be from trauma during labor and delivery, surgeries, weakness in the muscular system, general laxity or “looseness” in the ligaments and their support system or genetic predispositions, the organs are able to begin to shift lower and take up more space. While many women experiencing a pelvic organ prolapse may have no symptoms, there are also many women who do, and it may result in symptoms such as leaking urine or feces, difficulty with bowel movements, feelings of heaviness, or general discomfort. As with most things, knowledge is power, so understanding what a prolapse means is the first step to being able to sit in the driver’s seat and get in control of your body!

There are different types of pelvic organ prolapse, including:

Anterior wall (cystocele or urethrocele)

Cystocele: the bladder begins to fall down and into the vagina
Urethrocele: the urethra protrudes into the vagina

These may lead to increase in urinary frequency, leaking, limited bladder control, or recurring UTI due to the bladder not fully emptying.

Posterior wall (rectocele or enterocele)

Rectocele: the rectum begins to fall into the vagina
Enterocele: the intestines begin to fall into the vagina

Symptoms may include difficulty defecating or straining with bowel movements and a bulging sensation.

Vaginal Vault or Uterine prolapse

This type of prolapse occurs when the cervix begins to fall within the vagina, often leading to symptoms of bulging, pressure, and even pain with intercourse.

Tips to help a prolapse:

Do	Don’t
Keep hydrated	Strain during bowel movements
Keep exercising (full body and pelvic floor)*	Hold your breath during strenuous activity**
Make healthy life choices, as obesity can increase a risk of prolapse	Smoke

* While continuing to stay active and exercise is important, be mindful of the exercises you are doing. High impact activities and heavy lifting may lead to a worsening prolapse or increased symptoms. For more advice on how to get back to these activities while keeping your prolapse in check, consider asking a professional for guided help.

** Holding your breath can increase the pressure in your abdomen and push the pressure down through your pelvic floor. Timing breathing with exertion can be a very helpful step to take.

Unsure if you have a prolapse or what you can do for it? Ask a physical therapist! We are able to help understand and improve your prolapse and manage your symptoms! For a free 10-minute consultation, visit us at https://imovedaily.com/womens-health/ and fill out the form to contact a Women’s Health Physical Therapist and schedule your consultation.

Resources:

Columbia Department of Urogynecology. Vaginal or Pelvic Organ Prolapse. https://www.columbiaurology.org/adult-urology/urinary-disorders/female-urinary-disorders/vaginal-or-pelvic-organ-prolapse-pop

Voice for PFD. Pelvic Organ Prolapse. https://www.voicesforpfd.org/pelvic-organ-prolapse/symptoms-types/

Advanced Gynecology. The Major Types of Pelvic Organ Prolapse and Their Differences. https://www.advancedgynecology.com/2020/the-major-types-of-pelvic-organ-prolapse-and-their-differences/