Prolapse is a condition where the walls of the vagina have weakened allowing the pelvic organs to press in on the walls of the vagina. Often prolapse is defined according to the organ that is pressing on the weakened vaginal wall, whether it is your bladder, urethra, rectum, or small intestines.
Uterine prolapse is a condition where the uterus has begun to descend into the vaginal canal causing the cervix (opening to the uterus) to drop down.
The symptoms of prolapse may include:
- A lump at the opening of the vagina
- Pain or pressure in the pelvis
- Decreasing pain or pressure when lying down
- Recurrent urinary tract infections
- Pain with intercourse
- Incontinence of bowel and/or bladder along with other bowel and bladder dysfunctions
- Some people with prolapse experience no symptoms at all (Herman and Wallace)
Risk factors for pelvic organ prolapse may include:
- Childbirth with a vaginal delivery
- Pelvic floor trauma
- Chronic constipation
- Systemic disease
- Menopause-estrogen deficiency
What is causing my prolapse?
As we age, have children, lose estrogen, etc. our pelvic floor and vaginal walls can become weaker. When this happens, prolapse is often the result.
What are my treatment options?
This all depends on how severe your prolapse is and how much your prolapse is affecting your everyday life. Some women need surgery to lift the organs that are protruding into the vaginal wall. Discuss this with your doctor to see if he/she feels this may be a necessary treatment approach for you. Sometimes your doctor may prescribe a device to help support the pelvic organs within the vaginal canal. This device is called a pessary and may be a good non-surgical treatment approach for you. Physical therapy may also be a good treatment option. Whether it is in conjunction with other medical treatments or your only treatment, physical therapists trained in pelvic floor dysfunction can help in the management of prolapse.
How can physical therapy help?
Physical therapists trained in pelvic floor dysfunction can assess the degree of prolapse and any muscle weakness you may have in your pelvic muscles. This is best determined with an internal pelvic exam. Physical therapy treatment may include pelvic floor exercises, abdominal exercises and stabilization techniques along with education regarding proper pelvic bracing techniques for everyday activities. You and your therapist will come up with a treatment plan that is right for you and address any other pelvic floor issues that often accompany prolapse.