Pelvic Organ Prolapse

Pelvic organ prolapse is the symptomatic descent of one or more of the bladder, bowel, the uterus (cervix), or the apex of the vagina (in the absence of a cervix) from the normal anatomical position.

Often women come to the clinic already suspecting they may have a prolapse. They’ve felt something, looked in the mirror, read things online etc. Unfortunately there is a lot of misinformation out there which often means when we see women they are scared, feel like their body has betrayed them, and may have ceased exercising.

Pelvic organ prolapse (POP), is extremely common. It occurs in up to 75% of women across the course of their lifetime. However, it is not always symptomatic! Women describe feeling a sensation of vaginal heaviness, a bulge, like they’re ‘sitting on an egg’, or they may have felt a bulge when washing in the shower. Other times, women will report a change in bladder or bowel symptoms, for example, a feeling of not emptying properly, or a dribbling of urine after standing up from the toilet.

POP is commonly detected in the post-natal or post-menopausal period, or may be symptomatic around the time of your period, or following heavy lifting. In the early post-natal period we can also assess to determine whether you are at risk of developing a prolapse and put into place strategies to PREVENT a prolapse from occurring!

The management of pelvic organ prolapse (POP) is varied and specific to the patient, their goals and their life stage. At Femme Fit Physiotherapy, we endeavour to understand not only your symptoms, but also the bother associated with these to determine the optimal treatment pathway to offer you.

There are so many options available for the treatment and management of POP. Women are often amazed and so encouraged by the options we have to offer.

An assessment with a women’s health physiotherapist may involve a vaginal exam - it is the only way for us to get a truly accurate assessment of whether you have a prolapse, assess the strength of your pelvic floor, as well as assessing the condition of the vaginal tissues. If you experience symptoms while standing or exercising, we may also perform a vaginal exam with you in an upright position, while squatting, or even whilst lifting a weight to assess for the presence of a prolapse and the coordination of your pelvic floor.

Treatment for a pelvic organ prolapse is totally individualised, but may involve:

• Pelvic floor muscle training

• Changes to bladder and bowel habits

• Toileting positions to facilitate proper emptying

• Adjustment of exercise programs - please note we endeavour to keep you being able to do the exercise you want to do!

• Fitting of a pessary - a silicone medical device inserted vaginally to support the presence of a prolapse

Ladies, if you suspect you may have a prolapse, please make an appointment to have an assessment