Imagine your pelvic floor muscles are like a hammock. This hammock generally supports 3 organs in females: the bladder, uterus and rectum. The hammock is designed to stretch but still be supportive. If the “hammock” is damaged or weakened, it may lose support and strength and may not be able to support all the organs. These organs may start to drop into or through the vaginal walls, this is otherwise known as pelvic organ prolapse. Pelvic Organ Prolapse occurs when a pelvic organ such as the bladder, uterus, bowel, or rectum descends from the normal anatomical position. A prolapse can descend within the pelvis or can come out of the body as well. What can put you at risk to develop a prolapse? Several risk factors exist, including, systemic hypermobility, and obesity. Furthermore, approximately 50% of women globally develop POP caused by childbirth.

Several types of prolapse exist, including:

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  • Cystocele (prolapse of bladder)

  • Urethrocele (prolapse of urethra)

  • Uterine prolapse (prolapse of uterus)

  • Rectocele (prolapse of small rectum)

  • Enterocele (prolapse of small bowel)

Most common symptoms include:

  • Feelings of pressure, bulging, pain, or fullness in vagina, rectum, or both -- sometimes you may even see a physical bulge coming out of the vagina or rectum

  • Incomplete bladder or bowel emptying

  • Urinary incontinence & frequency

  • Low back/pelvic pain that worsens with standing or exercising and is relieved with laying down

  • Chronic constipation

If you do have a pelvic organ prolapse, there are many conservative options to manage your symptoms. Pelvic floor muscle training is the #1 recommended intervention for pelvic organ prolapse. Recent high quality studies have shown that pelvic floor muscle training can significantly improve feelings of heaviness, reduce vaginal position and bulging, and also reduce urinary and fecal incontinence.4 Pelvic floor physical therapists can educate you on pelvic floor muscle training and teach you strategies to help reduce your symptoms and improve your quality of life. If you are dealing with symptoms like this, come see one of the pelvic floor specialists at Zion so we can help get you back on track to living life the way you want to!

1. Veit-Rubin N, Cartwright R, Singh AU, Digesu GA, Fernando R, Khullar V. Association between joint hypermobility and pelvic organ prolapse in women: a systematic review and meta-analysis. Inter. Urogyn. Jour. 2015;27(10):1469-1478. doi:10.1007/s00192-015-2896-1.

2. Lee UJ, Kerkhof MH, Leijsen SAV, Heesakkers JP. Obesity and pelvic organ prolapse. Current Opinion in Urology. 2017;27(5):428-434. doi:10.1097/mou.0000000000000428.

3. Schmid C, Maher CF. Epidemiology, Risk Factors, and Social Impact of Pelvic Organ Prolapse. Pelvic Organ Prolapse. 2013:1-9. doi:10.1016/b978-1-4160-6266-0.00001-0.

4. Brækken I, Majida M, Engh ME, Bø K. Can pelvic floor muscle training improve sexual function in women with pelvic organ prolapse? A randomized controlled trial. Physiother. 2015;101. doi:10.1016/j.physio.2015.03.322.

-By Brooke David, DPT & Elizabeth Santo, SPT