What is a prolapse?

Written By Melissa Bull

What is a PROLAPSE?

A prolapse is the name used when your uterus, bladder or bowel comes down into the vagina instead of sitting in its normal position. It is much more common in women who have had at least one vaginal birth. Symptoms can include:

  • A heavy, dragging or aching sensation in the vaginal area, which often feels worse at the end of the day and better in the morning or after lying down.

  • A bulge or lump in the vaginal opening

  • Feeling like everything is going to “fall out” is how many women describe the sensation of a prolapse.

  • UTI’s and urinary retention

  • Lower abdominal or back pain

  • Difficulty inserting tampons

  • Frequent urination

There are different types of prolapse and different stages/levels.

Why does prolapse happen?

The pelvic organs are supported from above by ligaments and by the pelvic floor muscles and fascia (fibrous tissue within the pelvic floor) from below. If either or both of these structures weaken, there is less support for the pelvic organs and they can start to drop down. There are many reasons why this could occur, including:

  • Injury to pelvic floor (following childbirth)

  • Weakened pelvic floor muscles (following pregnancy & birth)

  • Quick (<20 minutes) or long (> 2 hours) second stage of labour.

  • Increased weight gain

  • Heavy lifting

  • Straining to open your bowels

  • Returning to high impact exercise or sport too soon following birth

  • Effects of gravity and doing too much too soon following birth

What can I do if I have a prolapse?

If you develop a prolapse during pregnancy or after the birth of your baby, there is a chance that it may be temporary due to your pelvic floor muscles being weakened and the effects of pregnancy hormones. As the hormonal effects wear off and your pelvic floor muscles strengthen, the support for your pelvic organs should continue to improve over the months following the birth.

  • Perform pelvic floor muscle exercises during pregnancy and after birth,

  • Avoid straining to open your bowels,

  • Make sure you get 2 hours/day horizontal rest in the last few weeks of pregnancy and first 6-8 weeks postnatally to avoid extra load/gravity effects to your pelvic area,

  • Perform ‘prolapse safe’ exercises,

  • Avoid heavy lifting and squats,

  • Seek treatment with a Womens health Physiotherapist.

How quickly can I expect to improve if I do have a prolapse?

Not everyone will improve quickly after experiencing prolapse symptoms. Sometimes it can take a few months and unfortunately for some women it takes a lot longer. However there are specialists to help guide you with treatment options including womens’ health physiotherapists and gynelogical specialists. There are special devices called “pesary” that can be used internally to help manage prolapse symptoms, a Physiotherapist can help with fitting these.

Some women have found that they continue to gain improvement even more than a year after the birth. Sometimes, once women stop breastfeeding, they notice that their muscles tone up and that their prolapse improves. However, it is possible that symptoms may return later in life, indicating the need for other treatment.

Melissa Bull
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