Prolapse: What is it and how to live life after a diagnosis
Discovering your have a prolapse, or feeling the moment when a prolapse happens, can be a scary time for a woman.
You may not know what to do or where to go, and it may feel like your whole life is now governed by this new heaviness in your life.
If you have been diagnosed with a prolapse (POP), think you may have one, or are having / had POP surgery, read on for some ways to carry on with your life.
What is a Prolapse?
Before we get going, how do you know if you have a prolapse? What is one and how can you get help?
a slipping forward, or down, of an organ (eg rectal prolapse)
There are 3 main types of pelvic organ prolapse. These are:
Bladder Prolapse (Cystocele) - Where the bladder descends or falls against / into the vaginal cavity.
Uterine / Womb Prolapse - Where the uterus decends into the vagina
Rectal Prolapse (Rectocele) - Where the rectum descends and falls against / into the vaginal cavity.
You can see the different types of prolapse in the image below.
The 4th type of prolapse listed on the image (vaginal vault prolapse) can happen after a hysterectomy, when the vagina loses it's normal shape and drops down or out of the vaginal opening.
The images above also show only one level of prolapse. Each prolapse is graded by how far the organ has descended.
Grade 0: No prolapse
Grade 1: The organ or vaginal wall protrudes a little way into the vagina
Grade 2 The organ / wall is within 1cm of the vaginal opening.
Grade 3: The organ / wall is protruding between 1cm - 2cm outside of the vaginal opening
Grade 4: The entire organ is outside of the vagina
What Causes Prolapse?
A prolapse results from the weakening of pelvic floor muscles and supportive tissues.
Anything that puts pressure on the pelvic floor, has the possibility of causing a prolapse. These can include:
Difficult labor and delivery or trauma during childbirth
Delivery of a large baby
Being overweight or obese
Lower estrogen level after menopause
Chronic constipation or straining with bowel movements
Chronic cough, e.g. asthma, COPD or bronchitis
Repeated heavy lifting, e.g. lifting children, weights, caring for adults, lifting at work
Women who have had pelvic surgery may also have increased risk of prolapse.
What are the Symptoms of Pelvic Organ Prolapse?
Heaviness or dragging sensation in the pelvis.
Urinary incontinence, e.g. leaking urine or a chronic urge to urinate.
Incomplete emptying of the bowel
Inability to insert a tampon
Lower Back Pain
Where Can I go for a Diagnosis?
A women's health physiotherapist (pelvic floor physiotherapist) can assess:
If you have a prolapse
The grade of prolapse
Which organs are prolapsed
Your pelvic floor function
Managing a Prolapse
Often, following a prolapse diagnosis, you may be told to do your pelvic floor exercises, or that you need surgery, or you should refrain from lifting or high impact exercises.
That can often be very hard to hear. Especially as life is lived on our feet.
Thoughts might run through your head such as:
Will everything fall out if I run for the bus?
How do I look after my children / grandchildren if I can't pick them up?
How do I exercise now?
If I can't exercise, I'll put on weight, and that's going to make it worse too!
Do I have to keep squeezing to keep everything in?
Talk to your physio
Your physiotherapist would have graded your prolapse and given you some information, exercises or tools to help you.
Sometimes they will refer you on to a coach you can help you with your pelvic floor exercises, or a specialist for a surgical consultation.
To manage a weak pelvic floor or a mild prolapse. You will often be given information on:
pelvic floor exercises.
To manage a mild to moderate prolapse, you may have the following recommendations (please note that each prolapse is different and this doesn't replace medical / clinical advice)
Pelvic floor exercises with the physiotherapist or with a trained pelvic floor coach (look at our Recovery programme for 1:1 help in person or online)
For prolapses that are protruding outside of the body, surgery is usually required.
You will often be referred to a gynaecologist for a clinical consultation on the right type of surgery for you.
After you have had the surgery and are given the all clear, you may then be referred back to the physiotherapist for pelvic floor exercises, referred to a pelvic floor coach, or left to your own devices.
If you are looking to get reconnected to your pelvic floor muscles after surgery and manage lifestyle changes (as mentioned in grades 0-1), please look at our Holistic Core Restore® Recovery programme for bespoke rehabilitation in conjunction with your women's health physio.
It's Never Too Late to Connect to Your Pelvic
Like any other muscle, it's a case of use it or lose it, and with the pelvic floor, they need to be functioning at their best to not only reduce the risk of prolapse, but also to prevent or stop incontinence.
Pelvic floor coaching is so much more than squeezing and holding. We coach you through:
Down training (the pelvic floor, like any other muscle, needs to relax too)
All of these play a huge role in how everything in your body functions. Our focus on these is how you manage the downward pressure as you do these above activities and how nutrition helps your body with healing, repair and recovery.
At Connect, we specialise in helping women connect to their core and pelvic floor, no matter what stage of life you're at.
Please share this blog with anyone who may benefit.
Never be afraid or embarrassed to talk to us. Everything we discuss is always in the strictest of confidence.