04/04/2022
Prolapse
What is it?
Prolapse is diagnosed when the pelvic organs move out of place and descend downward in the pelvis. This occurs when the ligament and muscle structures in the pelvis are not providing as much support as they used to.
There are multiple organs in the pelvic area, so prolapse can present quite differently depending on what structures have moved.
Types:
Vaginal - the walls of the va**na descend downward
Uterine (womb) - the uterus descends toward the entrance of the va**na
Bladder (cystocele) - the bladder leans back creating a bulge on the front wall of the va**na
Bowel (rectocele) - the bowel leans forward, creating a bulge on the back wall of the va**na.
Symptoms:
-heaviness of dragging in the lower pelvis. Often associated with fatigue, standing for long periods or increased physical activity
-a bulge in the va**na - can often make inserting a tampon tricky
-unable to empty bladder or bowel
-incontinence of bladder or bowel
-pelvic pain and back ache
What can cause prolapse?
-pregnancy and delivery
-heavy lifting (repetitive)
-weight gain
-menopause
-chronic straining eg. constipation or straining to empty the bladder
-chronic coughing
There are varying degrees of prolapse. And management is based on level of bother, not degree organ movement.
For example:
-One person may have a large prolapse, but no trouble with continence or exercise.
-Another person may have a small prolapse, but be very bothered by bulging and continence issues.
Treatment:
Healthy bladder and bowel habits - avoiding straining and constipation with good toilet positioning and food/fluid intake
Pelvic floor exercise - increasing the muscle strength in your pelvis will mean that your pelvic organs are more supported.
In many cases, the above strategies are all that are needed to maintain and manage prolapse long-term! For more advanced cases of prolapse, specialist input may be indicated for additional treatment options.
Life gets busy, but if you are experiencing any of the above symptoms please have your doctor or pelvic floor physio assess you for prolapse. It may also be something to discuss when you have a PAP smear/ CST screen.
