Have you ever felt a heaviness or feeling of “falling out” coming from the vaginal opening? Sometimes you can feel or even see something that shouldn’t be there? When women become aware that they have a pelvic organ prolapse it can be very worrisome. I get many panicked emails asking what the diagnosis means, what they can and can’t do, and what options are available to fix it.
A pelvic organ prolapse is when an internal pelvic organ drops lower into the vaginal canal than it should. This organ could be the bladder (cystocele), the uterus (uterine prolapse), the urethra (urethrocele), small bowel (enterocele) or the rectum (rectocele). You can also have the rectum descend through the anus (rectal prolapse).
Lots of things contribute to a pelvic organ prolapse; pregnancy, vaginal delivery, aging, constipation, diarrhea, chronic coughing/sneezing, standing and lifting posture.
Symptoms can include:
- Seeing/feeling pelvic organ tissue descend into and out of the vagina
- Increased frequency of urination
- Feeling like you can’t fully empty your bladder
- Dribbling after urination
- Vaginal heaviness
- Ache in and around the vagina
- Pressure from the rectum
- Difficulty evacuating bowels
- Having to apply manual pressure again the pelvic floor to properly empty bladder or bowels
- Low back pain
If you are worried that you might have a pelvic organ prolapse there are some things that you can try to help!
- Learn how to properly perform a kegel exercise. Strengthening the pelvic floor can help support the organs. Not sure how? Here’s how I teach a kegel.
- Lean forward on the toilet and lift your tailbone slightly – this helps to keep the bladder forward allowing it to empty better. It also helps to keep the direction of the force on your stool out the rectum and not towards the vagina.
- Pay attention to which activities worsen your symptoms. Are all of those sit-ups making you feel worse? Did yard work make your prolapse more obvious? Reduce those activities that you suspect are putting pressure on your organs, until you can talk to a pelvic floor physiotherapist.
- Talk to your doctor about treating any constipation, diarrhea, coughing, and/or sneezing that might be putting unnecessary pressure on your pelvic floor.
There are also some women who do need surgery to correct their prolapse. This is why it is best to see your doctor right away so you can be referred on to a gynecologist if needed. But even corrective surgery doesn’t last forever. It is always best to learn how to reduce strain through your pelvic floor, and to keep your pelvic floor and core muscles as strong as possible.
If you think that you might have signs and symptoms associated with a pelvic organ prolapse, talk to your doctor about finding a pelvic floor physiotherapist.
Katie Kelly, Physiotherapist
Bsc., MSc. PT