Prolapse

What is a prolapse?

A prolapse occurs when one or more pelvic organs slide out of their usual position. The organs that most often prolapse include the:

• Uterus (uterine prolapse)
• Bladder (cystocele)
• Rectum (rectocele)

What causes a prolapse?

The organs prolapse when the pelvic floor muscles get stretched, weakened, or torn due to:

• Pregnancy
• Vaginal or c-section childbirth
• Delivering a large baby
• Hysterectomy
• Low estrogen after menopause
• Loss of tone and strength due to aging
• Severe, long-lasting cough
• Heavy lifting

The pelvic floor muscles stretch like a hammock from your public bone to your tailbone. The muscles hold your pelvic organs in place, control urination and bowel movements, and support sexual health.

What symptoms will I have with a prolapse?

You may have a vague feeling of pressure when the organ first prolapses. As it gets worse, you may have:

• A bulge in your vagina
• Pressure or aching in your pelvic area
• Pelvic pressure when coughing
• Low back pain
• Constipation
• Urine leakage or incontinence
• Urgent need to urinate (urge incontinence)
• Pain during sex

In severe cases, tissues may stick out of the vaginal opening, causing tenderness or bleeding.

How does pelvic physical therapy improve a prolapse?

Pelvic floor physical therapy is the first line of treatment for a prolapse. 

The Inland Pelvic Health & Physical Therapy team completes a thorough evaluation, including assessing your pelvic joints and muscles and doing an internal exam to evaluate the tone of the pelvic floor muscles. Then they create a treatment plan that may include:

• Pelvic floor strength training
• Vaginal inserts for support (pessaries)
• Patient education
• Home exercises
• Abdominal muscle exercises
• Manual manipulation
• Biofeedback (techniques that improve your awareness of muscle activation)

Your therapist teaches you how to perform the exercises properly and gives you an exercise routine to follow at home.

The work you do at home is more important than your physical therapy sessions because the goal is to build and strengthen the muscles, which takes time and consistency. A once-weekly therapy session typically isn’t enough to improve the muscles and treat the prolapse, but along with home exercises, can be really effective for treatment. 

The earlier you start treatment, the better your chances are of preventing a serious prolapse. Request an appointment online or call Inland Pelvic Health & Physical today.