the pelvic floor, which is made up of both muscle and ligaments, is like a trampoline supporting the vagina, uterus, bladder and bowel.
when the pelvic floor becomes weak and stretches down, the organs may also slowly drop down. nothing is wrong with the organs, it's more that the pelvic floor, which was once strong, tight and elevated is now less strong and more stretchy, causing the organs to sit lower than they did before.
prolonged downward pressure on the pelvic floor can increase risk of prolapse:
- a history of straining/pushing to pass stool or urine
- repetitive lifting of heavy objects or weights
- pregnancy and childbirth, particularly forceps deliveries
- smoking and chronic lung diseases associated with coughing
- excess weight
recent research suggests a strong correlation between prolapse and genetics - if your grandmother or mother have prolapse, it's worth learning about all that you can do to prevent prolapse for yourself.
symptoms of prolapse can include:
- difficulty with fully emptying your bladder or bowel
- when you attempt to pass urine, the flow takes a while to start
- straining to empty your bowel, even when the stool being soft and well formed
- the flow of urine tends to stop and start
- fullness or pressure inside your vagina, sometimes described as a 'bubble'
- vaginal heaviness or dragging sensation
- recurrent urinary tract infections
- an urgency to empty your bladder or bowel
- leakage of your bladder or bowel
- feeling or dragging or pain in the lower back or abdomen
depending on your symptoms, treatment might include:
- a clear understanding of individualised, evidence-based management options for your prolapse
- tailored pelvic floor muscle strength exercises
- addressing bladder or bowel symptoms
- lifestyle changes
- pessary fittings, customised to fit your pelvic floor anatomy and goals (e.g. running, strength training or day to day activities)
- education on different surgical techniques for management of more severe prolapse
