What is Pelvic Organ Prolapse?
By Isabella Gosling | Registered Nurse (B. Nurs & B. Ed)
Pelvic Organ Prolapse Awareness Month takes place in June each year to raise awareness for the up to 50 percent of people assigned female at birth (AFAB) affected by Pelvic Organ Prolapse (POP).
What is Pelvic Organ Prolapse?
Pelvic Organ Prolapse (POP), is where the muscles, tissue and ligaments that are across your pelvis, known as your pelvic floor are weakened, no longer being able to hold your pelvic organs in place (bladder, bowel, uterus and vagina) (The Royal Australian and New Zealand College of Obstetricians and Gynaecologists, 2022). As such, one or more of these organs protrudes or bulges into the vagina (Continence Foundation of Australia, 2024).
What are the different types of prolapse?
There are different types of prolapse, and you may have more than one organ prolapse at the same time (Australian Commission on Safety and Quality in Health Care, 2018). These include;
Front wall of the vagina (cystocele)
Back wall of the vagina (rectocele)
Uterus (uterine)
Top of vagina (vault)
What are the Symptoms of Pelvic Organ Prolapse?
You may not feel or notice a prolapse at first, or if you have a lower stage and the prolapse has not moved far. However, if you have a greater staged prolapse, symptoms can include:
A bulge or lump coming out of your vagina that you can feel or see
A pressure or heaviness feeling in the vagina
Lower back pain
Pelvic pain
Reduced sensation or pain with intercourse
Unable to effectively open your bowels or urinate
Less control over your bowels or bladder
Recurrent urinary tract infections
These symptoms may improve after periods of rest, and can be worse after physical activity or after standing for long periods.
What can cause Prolapse to happen?
Almost 50 percent of people assigned female at birth will be affected by prolapse (The Royal Women’s Hospital, 2024). Prolapse most commonly occurs postpartum, as during pregnancy the hormonal changes and additional weight in the pelvic area can weaken the pelvic floor (The Royal Women’s Hospital, 2024). During delivery, the pelvic floor muscles and supportive tissue can be stretched or torn by the baby (Continence Foundation of Australia, 2024). Other causes can be excessive coughing through asthma, bronchitis or emphysema, heavy weight lifting, chronic constipation or straining to open your bowels, as well as through aging and post hysterectomy (Australian Commission on Safety and Quality in Health Care, 2018; Continence Foundation of Australia, 2024).
How is Pelvic Organ Prolapse Diagnosed?
A pelvic organ prolapse may be assessed or diagnosed by a gynaecologist, general practitioner (GP), a pelvic physiotherapist or women’s health physiotherapist.
It is usually done via an internal examination of the vagina with a speculum (an instrument which separates the vaginal wall) or via digitation (using the fingers) and the rectum (The Royal Australian and New Zealand College of Obstetricians and Gynaecologists, 2022).
Medical imaging (such as ultrasound, MRI or CT) can also be used to diagnosed the degree or severity of a prolapse.
What Treatment is there for Pelvic Organ Prolapse?
Seeing a pelvic physiotherapist can assist greatly in managing pelvic organ prolapse. They can assist with;
Pelvic floor strengthening exercises and breathwork
Bladder and Bowel training
Pessary use (a device that sits in your vagina) to provide support for your pelvic organs internally
Returning to exercise safely
Surgery could also be required, which can strengthen the vaginal wall and provide greater support to the pelvic organs. There are many approaches that will be discussed and depend on what is best for you.
Where can I get support?
You can ask questions and get peer related support from the Let’s Talk, Period. community here.
The Continence Foundation of Australia provides a national helpline which can provide confidential and free information, support and advice, as well as resources and referrals to local services to support you. Their number is 1800 33 00 66.
References
Australian Commission on Safety and Quality in Health Care. (2018). Treatment options for Pelvic Organ Prolapse. https://www.safetyandquality.gov.au/sites/default/files/migrated/Treatment-Options-POP-Consumer-Info.pdf
Continence Foundation of Australia. (2024). Pelvic Organ Prolapse. https://www.continence.org.au/who-it-affects/women/prolapse
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. (2022). Pelvic Organ Prolapse. https://ranzcog.edu.au/wp-content/uploads/2022/05/Pelvic-Organ-Prolapse.pdf
The Royal Women’s Hospital. (2024). Vaginal Prolapse. https://www.thewomens.org.au/health-information/vaginal-prolapse/causes-and-treatment
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