Pelvic Organ Prolapse is a condition where one or more of the organs in the pelvis lose support and descend downward toward the vagina.
Prolapse will occur in about 50% of women throughout her lifetime.
35% of women will experience it postpartum.
12% of women will eventually undergo surgery.
Of those that undergo surgery for prolapse, many will develop pelvic pain, constipation, recurrence of symptoms or other complications with the surgery.
Since pregnancy and birth are large risk factors for developing prolapse, it's important for women to know the signs and symptoms of prolapse and how to prevent it.
Is it a prolapse?
Symptoms of prolapse generally start with the sensation of heaviness or bulge in the vaginal region.
The affected organ can be the bladder, uterus, or colon, or a combination of these three.
You will likely notice the sensation with activities that are high impact or require a lot of standing. In more mild cases, the symptoms will decrease or go away once you sit or lie down for some time.
More severe cases can result in one or multiple organs visibly descending past the opening of the vagina. In this case, you will be looking at vaginal tissue but the organ will be on the other side.
You will notice a ball in the vaginal opening with shiny tissue that doesn't necessarily look like the dark red muscular tissue normally present at the opening of the vagina.
If you palpate the ball, you might have symptoms like the need to pee or poop.
In severe cases, symptoms are generally present all day but worsen with upright positions, lifting or high impact activity.
Prolapse is not a painful condition. It is not life-threatening or emergent (although it sure feels that way).
You are more likely to notice difficulty fully peeing or pooping with prolapse than pain.
Tight pelvic floor muscles can sometimes mimic symptoms of prolapse, so it's important to be evaluated by a pelvic floor physical therapist if you think you have it.
Will it go away?
Not without treatment. Even if your symptoms fully resolve by the first 12 weeks postpartum, you are experiencing estrogen levels masking the underlying dysfunction that caused the prolapse.
You need to address the underlying why.
It's important to strengthen and learn how to activate your core correctly to prevent reoccurrence of the prolapse, which is likely to occur after your next pregnancy or post-menopause if the underlying why is not addressed, even if symptoms resolve completely on their own.
Symptoms of prolapse that linger past 12 weeks postpartum are not likely to go away without treatment, and are likely to worsen into a more severe prolapse.
I'll just get surgery
Surgery for pelvic organ prolapse is a big decision. It's best performed on very severe cases and often includes a hysterectomy (removal of the uterus).
Pelvic surgery can result in major complications and is not a quick fix. Symptoms of prolapse can also reoccur after surgery if the underlying reason for the prolapse is not addressed.
Pelvic floor physical therapy should be utilized before and after surgery for best outcomes.
Pelvic floor physical therapy is critical for prevent and treatment prolapse!
Conclusion
Pelvic organ prolapse is a very common condition, but can be very frightening and frustrating for the person experiencing it.
In general, I see far fewer issues with prolapse in those that come for physical therapy before, during, and after pregnancy.
If you do develop prolapse postpartum, it's really important to address it as soon as possible. Most cases can be resolved completely if addressed thoroughly early on!
Even if you choose to delay treatment, prolapse can improve with physical therapy.
But for those that don't address it, prolapse can worsen overtime and significantly decrease your quality of life.
If you are dealing with this, make sure you book your appointment with pelvic floor physical therapy today!!