What is a Pelvic Prolapse?
Pelvic organ prolapse is a common condition, particularly affecting older women. Prolapse literally means ‘to fall’ and it occurs when the structures designed to keep organs in place weaken or stretch, so that one or more pelvic organs (the uterus, bladder, bowel or rectum) starts to slip out of place.
Causes of a Pelvic Prolapse
It is the pelvic floor muscles and supporting ligaments which keep the pelvic organs in their proper position. The pelvic floor muscles may become weakened for many reasons, such as pregnancy and childbirth, ageing, heavy lifting, obesity, chronic straining, surgery or injury.
Types of Prolapse
As with many conditions, the prolapse may be
- mild,
- moderate or
- severe
There are a range of management options and some do not require surgery
Conservative Treatment
While physiotherapy will not be able to return the prolapsed pelvic organ to their original position, it can help improve the strength of the pelvic floor muscles, so that they provide more support to the pelvic organs to prevent further slippage.
As a treatment for Pelvic Prolapse, physiotherapy can also play an important part in teaching you how to avoid certain activities and helping you make simple lifestyle changes which will prevent you from causing further damage and stretching of your pelvic floor muscles. It can also teach you how to improve your bladder control.
Physiotherapy Prolapse Assessment
Physiotherapy is always carried out in a private treatment room, always with the same Physiotherapist, providing sensitive, professional treatment. It starts with a thorough assessment.
An initial assessment is conducted by asking detailed questions about your symptoms, your bladder and bowel control, your medical and surgical history, pregnancies and births, your diet and lifestyle. A physical examination will then follow, which may include looking at your posture, back, abdominal muscles and likely an internal examination.
Once the examination is complete, a discussion follows, explaining the findings and exploring treatment options. It is a good opportunity for you to ask questions to gain a better understanding of your problems.
Reduced Symptoms by Physiotherapy
The goals of physiotherapy treatment for prolapse are to reduce the symptoms caused by the prolapse and to improve your pelvic floor support.
Treatment will always involve education, to teach you simple measures which can make a big impact on your comfort and control, for example; instructions on how to pass bowel movements without straining.
Treatment is often focused around the pelvic floor muscles – the sling of muscles which help to support and control the bladder. You will be taught how to identify them, how to tighten them (Kegel exercises) and how to use them functionally to help support your pelvic organs during daily activities.
Treatment techniques may include
- computerized biofeedback, to teach pelvic floor muscle awareness,
- bladder retraining,
- posture reeducation,
- exercises for the abdominals and other ‘core’ muscles.
A home exercise program will always be an important part of your treatment.
