Pelvic Organ Prolapse
Pelvic organ prolapse (POP) is the descent of 1 or more of the pelvic organs into the vagina. This can be recognised by a lowering of either the front (bladder) or back (rectum) walls of the vagina, and/or the uterus lowering downwards into the vagina.
The pelvic floor is made up of muscles, ligaments and connective tissue called fascia. The ligaments and connective tissue is very important for holding up the pelvic organs (bladder, rectum, uterus) while the muscles are very important in providing support from underneath.
POP can result from a stretch or tear to the fascia and/or muscles which can occur due to the added weight of the baby during pregnancy or from the birth itself.
The Symptoms
A bulge at the entrance of the vagina (usually at the end of the day)
Heaviness or a dragging feeling in the vaginally (usually worse at the end of the day or after exercise)
Difficulty emptying your bladder or bowels known as "incomplete emptying"
Painful intercourse
Low back ache
How is prolapse assessed?
Your treating physiotherapist will undertake an internal examination (with your consent) to indicate if you have a prolapse or not. We use specific skills to measure the grade of the prolapse (mild, moderate or severe). We will also assess your pelvic floor (tone, strength, coordination) that may be contributing to your prolapse symptoms.
Treatments available
Pelvic Floor Muscle Training. Improving the tone, strength and coordination of these muscles.
Optimise breathing patterns and the abdominal wall, particularly during exercise and functional movement.
Optimise bowel and bladder health (reduce straining, how to empty your bladder effectively)
Exercise and lifestyle advice - what you can do and what you should minimise/avoid.
Pessaries - a 'brace for the vagina', to support the organ/s that descend down into the vagina which are contributing to your symptoms.
Talk to gynaecoglogists/colorectal surgeons regarding prolapse management/post-op advice
What is a Pessary?
A vaginal pessary is a device used to treat pelvic organ prolapse (POP). It is made of medical grade silicon and is inserted into the vagina to hold the prolapsed organ(s) in place. We explain to patients that it is like a 'brace for the vagina', to support the organ that is descending down into the vagina, and to reduce the symptoms they might be experiencing such as heaviness, dragging, and/or incontinence. It is designed to substitute the support that was previously provided by the muscles and fascia, and thereby relieve the symptoms of POP.
We can fit a variety of pessaries at our clinic. There is 'no one size fits all' so it is important to discuss with your treating women's health physiotherapist and find the best pessary for you.