How to Reverse Pelvic Prolapse and Avoid Prolapse Surgery

Pelvic prolapse surgery

Are you trying to avoid pelvic prolapse surgery?

Would you like to reverse your prolapse?

This Physiotherapy prolapse information teaches you about:

  • How to improve your pelvic prolapse without surgery
  • Your non-surgical prolapse treatment options
  • How to avoid your prolapse worsening

Can Pelvic Prolapse be Reversed?

Yes!  Pelvic organ prolapse can be treated and improve without surgery in some women.

Prolapse results when the pelvic floor tissues are overstretched and weakened, just like overstretching a spring.

Your pelvic floor muscles should work to help support your pelvic organs (i.e. bladder, uterus and rectum). Women with prolapse have weak pelvic floor muscles 1 so they have decreased internal support to hold their pelvic organs in position.

In some women with mild to moderate prolapse (i.e. pelvic prolapse sitting above the vaginal entrance rather than beyond) scientific research 2  shows three months of pelvic floor muscle training reduces the severity of vaginal prolapse.

In women with more severe prolapse problems (i.e. prolapse protruding below the vaginal entrance) pelvic floor muscle training is less effective in reversing prolapse.

Most women are still likely to benefit from pelvic exercises, especially if they are undergoing prolapse surgery and seeking to avoid repeat prolapse.

Effective Non-Surgical Prolapse TreatmentIncludes:

1. Training the pelvic floor muscles to increase prolapse support

2. Getting fitted with a support pessary

3. Modifying lifestyle factors that worsen prolapse problems (e.g. straining with constipation, heavy lifting and inappropriate general exercise)

4. Learning The Knack exercise technique to reduce prolapse strain (see video below)

This video teaches you how to do ‘The Knack’ exercise technique for prolapse treatment.

Prolapse Exercises e-Book

International best selling prolapse exercise guide for women with prolapse and after prolapse surgery.

Prolapse Exercises Book

Prolapse Exercises teaches you how to:

  • Exercise safely after prolapse surgery
  • Reduce your risk or repeat prolapse
  • Avoid unsafe exercises
  • Choose pelvic floor safe exercises
  • Reduce your risk of prolapse worsening
  • Improve prolapse support
  • Increase your strength and fitness
  • Strengthen your core
  • Lose weight

Can Non-Surgical Treatment Relieve Prolapse Symptoms?

Yes! Pelvic prolapse symptoms can be relieved without surgery in some women, particulalry the severity of symptoms and how frequently they occur.

Scientific research shows that women can reduce how often they experience prolapse symptoms with pelvic floor muscle training 2.

Some of the most common prolapse symptoms i.e. vaginal bulging and heaviness that are often the main indicators for prolapse surgery have also been reduced with pelvic floor muscle training.

How Much Pelvic Floor Muscle Training for Results?

Pelvic floor muscle training to reverse pelvic prolapse and relieve symptoms of vaginal bulging and heaviness involves:

• Performing 3 sets (groups) of daily pelvic floor exercises
• Repeating your exercises 8-12 times in a row
• Contracting your pelvic floor muscles strongly with every exercise

If you are suffering from prolapse problems, pelvic floor exercises can help you take back some control over your body. These muscle training exercises can be completed any time and there are no adverse side effects if they are done correctly.

More Tips for Treating Prolapse Symptoms

There are a number of ways to take pressure off your prolapse and relieve prolapse symptoms including:

losing weight

  • Losing weight especially abdominal fat (if you are overweight)
  • Correcting your posture
  • Managing your bowels using the correct bowel emptying technique
  • Using a support pessary
  • Managing chronic chest conditions that cause coughing
  • Modifying adverse lifestyle factors (e.g. using safe lifting techniques)
  • Staying strong and fit with pelvic floor safe exercises.

For more details on how to treat these prolapse symptoms listed please refer to further reading and videos (below).

Will Your Pelvic Prolapse Worsen?

Unfortunately there is currently no way of predicting whether a woman’s pelvic organ prolapse will worsen over time or how quickly.

There is no one rule fits all when it comes to prolapse worsening.

Some women don’t experience prolapse worsening over time whereas others experience prolapse worsening to the extent that they require prolapse repair surgery.

Pelvic organ prolapse tends to progress as women increase in age3. This suggests that life-long prolapse management involving pelvic floor muscle training is important for women living with prolapse problems who are seeking to avoid prolapse surgery.

Key Points

  • Pelvic floor muscle training is a scientifically proven effective non-surgical pelvic prolapse treatment for some women in the short-term at least.
  • You may be able to avoid pelvic prolapse surgery with pelvic floor muscle training if you can relieve those prolapse symptoms that are the main indicators for repair surgery.

If you’re not sure about how to proceed with pelvic floor training to manage your pelvic prolapse you may like to seek the guidance of a Pelvic Floor Physiotherapist.

ABOUT THE AUTHOR, Michelle Kenway

Michelle Kenway is an Australian Pelvic Floor Physiotherapist.

Michelle lectures to health professionals and promotes community health through her writing, radio segments, online exercise videos and community presentations. She holds dual post graduate physiotherapy qualifications in women’s health and exercise.

Further Reading & Related Videos

» How Pessaries Can Help Prolapse Symptoms And Support

» Safe Lifting Weight Limit With Prolapse or After Hysterectomy

» Pelvic Prolapse Exercises for Fitness? Get on Your Bike and Ride!

» Best Exercise to Lose Weight After Hysterectomy or Prolapse Surgery


1 DeLancey J, Morgan D, Fenner D, et al. (2007) Comparison of levator ani muscle defects and function in women with and without pelvic organ prolapse. Obstetrics & Gynecology;109:295-302.

2 Brækken, I, Majida M, Engh M, & Bø, K. (2010) Can pelvic floor muscle training reverse pelvic organ prolapse and reduce prolapse symptoms? An assessor-blinded, randomized, controlled trial. American Journal of Obstetrics and Gynecology, 203(2), 170-e1.

3 Hunskaar S, Burgio K, Clark A, et al. (2005) Epidemiology of POP. In: Abrams P, Cardozo L, Khoury S, Wein A, eds. Incontinence. Plymouth,UK: Health Publication Ltd; 290-8.

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  1. Firstly I wanna give a HUGE hug to the women in the comments, specially the young women because anything “different” will make us so insecure, I am 28 years old, i’ve found it so difficult to find other young women talking about their prolapse online, nobody tells you it can happen to anyone. I have a stage 2 cystocele (bladder prolapse) you can somewhat see it at the entrance, I went for evaluation twice, they made me push and I got the same answer twice. I didn’t want to accept this, it made me feel unattractive and less sexy, I have always depended on my sex appeal so knowing I had this really killed me and i’m still getting used to the fact. I have 2 babies, 2 c sections. Admittedly ive always been bad with my digestion and strain, I never realized this could make matters worse. I asked them if i get surgery if it was permanent which they told me they can’t tell me because they’ve seen permanent cases as well as people that have needed to get surgery again, i just want the issue gone, they said they recommend a physical therapist because i’m young and i kept asking if it will reverse the bladder prolapse, i guess i want whatever will give me the bladder i had before kids, will physical therapy help me get there if i work hard enough? I scheduled an appointment, surgery is a last case scenario if it bothers me too much.. I don’t leak, i feel mostly normal but know i have this has made me over analyze ANY feeling i get down there, i find myself squatting with a mirror under me a lot, pushing semi hard (not too hard but also hard enough to reassure myself i’m not in a worsening stage). I just want to reverse all of this damage, sorry for how long this is, my doctors said cystoceles are completely normal, in young and older women and that most of the time they don’t even a tell women if they see one if the women doesn’t complain about it or have no symptoms. Can you give me some peace of mind? I haven’t been able to fully live life happily because i feel so insecure about this. :/ how common is it? Is it truly normal for women of any age to get this? Most affective way to reverse It 100%? What if i got surgery AND did physical therapy? Haha i’m sorry again, i guess i just need a pick me up

  2. Hello, I am Rebecca from Australia and I have been diagnosed with a stage 2 uterine prolapse. What is the most effective way to manage this condition to avoid having surgery and can it be repaired naturally?

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Rebecca
      Yes with moderate uterine prolapse you do have a number of options – pelvic floor exercises/rehabilitation is a priority, you may like to look into pessary support as well (via pelvic floor physio or gynae). The best way forward is to see a qualified pelvic floor physiotherapist who will be able to assess your other risks and address accordingly too. In Australia pelvic floor physio is easy to access with many highly trained and experienced physios working in this field and this does not require a referral so you have this service readily available. I hope this helps you moving forwards, all the best!

  3. Hi I’m Shalomi from Sri Lanka,(sorry for my bad English)i am 20 years old and I am having pain in my vaginal and bladder area from my childhood …when I am writing this comment I am also having that bad pain…because of this pains I met a doctor and he examined me and asked some questions and told me that I have a bladder prolapse….I feel very sad and I really worrying about this my country there’s no special treatments for this prolapse things.doctors also told me that I am too young to have one is understanding me.i can’t explain my pain..sometimes I use painkillers.some nights I can’t sleep…I am not over weight my hight is 5’5 and weight is 57kg…and Also my bladder is overacting and doctor gave me medication for that..before i recognize this I didn’t care my pains and I did many sports..Zumba..and many workouts..but now I am really scared of doing anything active and I always stay home.i was a librarian and I stopped going to working because of this bladder prolapse.i can’t even stand for 30 minutes if I stay standing for more than 20-30 minutes it getting started my pains worse and i can’t even run jump or lifting heavy things..a one inch sized ball shape thing can see in my vaginal open…doctor told me to do kegals for three times a day..but I don’t know how to do kegals correctly.I watched videos and practiced kegals but I feel more pain when l am doing it.should I do kegals?can I do other work outs as usual??can this be worsen..I don’t know what to do I am really down now.

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Shalomi
      I am sorry to read your story – thank you for writing and your English is fine, no need to apologise. Shalomi your bladder prolapse condition can be treated. If Kegels aren’t working because the prolapse is too severe then there are other treatment options for you. This is going to be tricky at the moment with Covid-19 preventing international travel. I am going to make some enquiries immediately regarding the best course of action and I will let you know the best way forward. At the moment just do what you can manage comfortably – even just some walking or do you have access to a bike? This would be the best option at the moment to help you exercise. Stay strong Shalomi, I will start to make enquiries on your behalf now. I will email you privately from now on, no need to post further here.

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Just in case you are following this thread from Shalomi, we have managed to access excellent Urogynaecology support and treatment in India. I will be initiating fund raising to help with her travel and accommodation in India (from Sri Lanka) in the near future. Thanks for your interest and support (via email [email protected])

  4. Hello Michelle,

    I am an active 66 year old with Stage 3 pelvic prolapse. I came from Mexico where I live to Los Angeles where family live 10 days ago to have the surgery. The complexity of the health insurance world, and the delay of elective surgeries due to Covid, have made me question my decision to have the surgery and to seek other options. I was diagnosed with a mild form of prolapse and advised to have surgery 23 years ago. With kegals and yoga, I’ve managed to control it for over 2 decades. My main and only symptom at this time is that my bladder is beginning to bulge from my vagina. I love to walk, bike, Zumba, dance, and want to maintain intimacy with my partner…but have had to cut back on physical activity due to recent worsening of my bladder prolapse. I was examined by a gyn last week who recommended a hysterectomy, a bladder sling, and repair of the vaginal walls.He said I also have a rectocele, which he would not repair during the surgery, but would require future surgery.

    Help! Can I avoid this surgery or is surgery my only option at this point? If I do have to have the surgery, would you recommend a pelvic prolapse specialist (urogynolcologist) as my best option? I don’t really want to have someone who spends 99% of their practice delivering babies to do the surgery, preferring someone who specializes in this procedure.

    I have read about so many negative side effects of surgery. Please advise.

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Robin
      What a difficult decision, I understand. Urogynaecologists are fantastic having a dual specialization in Urology and Gynae otherwise seek out a highly experienced Gynae with a special interest in prolapse surgery. Have you trialed a support pessary as an option to manage your prolapse and avoid surgery longer? Once again I would be seeking out one of the specialists already described. I hope this gives you some direction in moving forward Robin, all the best to you

  5. I’m only 25 and suddenly it feels as though all the organs surrounding my vagina have prolapsed, meaning I can feel a soft ball at the back of my vagina, it feels like my cervix is lower than usual and my bladder is hanging down. I’m also having to urinate and have a BM very frequently, and have to assist BMs by pushing on the bulge. Is it likely I could ever go back to my normal vagina or has my quality of life changed forever? I’m feeling no pain, but I don’t want to live like this because I can’t imagine leading a normal healthy life needing to use the bathroom constantly and always needing help having a BM, I’m also very stressed about my sex life being effected. I’m not sure how or why this happened so suddenly, and only a few days ago everything felt fine. I’m unable to see a doctor right now so I can’t get any help for this condition.

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Sandy I completely understand your concern you must feel worried and on your own right now. Sandy is there someone you can share your problem with and are you able to see a pelvic floor physiotherapist for an assessment? The first step is to know what you’re dealing with. If this is a prolapse there are many ways to manage and lead a very normal healthy life. The important thing is to know what you’re dealing with first of all, then appropriate management can be undertaken. Pelvic prolapse can happen gradually or suddenly. If you know how to do pelvic floor exercises (Kegels) this is something that you can start regardless of whether you have a prolapse or not while you wait for an appointment to see someone. Please let me know if there is something specific I can provide information to help you

  6. Madumita says

    Hi dear.I am mother of two by vaginal delivery.after the 2nd birth my vagina is much wider and my ueterus feel down wuth pain sometime.not outside .but due to that its pain alot lower abdominal till my mother massage it back to up.what exercise will behelpfull.and yes mating difficultiesin dog position..i felt he is pushing something front and back inside want to improve my sexlife too.

  7. Hi Iam Pauline I had a Cervix prolapsed on 5th December 2019 I visited a Gaenacologist.She told me iam in stage1 laiter She advised me to excercise Kegels.Now it’s 3weeks iam improving my cervix has stated moving in I only feel it while going for a long call is when it penetrate then disappear after I sometimes feel uncomfortable because have never pass through such situation upto now just feeling back pain sometimes I can’t bent or sit.Please I need an advice how long iam I going to wait and the best pain killers to cool down the pain because it has even made me to start feeling like adrenal.Anyone who had same problem please advised.

  8. Do you have DVD for exercise routines?

  9. I am getting close to age 71 and have considered myself active and healthy…..hiking, biking, aerobic/strengthening exercise class at the Y etc. Got back last month from trip to France (10 hour flight both ways) and along the way got quite constipated with the sitting and dietary choices on trip (low fiber). Anyway, ended up with serious straining and realized I had an egg like protrusion out of my vagina. I was a nurse so realized I had a cystocele and from presentation a stage 3. Got referral to Urogyn but she thought because of my age related vaginal atrophy (plus a hystorectomy 30 years ago and no ovaries or cervix eithther) and small vaginal canal (never had childbirth) it would be difficult to do surgery. I am really depressed at this thought. I have been doing pelvic exercises in the month it took to get seen (including your online videos) but she acknowledged that a stage 3 prolapse likely would not improve from PT (altho I am seeing one in the morning here). I was able to get an appointment in a larger city at a University Hospital Specialty Clinic next week. Are you familiar with a situation like this? I just started estrogen cream too.

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Lynne
      I think you’re correct to start pelvic floor exercises. They have been shown effective in mild to moderate prolapse both in terms of symptom relief and lifting prolapsed tissues within the vagina. You’ll need 5-6 months of these to see your best possible outcome. There are also other options for you too including vaginal support pessary and this will be worth discussing with your specialist too. Estrogen creme is often used along with pessary to thicken the vaginal walls and reduce the risk of erosion so good that you’ve started this too. You’re probably aware of how important good bowel management is in your situation using the correct bowel emptying technique and avoiding straining, along with keeping the stool soft and well formed to facilitate emptying. I’ll be keen to hear the outcome of your appointments if you have time Lynne, I hope this gives you some ideas for where to start. All the best to you

      • Hi iam Linda I delivered one month ago after two weeks of birth my Cervix open up I visited a Gynaecologist advised to excercise Kegels since I had no any pain in my Vagina but cervix was inside my Vagina now iam two weeks practising Kegels I could only feel my cervix moving while trying to push just for a long call.I think IAM still under second stage still feels my bowels moving to.Please how long will I wait for my Cervix to close and resume back to normal.Please anyone who has pass through this problem advise please

  10. Hi Michelle,
    I was seeing a post natal physio due to back and pelvic pain following birth of my baby and was found to have tight pelvic floor muscles. I started working on relaxing these with reverse kegels and that’s when I developed a grade 1 bladder prolapse which then progressed to grade 2 plus rectum prolapse.
    I went back to physio and at first my pelvic floor muscles were barely twitching and were extremely weak. We started working on pelvic exercises but after my prolapse got worse my physio advised I use a e-stims machine, which I have been using daily since.
    I was not seeing any major or significant improvement (in my symptoms although I could start to just feel pelvic muscles contracting) when using the machine and as I was exclusively breast feeding, physio said hormones could be playing a part as it relaxes tone of vagina walls. I stopped breast feeding two weeks ago and have seen more progress and improvement in these last two weeks than in the three months since I first happened. I am still using the stims machine. My muscles are still very weak (my physio said when I last saw her a grade 1-2ish)
    My question is regarding exercise and whether it is safe to do so: since my prolapse happened I have not been active at all as I was worried about making it worse and was also physically uncomfortable when out and about and hopes rest would help. But I understand that exercise is important and that the body works as a whole, and as I am starting to see some improvement now in my prolapse symptoms I would like to start trying to strengthen my overall body. Is this a good idea when my pelvic floor is still very weak? Are there any safe exercises to do to strengthen other areas of the body whilst pelvic floor is still weak? Or should I be waiting until I see more progress and strength in my pelvic floor? Is it likely to be many more months before they become much stronger? Currently I have only been doing some light walking in terms of exercise.
    Thank you

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Nora
      I’m sorry to read of your trials, thanks for sharing and for your excellent question. I’m almost always supportive of women returning to exercise as soon as feasible and yes there are many exercises that avoid placing load on the pelvic floor. Water based exercise could be a nice place to start if you have the right climate and someone to watch your baby. Even if this involves some gentle walking in the water. A graduated approach is very important. Otherwise walking flat surface again progressive would be a nice place to start. There are many strength exercises that can be performed without loading the pelvic floor. I have these outlined at length on this site and in my book Prolapse Exercises. I firmly believe that whole body strength reduces the overall load on the pelvic floor and I think this would be especially helpful when looking after a baby too. Simple exercises such as floor bridging (lifting the buttocks off the floor), mini squats and seated upper body exercises could all be options for you to undertake. I hope this helps you a little and gives you a starting point. Your Physiotherapist may be able to suggest some appropriate exercises to undertake too. All the best Nora and thanks once again for contributing.

  11. I’m in my 70’s and have been wearing a pessary in the daytime for a couple of years when I started having a fairly severe prolapse problem. Lately, I’ve found that I can stop wearing the pessary for up to 4 or more days without my prolapse bulging much below the vagina entrance, to where I’m still comfortable sitting down, etc. Usually if I go out for the day I’ll wear it but if I’m just going to be home I won’t, even though I usually take a walk every day and also garden. So I just wanted to let women know that that might work for them too. Thanks, Michele, I really appreciate your newsletter articles and videos.

    • Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Donna
      Thank you so much for taking the time to describe your experience with a pessary and yes I’m sure reading this will definitely help other women too. Thanks so much for taking the time to comment.

  12. Hi Michelle,
    I have a uterine prolapse Grade 2/3. I does not protrude but is “right there”. Before I found your exercises I was following along with an online PT who specializes in women’s pelvic floor dysfunction as well as local PT therapy and have had good results. Since finding your exercises I have followed you as well; pretty much what I was doing and what you offer were on the same page!! I still, however, am quite symptomatic. I have lost quite a bit of weight over the last year and am continuing to do so. My gynecologist says my uterus is a bit unusual as it is “longer” than it should be thus contributes to the prolapse and symptoms. He feels by removing my uterus via hysterectomy this should help to eliminate my symptoms. I questioned him about the possibility of increasing bladder or rectal prolapse with removal of my uterus. He said he felt my pelvic floor muscles were as good as I could get and that he could tell I had been doing pelvic floor strengthening exercises. My bladder is already a bit prolapsed from childbirth (27 years ago) but he feels my pelvic floor is strong.. I am unsure of how to proceed. By no means is he is pressuring me for surgery and is really quite reserved as far as surgery but does feel at this point it would help me symptomatically. Pessary not being an option as I am very sensitive an battle itching, infections, etc., already. I would appreciate any input or thoughts you could suggest. Thanks for all the information you put out there!!

  13. Hi just a question about a shelf pessary I had one inserted in October 2018 for a blabber prolapse after not getting on with the ring pessary then in January I had ithe recommended renewal the first 3 months it was very comfortable & I had no sensation of it being inside me but since the second one being inserted I have experienced an uncomfortable feeling of pressure when sitting on my sitting bones (only to the right side) I’m wondering if it has moved out of place I do go to yoga a few days a week
    and am wondering if I’m doing too much or something wrong if I decide to have it removed will pelvic exercise be enough as the prolapse didn’t protrude out just inside me perhaps you could give me some advice

    • Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Kathryn
      When the pessary is well fitting you shouldn’t feel it so the best thing to do is return to your gynaecologist. It may be the wrong size or out of position. Pelvic floor exercises can help with prolapse symptoms however there’s also suggestion from some women that pelvic floor exercises can improve prolapse symptoms more when combined with a pessary. This doesn’t decide for you however at least you are aware of your alternatives; no pessary & exercises alone or pessary and exercises which may have a better effect long term. All the best

  14. I have had cervical cancer (22yr ago) I needed a Mytroffanof (instead of a stomo bag 7yr ago) and was left with a prolapsed bowl I am waiting to go to see a surgeon to see if I can get help my poop pushes into my front passage I then have to push it out with my fingers covered with a disposable glove and toilet paper if I make my poop to soft then I have an accident my fingers have now got arthritis and it is getting so painful to push and use my fingers I can get myself into a real panick do you think I can get help I also dread the thought of more major surgery

    • Michelle Kenway Physiotherapist says

      Yes Ann, it’s not uncommon for women to need to use manual support to assist emptying with a rectocele or posterior vaginal wall prolapse. One of the keys to management is stool consistency. It can be worth trying a product called psyllium husk to keep the stool soft and well formed which can prevent accidents and make emptying easier. Here is comes as a natural husk or in a product called Metamucil. Most women start with a teaspoon per day and if well tolerated increase to 2 teaspoons. This may be worth trying to improve stool consistency and emptying.

  15. My prolaspe is so severe the Gyne doctor could not give me a pap smear she couldn’t see my cervic. Help an active 79 year mother of4 children my largest childbirth was for my son 10 1/2 pounds & 8 oz

  16. I had a 9 Pound 7 ounce baby 13 years ago. I noticed my vaginal Arrangement was different after that but couldn’t really pinpoint it. But now I’ve noticed vaginal loosening. After reading and looking at diagrams I believe it’s rectocele. But I noticed upon examination in a mirror I can see it inside the vaginal opening if I push down as if I am trying to poop but I can also tighten my muscles and pull it back in so that it cannot be seen and everything seems to be pulled back into place. Where does this leave me in the Spectrum of how bad this is and how well it could be corrected without surgery? No matter how hard I look I have not been able to find anything that gives you a better idea of what level you’re at based on what you’re able to do with it with your vaginal muscles. Do most prolapses just sit where they sit despite your best efforts or are most of them able to be pulled back into place with your vaginal muscles? And if so is there a way to make it stay without having to constantly Flex?

    • Michelle Kenway Physiotherapist says

      Hi & thanks for your question
      First and foremost this article on how to know the extent of your understand your prolapse diagnosis may help you a little. To have an accurate diagnosis usually requires an assessment of the prolapse both lying down and in standing by an experienced practitioner. Sometimes the prolapsed tissue can be repositioned within the vagina when the prolapse is not too severe. When more severe the prolapse will protrude to the entrance and/or out of the entrance of the vagina. Using the pelvic floor muscles to reposition the prolapse shouldn’t be done habitually – rather pelvic floor exercises are done to improve the overall support for the pelvic floor and prolapse tissue. Flexing or contracting the pelvic floor muscles without allowing them to relax can actually make prolapse worse because pelvic floor muscle tension and spasm can occur. This condition causes weakness in the pelvic floor and can contribute to prolapse worsening. I hope this explains things a little for you. Seeing a Pelvic Floor Physio for an assessment would be useful to help you know exactly the extent of your prolapse and the condition of your pelvic floor support too.

  17. Is there a correlation between placenta previa and vaginal prolapse?

  18. Hi, now that the mesh is no longer available because of the terrible stories we have heard, could we not grow some kind of skin or what ever using the patient blood so the body does not reject it and it attache’s to the mussel ? we grow bone and membrane for teeth surgery so why not go down this road ? also i have had a prolapse for 13 years some time i’m ok for weeks and then it just drops , no pain but it does drain me and depending were it is pressing some time it affects my walking, 90% of time I can flush my self empty. Or why can’t i be stitched up ? I do not have sex any more, seen’s my husband had his operation for colon cancer , so I no longer need my opening, could this be done and solve my prolapse.

    • Michelle Kenway Physiotherapist says

      Hi Maria
      Yes this can be done – the procedure is called a Colpocliesis and it’s relatively simple surgery. It’s ideal for women who no longer wish to have intercourse. The vagina is stitched along the mid line and effectively closed off thereby preventing prolapse. You can google the procedure and talk with your doctor about a referral to a gynaecologist or urogynaecologist that performs this surgery. All the best to you

  19. Prolapse disappeared. I feel fine. My children say I may be bleeding internally. That I should go to urgent care????

    • Michelle Kenway Physiotherapist says

      Hi Bette I’m not sure why your children think this, internal bleeding is not linked to prolapse unless the prolapse protrudes and rubs on undergarments so the skin becomes damaged with very severe prolapse. Hope this helps

  20. Hi and how you doing ? I am 21 years old and have a little girl already . Now I’m about 13 weeks and 1 day with my second child. I went in the bathroom to go pee , I saw something weird. I have prolapse for the first time and I’m scared . What should I do or take to make it go away ?

    • Michelle Kenway Physiotherapist says

      Hi Jennifer
      The first thing to do if you suspect a prolapse is to see your doctor for an accurate diagnosis. If it is a prolapse then the best way of managing during pregnancy is through pelvic floor exercises in addition to managing your bowels, avoiding constipation and straining, reducing heavy lifting and perhaps speaking with your doctor about the possibility of getting a support pessary if required to assist your pelvic floor muscles.

  21. Hi … i am having 3rd degree rectum prolapse. The rectum is coming out from the vaginal opening and not from the anus. Dr. Has recommended surgery for me what should i do now?? I am 34years old. 2kids normal deliveries. 2abortions one with DNC. Now i want one more pregnancy so want to avoid surgery. My problems worsen because of pure exercise monitoring by the physiotherapist. At that time i was having 2nd degree uterus and bladder prolapse. After i started the exercises the rectum came down as well. Now i want to take advise from you for how to control this. Whenever i walk the or do house chores the problem get worse. Dr. Says my bladder and uterus are now better and do not need passery.

    • Michelle Kenway Physiotherapist says

      Hi Sadia it may have been possible that you were performing the exercises incorrectly as correct pelvic floor exercises shouldn’t worsen your prolapse. Have you discussed this issue with your Physiotherapist? If not I suggest that you do. I would also think that trialling a support pessary in this situation could potentially be a very good option to help you with support for your prolapse and have another child. It could be worth seeking the opinion of another doctor or see a Physiotherapist who does fit pessaries. I’m not sure where you live however in Australia some Pelvic Floor Physiotherapists can fit support pessaries. An important part of management of rectal prolapse will be bowel management as well and you can read more on this with these links which I hope helps you manage your rectal prolapse symptoms better too. All the best!

  22. Hi Michelle, its really great that you’ve taken the time to answer everyones questions. I have one of my own. Ive recently been diagnosed with 2nd degree cystocele and 1st degree uterine prolapse, my doctor has prescribed physio for my pelvic floor, however I’m in the process of moving to a different continent with a three year old and a 4 month old… In my search for ways to isolate my muscles and be sure I am using the correct ones, I found a new device called an Elvie, perhaps you cannot comment on particular devices, but in general, are pelvic toning devices possible for someone with a cystocele? or does the device then sit improperly in the body?? any help? Thank you!

    • Michelle Kenway Physiotherapist says

      Hi Janine
      Pelvic toning devices can be used by most women with mild-moderate prolapse it’s important to sit the device in the correct position. These devices are used lying down passively – it’s then important to start active pelvic floor contractions too with the device and then without.
      All the best

  23. Hi Michelle,
    I am 48 years old and 25 kilos overweight, I am generally healthy and don’t take any medication, I eat healthily, plenty of fresh fruit and veg, wholegrain bread etc. (although portion control and chocolate has been an issue, clearly!) I had two children 15 months apart, weighing 10lb and 9.5lb, the first with episiotomy and forceps, 19 and 17 years ago. I have been overweight ever since. Recently I have been diagnosed with a stage 3 rectal prolapse and a stage 0-1 bladder prolapse. I generally do not suffer with constipation and following your bowel emptying techniques am able to go to the toilet without problems. I have been told I will need surgery by my gastro-enterologist, but he sent me to a urologist to see if it would be worth correcting the cystocele at the same time. After lengthy tests she was debating whether or not this would be necessary as I don’t have a serious bladder problem, and she gave me a lot of information about how my body could reject the polypropylene mesh, or that it could erode surrounding tissue and cause even worse problems. Unsurprisingly this has made me want to avoid surgery at all costs. I am working on losing the weight, I have been doing pelvic floor exercises daily and am going to get you dvd for pelvic safe regular exercise. Do you know if it is possible to manage problems like mine without surgery or is it too severe? I am just so scared and normally take responsibility for my own health where possible, I don’t even like taking a headache tablet if I can avoid it!
    Many thanks, Sam.

    • Michelle Kenway Physiotherapist says

      Hi Sam

      Great question. I tend to agree with your urologist in that if you can avoid bladder surgery then do so. You’re doing everything right focusing on good emptying techniques, pelvic floor exercises and losing weight. Sam I’m not sure whether you’re referring to true rectal prolapse where the prolapse comes from the anus, or rectocoele (posterior vaginal wall prolapse) which bulges from the vagina as both are often confused. True rectal prolapse often requires surgical intervention when it worsens. In contrast some women find they can manage mild-to-moderate rectocoele quite well without surgery with good conservative therapy. Just a small suggestion on not overloading on too much insoluble fibre which can actually increase constipation. At the end of the day the decision for surgery is yours and it really comes down to how problematic your prolapse is unless it is a severe rectal prolapse in which case surgery is indicated.

      I hope this helps you out!
      All the best

  24. I had a hysterectomy 3 years ago he left my cervix and took my ovaries now I have a prolapse stage 3 the cervix is falling with vagina will excercise help or hurt

    • Michelle Kenway Physiotherapist says

      Hi Virginia
      It really depends on what type of exercise you choose. Pelvic floor exercises will Kegel exercises are important and if done correctly should not cause any problems. Pelvic floor friendly general exercises such as those described throughout this site are the best type of exercises to perform. It may be worth discussing the possibility of support pessary with your specialist to help you exercise too.

  25. My uterus just prolapsed a week ago, I’m in my 40’s and don’t want to think about this for the rest of my life. If I choose surgery, does my cervix need to be removed?

    • Michelle Kenway Physiotherapist says

      Hi Bev
      No your cervix does not necessarily need to be removed if you choose to go with the surgical option. You will unfortunately need to think about this for the rest of your life because prolapse surgery does increase the risk of repeat prolapse. The best way forward is to understand your options for both conservative management and surgical intervention so that you can make a really well informed decision. It’s important to know that the younger you are when you undergo surgery the greater the risk long-term as surgical repair needs to last longer. It will be worthwhile seeing a pelvic floor physiotherapist for long-term management advice so that you know how to protect a pelvic floor and have a strengthened most effectively regardless of whether you have surgery in the future.
      All the best

  26. Is there much of a difference with a uterin prolapse if the uterus is inverted?

    • Michelle Kenway Physiotherapist says

      Hi Cindy

      Women with retroverted uterus are more likely to have prolapse problems than normal positioned uterus. When the uterus is retroverted it sits more directly above the vagina making the uterus more likely to descend and prolapse within the vagina.


  27. Hi, thank you for all of the information…

    I have a moderately severe prolapse and am waiting for surgery. I have had two back to back vaginal births and have been weight training throughout pregnancy and 6 weeks after with Dr’s ok, having no idea or information that all the push ups, planks, chin ups and heavy weights could potentially cause this issue when my pelvic tissues were already stretched and weakened… very frustrating as I had advised my Dr of the cramping of muscles and discomfort through my pregnancies and was still okayed to continue with my strenuous workout routine.

    Anyways, I’m a police officer and need strength for my line of work, so I appreciate the suggestions for modified exercises as opposed to other websites less then helpful suggestions of just not doing any form of strength training… My concern is that I wear a heavy gun belt and when I’m sitting for 12 hour shifts in my car or at a computer with it on it pushes down and into my bladder and since I’ve been back to work after my maternity for a few weeks my discomfort and symptoms having been getting worse. I really want to keep being a front line officer while I’m waiting for surgery, but I am concerned that my belt may make things worse. Also if things are getting worse, are there any complications that can occur while I’m waiting several months for my surgery? I’m concerned about doing other damage or getting an infection? Thank you for your time!

    • Michelle Kenway Physiotherapist says

      Hi Jennifer

      Thanks for your comment/question. Has your gynaecologist/obstetrician discussed support pessary with you to help you perform your regular duties? This along with pelvic floor exercises are both feasible to include in your current management plan. Are you able to loosen your belt sitting at your computer to reduce the pressure downwards on your pelvic floor when sitting? If the belt is tight it will increase pressure downwards on your pelvic floor. Finally the risk of vaginal infection is unlikely – this is not usually a problem associated with prolapse. I can’t say whether the prolapse will worsen while you wait for surgery and I don’t think anyone could accurately answer this, it depends on your activities, pelvic floor strength, body weight and more.

      All the best for your surgery Jennifer, I hope this helps a little

  28. Dear MIchelle,
    Thank for this space and your time… I have a prolapse Grade 3… I am 59 years old. I try once the pessary and not went well.. the doctor said direct to surgery(hysterectomy) .. I don’t like the idea so much.. it is any other actions that I should do? Regards, CN

  29. I would like a pamphlet on exercises for prolapse

  30. Hi I have a Cleo discreet electronic pelvic floor exerciser & haven’t really used it yet. I now have the onset of a rectal prolapse & am wondering if it is safe to use the exerciser? Any advice?x

    • Michelle Kenway Physiotherapist says

      Hi Chris
      Thanks for your question. My apologies I am not familiar with Cleo and its contraindications. If you read the instructions it should state whether it can be used with prolapse. Pelvic floor strengthening is important in managing rectal prolapse so this is worth following up. Maybe phone the manufacturers or distributors for more information.

  31. Hi Michelle I had a prolapse once before it was due to constipation, it went away in no time, I have one now and also due to constipation.. I can sure feel my pelvis floor flexing? Is this a good sign and do u think I will recover quickly again?

    • Michelle Kenway Physiotherapist says

      Hi Kristi

      Once the tissues prolapse they remain so for life – this happens because they are stretched beyond their elastic limits. Your pelvic floor muscles may have provided sufficient support to help you overcome this previously. Whether or not this can happen again depends upon the severity of your prolapse and how well your pelvic floor muscles support your pelvic organs so it will be wise to do pelvic floor exercises regularly life long.

      All the best

  32. Pelvic floor exercises aren’t good for everyone. I have a prolapse and at the same time my pelvic floor is in spasm, Pelvic Floor Dysfunction. Pelvic floor exercises like Kegels make it worse. I have been seeing a pelvic floor physical therapist to work on relaxing the muscles.

    I cringe every time I see people recommending exercises like these without the warning that for some women, they are harmful.

    • Michelle Kenway Physiotherapist says

      Hi Mary

      You’re correct! Pelvic floor exercises need to be performed correctly with a contraction and then relaxation of the pelvic floor muscles. Sometimes the pelvic floor muscles can become too tight and spasm which can be painful and debilitating indeed and yes this is a risk for some ladies after pelvic floor surgery. If women with pelvic floor spasm do pelvic floor exercises, they can worsen their pelvic floor spasm. For the general population pelvic floor exercises are very important which is why most women with spasm are then retrained to do their pelvic floor exercises correctly including the relaxation.

      Wishing you all the best for your recovery & thank you for your reminder.


  33. lara boris says

    How do I get this book

  34. Hi Michelle

    How long does it normally take for the muscles to strengthen adequately – i.e. for how long and how many sessions do you treat patients?
    Is a subjective improvement in symptoms from the patient’s point of view an adequate indicator of improvement, or which objective measures do you use?

    Kind regards
    (Physiotherapist in Namibia)

    • Michelle Kenway says

      Hi Marieke

      The time for pelvic floor muscles to strengthen varies from one woman to the next.

      This can depend upon a woman’s:

      * initial pelvic floor muscle strength and function
      * ability to perform pelvic floor exercises using correct technique
      * adherence to home exercises

      The research indicates that women with weak pelvic floor muscles can require 5-6 months of regular pelvic floor exercises to regain pelvic floor strength and that changes start to occur within a couple of weeks of commencing pelvic floor strengthening.

      Subjective improvement in symptoms is one indicator that can be used if you’re not performing vaginal examinations to assess the pelvic floor muscles. Vaginal assessment of pelvic floor muscle strength and grading pelvic floor muscle function is one of the most accurate methods objective methods of quantifying improvement. Ultrasound and EMG are also used in Australia as objective measures of improvement however these methods are not available world-wide. Different cultural practices and norms mean than vaginal assessment of pelvic floor muscles is not carried out routinely in some countries. So I think it really comes down to what measures are available for you to use in your country Marieke.

      I hope this information is helpful.

      All the best