Technically, a prolapse is a descent of the organs of the pelvis (bladder/bowel/uterus or vault if you have had a hysterectomy) into the walls of the vagina.
This can give you symptoms of a bulge, heaviness, ache or dragging sensation at the end of the day. It can also feel like there is an obstruction inside the vagina.
A prolapse can happen as a result of childbirth, with chronic constipation, or many other reasons.
A prolapse is a soft tissue injury (a bit like a sprained ankle) where symptoms can be made worse by increasing strain on the tissues, and made better by decreasing strain.
Strain can include:
There is a lot that can be done to help manage, improve, or totally get rid of your symptoms.
Things a pelvic physiotherapist can help with:
Your pelvic physiotherapist can work out a plan for you, which can include any/all of these things:
Managing your bowels so you're not straining. It doesn't matter how often you poo, what's most important is whether you can poo without pushing or straining. Aim for a Type 3 or 4 poo on the Bristol Stool Chart.
Resting each day. Just as you would elevate a sprained ankle, it's important to rest with your pelvis higher than your chest for 5–20 mins at a time to help reduce your symptoms by refreshing your tissues. Lie down and put a pillow or cushion under your pelvis. Keep your knees bent and your feet on the floor or bed and rest in this position in the middle of the day or at around 5 pm before you start your evening activities. Roll out of this position afterwards, don’t sit straight up.
Adjusting any lifting, avoid straining and pacing yourself with certain activities during the day.
Working on your muscle activation. Your pelvic physio will help you to strengthen and improve the activation of weak muscles. Sometimes muscles can hold on too tightly – you need to learn to relax these muscles so they are strong but flexible, and working well for you.
Providing guidance about whether a support pessary would be useful for you
A pessary is a medical silicon device that can be worn to help support a prolapse in women. Fitting a pessary is an evidence-based, conservative, low-risk measure to help support the prolapse. It is similar to wearing a knee brace when you have alignment issue.
A pessary helps you do the things you want to do in life. You can wear it during certain activities or all the time.
Some people put theirs in when they’re doing sport or gardening, to reduce the symptoms during the day, to make their pelvic floor exercises more effective, increase sexual satisfaction.
A pessary can improve tissue structure, which enables the prolapse to improve or at least not worsen.
