Pelvic Organ Prolapse
Pelvic organ prolapse occurs when pelvic organs descend from their normal position. Our women’s health physiotherapists provide comprehensive conservative management, often helping patients avoid or delay surgery.
Understanding Prolapse
Types of Prolapse
- Cystocele: Bladder prolapse (most common)
- Rectocele: Rectal prolapse
- Uterine Prolapse: Uterus descends
- Vaginal Vault Prolapse: After hysterectomy
- Enterocele: Small bowel prolapse
Grading System
- Grade 1: Mild descent, above hymen
- Grade 2: Descent to hymen level
- Grade 3: Descent beyond hymen
- Grade 4: Complete prolapse
Risk Factors
Childbirth-Related
- Vaginal delivery
- Large babies
- Prolonged labor
- Instrumental delivery
- Multiple pregnancies
Other Factors
- Aging and menopause
- Chronic constipation
- Heavy lifting
- Chronic cough
- Obesity
- Genetics
Symptoms
Common Complaints
- Feeling of “something coming down”
- Heaviness or pressure in pelvis
- Visible or palpable bulge
- Worse at end of day
- Better when lying down
Associated Problems
- Incomplete bladder emptying
- Urinary frequency/urgency
- Difficulty with bowel movements
- Sexual dysfunction
- Lower back pain
Conservative Treatment
Pelvic Floor Muscle Training
- Specific strengthening exercises
- Proper technique essential
- Progressive program
- Functional positions
- Long-term maintenance
Pessary Management
- Assessment for suitability
- Professional fitting
- Various types available
- Regular follow-up
- Self-management education
Lifestyle Modifications
- Weight management
- Constipation prevention
- Proper lifting techniques
- Chronic cough management
- Activity modification
Treatment Techniques
Manual Therapy
- Pelvic floor muscle release
- Fascial techniques
- Posture correction
- Core retraining
Real-Time Ultrasound
- Visual biofeedback
- Correct technique
- Monitor progress
- Patient education
Functional Training
- Safe exercise programs
- Return to activities
- Sport-specific advice
- Work modifications
Prevention Strategies
During Pregnancy
- Pelvic floor exercises
- Optimal birth positioning
- Perineal massage
- Birth preparation
Postpartum
- Early assessment
- Graduated recovery
- Safe return to exercise
- Long-term pelvic health
Expected Outcomes
With Treatment
- 40-60% symptom improvement
- Prolapse progression slowed
- Many avoid surgery
- Improved quality of life
- Better bladder/bowel function
Success Factors
- Early intervention
- Exercise compliance
- Lifestyle changes
- Regular follow-up
- Realistic expectations
When Surgery May Be Needed
- Conservative treatment failed
- Severe prolapse
- Significant quality of life impact
- Patient preference
- Completed childbearing
Living with Prolapse
Daily Management
- Symptom tracking
- Exercise routine
- Pessary care
- Activity pacing
- Support strategies
Long-Term Care
- Regular physiotherapy review
- Pessary checks
- Exercise progression
- Menopause considerations
- Ongoing prevention
