Prolapse of a Pelvic Floor Organ

What is prolapse?

Prolapse is a term to describe the falling out of place of an internal organ or body part, and it is used mainly for prolapse of pelvic organs.  For women the the major pelvic organs include the bladder, bowel, vagina and uterus.

According to the Continence Foundation of Australia , over half of all women who have had a child have some level of prolapse. Prolapse can have a substantial effect on a woman’s quality of life and up to one in five women who have a prolapse will need to seek medical help. A lot of the women who experience this condition also leak some urine.

What caused the prolapse and what non surgical treatments are available?

What caused the prolapse of a pelvic floor organ in women?

• Childbirth (the more vaginal births you have the more likely you are to have a prolapse);
• Persistent coughing;
• Lifting heavy weights;
• Constipation (long term, persistent to empty the bowel);
• Menopause / Ageing – Reduced oestrogen can cause the pelvic floor muscles (like all other muscles) to weaken;
• Runs in the family;
• Being hypermobile, ligaments become loose and weak.

What is the pelvic floor?

The pelvic floor is the muscular sling (like a hammock), that supports the major pelvic organs including the bladder, bowel, vagina and uterus to stay in the correct position. It has two major functions:

1. Closing (Sphincter Control): Contracting pelvic floor muscles closes the urinary and anal sphincters, allowing for continence to be maintained. If this function does not work one becomes incontinent.  Incontinence is one of the most common conditions why women move to aged care facility.
2. Relaxing pelvic floor muscles opens the urinary and anal sphincters, allowing for voluntary urination and defecation. This function is very important for sexual health.

What can you do about the prolapse?

Non surgical treatment options focus on to decrease the load from above arriving into your pelvis and increase support from below via increased Pelvic Floor Muscle strength (PFM).  An experienced Pelvic Health Physiotherapist will be your best guide.  If you are in Sydney (NSW) Sherin Jarvis from Women Health and Research Institute is well known for her work in this area – https://www.whria.com.au/our-services/pelvic-floor-physiotherapy/

• Think about the five G’s of prolapse – gardening /golf / gym / lifting grandchildren & groceries (carry them in smaller loads);
• Manage constipation;
• Change your position  for evacuation. Place the feet on some elevation so they will be higher then the knees, relax the abdominal;
• Minimize heavy lifting;
• Avoid standing for long periods;
• Aim for ideal body weight;
• Functional bracing: contract the PFM before cough, sneeze, lift, nose blow or anything which requires effort;
• Manage cough – see your GP sooner rather than later;
• Consider trialing a pessary which supports your pelvic floor organs;
• Modify your exercise routine, no wide leg squats, no breath holding.  Narrow base squats OK, lunges OK, seated or lying weights OK – this are just some examples not a comprehensive list of do’s and don’ts.

Yoga poses which help:

To start with warm up the body and to bring some movement in: cat / cow. Kneel on the floor, hands are under the shoulders, knees are under the hips. Inhale concave the beck (raise the chest, head and the tailbone). Exhale round the back and bring the head in towards the navel. Do a few cycles with awareness where the movement follows your breath.  Once you warmed up try the sequence below:

The management of this condition is slow, be patient and you will see improvement in your condition and in your mood.

As always, keep breathing softly and enjoy your practice!

*** Please note *** this post is a general guide, please consult your doctor & specialist if you notice a bulge / prolapse.