What Is Pelvic Organ Prolapse

Many of my clients fear prolapse or think that they are destined for surgery if they are diagnosed with prolapse, but the truth is that there is a LOT of variance in how prolapse can impact a woman’s quality of life. Many women have a small amount of prolapse and have no symptoms. As the prolapse progresses, women often have many life changing symptoms. There are a few things to know about prolapse including: 1. What does prolapse actually refer to 2. What are the symptoms of prolapse 3. What can contribute to prolapse and 4. How can you minimize the risk of developing organ prolapse. This blog will discuss what is organ prolapse and some myths about prolapse.  Next week you will learn how to do a self check, prevent prolapse and what to do if you have organ prolapse!

What is organ prolapse?
Organ prolapse refers to the descent the anterior or posterior vaginal wall, cervix or the apex of the vagina (only after hysterectomy). This impacts the either your bladder or urethra if the anterior wall is impacted and the rectum/colon if the posterior wall is impacted. This can happen in one area or multiple areas and can impact bladder and bowel function. There are stages to organ prolapse where 0 refers to no prolapse and 4 refers to when the organ shifts or is evident on the outside of the vaginal opening. Stages 0-3 are can be treated successfully with PT and supportive devices as needed.

What are the symptoms of organ prolapse?
Symptoms of prolapse include pelvic heaviness that worsens as the day progresses, leaking of urine or difficulty emptying bladder, difficulty emptying bowels, vaginal bulging or heaviness or low back pain that worsens at the end of the day.  Often there are no symptoms of prolapse until the severity increases. Many women feel the need to splint or hold their perineum during bowel movements. 

What causes prolapse?
There is not one cause of organ prolapse. Often women have several of the following in their history: Pregnancy, delivery (especially with vacuum or forcep use or extensive time pushing), scar tissue from perineal scars or c section scars that cause imbalance in the pelvic floor, chronic constipation, improper pressure management when lifting, straining or exercising. Many women who have connective tissue disorders like Ehler’s Danlos Syndrome may be more susceptible to prolapse. A recent study compared 1379 women who either participated in Cross Fit or were runners and reported that the runners reported a higher incidence of pelvic organ prolapse and anal incontinence.

Myths
There are several myths that circulate with regards to prolapse. Many women and practitioners think that doing kegels is the # 1 thing to do to reduce your prolapse. Nothing could be further from the truth. Yes, we want a strong pelvic floor but strong means able to lengthen and shorten. If you only think about contracting you may not be actually strengthening the full range of the pelvic floor and this will set you back. Just like your bicep works when lengthened and shortened, your pelvic floor needs to do the same. Additionally, lots of videos float around with women doing exercises with their butts elevated to”put back” the prolapsed organ. However, doing that set of exercises even daily will not combat the other 12-15 hours you are sitting, standing or moving that may be leading to over pressure of your pelvic floor. Learning about how you use your body to support or detract from your pelvic floor is key! Can those exercises be part of your plan, yes, but they should not and cannot be the only approach.

Up Next... 
Next week we will talk about what you can do to reduce the risk of prolapse. If you've got immediate questions, reach out! 

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