Pelvic Organ Prolapse

Pelvic Organ Prolapse

What is a prolapse?

You have been diagnosed with a pelvic organ prolapse, or perhaps more specifically a cystocoele (bladder), rectocoele (lower bowel) or uterine prolapse. A prolapse occurs when one, or a combination, of the pelvic organs lose their normal support and move out of position to sit lower in the vaginal canal. It may be mild, moderate, or more severe and can cause some discomfort or bladder & bowel symptoms.

Risk factors for prolapse include:

  • pregnancy & childbirth
  • family history
  • ageing & menopause
  • chronic constipation
  • weak pelvic floor muscles
  • chronic respiratory illness
  • being overweight or obese
  • repetitive heavy lifting
  • large fibroids
  • previous gynaecological surgery

Prolapse Symptoms may include:

  • sensation of pressure, dragging, heaviness or discomfort vaginally
  • a feeling of a bulge or ‘something coming down’
  • backache
  • difficulty empting the bladder or bowel
  • needing to pass urine more frequently
  • bladder or bowel incontinence
  • discomfort during intercourse

How can I manage Prolapse?

  • Practice regular pelvic floor muscle exercises as instructed by your physiotherapist after an internal examination. These need to be specific for you in order to be most effective.
  • Squeeze your pelvic floor muscles when you cough, sneeze, lift, laugh etc.
  • Avoid very high impact exercise (e.g. trampoline, running, jumping) or exercise with increases the intra-abdominal pressure (e.g. planks, sit-ups, rowing).
  • Try to avoid long periods of standing; take regular breaks or do some tasks in sitting such as preparing food etc.
  • Avoid very heavy lifting, pulling, pushing or dragging. Delegate where possible or split up the load.
  • If you are caring for a relative seek help with moving and lifting where possible. Look at aids such as slings and hoists to reduce the load, or simply another pair of hands when available.
  • Try to maintain an ideal weight (BMI 19-25). Lose some weight if you need to in order to reduce pressure on the pelvic floor muscles, pelvic organs and ligaments which being overweight or obese can cause.
  • Avoid straining to empty your bowels. Eat a balanced diet with adequate water intake (at least 1.5 – 2 litres) and fibre (wholegrains, fruit and vegetables) to prevent constipation.
  • Avoid smoking to minimise the risk of coughing and chest infections.
  • Sexual intercourse will not make your prolapse any worse. It will not do harm but occasionally may be uncomfortable. Use a vaginal lubricant for more comfort and try different positions to see what works best for you both.