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What is Pelvic Organ Prolapse?



Pelvic organ prolapse, sometimes referred to as POP, is the descent or lowering of one or more pelvic organs including the bladder, rectum, and uterus. POP can occur as the pelvic floor muscles weaken over time, making it harder to hold up the pelvic organs in their highest position. The ligaments, muscles, and tissue keeping your organs lifted can be affected by genetics, what you do for work--like heavy lifting, longstanding constipation, how many children you've had, complications during birth, age-related pelvic health changes like menopause, and family history.


Pelvic organ prolapse is diagnosed by grades with 0 meaning no prolapse at all and 4 being the most significant. This is determined by how low the bladder, uterus, or bowel has become:

  • Grade 1 - organs have only moved down a little

  • Grade 2 - organs have moved to the level of the vaginal opening

  • Grade 3 - up to 1 cm of bulge out of the vaginal opening.

  • Grade 4 - more than 1 cm of bulge out of the vaginal opening


Being diagnosed with pelvic organ prolapse can be scary and overwhelming. You may be unsure of what that actually means and what steps are needed to fix it. You may be wondering if you will need surgery and what the long term impacts to your normal lifestyle and routine will be. 





Research shows that 50% of women have prolapse on examination--many without symptoms. While it’s a relatively common condition, it’s normal to be concerned. Understanding more about this common condition can ease some of the fears you might be experiencing.





Symptoms of Pelvic Organ Prolapse


Pelvic organ prolapse can present no symptoms. However, the typical symptoms of prolapse can include:

  • Seeing or feeling a bulge of tissue at or beyond the opening of the vagina

  • Pelvic pressure, heaviness or pain

  • Lower back pain

  • Feeling like a tampon is present when one is not

  • Bladder changes

  • Bowel changes

  • Pain with intimacy


If you are concerned that your organs may "fall out", the answer is probably not! For the bladder and the rectum, it would be physically impossible for the organ to actually “fall out” unless there’s a hernia or fistula. Technically, the uterus can drop fully into the vaginal canal, but this is extremely rare. For a cystocele (bladder prolapse) or rectocele (when the rectum pushes on the back wall of the vagina) you can imagine placing your hand inside a sock and pinching one piece of the sock slightly in. That’s a better visualization of a prolapse, rather than the organ “falling out” of your body.


Management & Treatment Options for Pelvic Organ Prolapse





More significant forms of prolapse may require surgery. For minor to moderate prolapses that don’t require surgical intervention, pelvic floor physical therapy is a great option for alleviating prolapse symptoms. With prolapse, learning how to use your core correctly will help decrease any downward pressure that might be contributing to prolapse symptoms. 




Pressure Management

Work on upright posture to limit downward pressure on your organs.


Constipation Management

Keep your bowels moving regularly and your stool consistently formed but soft.


Strengthening & Mobility Work

Work to strengthen, and fully relax, your pelvic floor muscles to better support your organs. Treatment is more often about relaxation and lengthening the pelvic floor muscles than strengthening them.


Activity Modifications

Do cycle, swim, water walking, water aerobics and elliptical.

Avoid running, jogging, jumping, skipping and any exercise on a hard surface.


Splinting

When you have a bowel movement hold your vagina closed externally as you evacuate –or– insert your thumb to support the back wall of the vagina.


Recognize Muscle Fatigue

Signs include: a feeling of heaviness/aching in your pelvis, incontinence, pain, or an inability to perform a pelvic floor muscle contraction.





If you think you may have pelvic organ prolapse, don't hesitate to reach out to a pelvic floor therapist. We are equipped with the knowledge, tools and skills to help you manage this condition and get you back to feeling like yourself again!







If you have pelvic health concerns and would like to see how our therapists at

Embrace can help, follow the link to schedule your free discovery call.





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