Pelvic prolapse is estimated to occur in at least fifty percent of women who have had a baby.
Pelvic organ prolapse is a condition that occurs when one or more of the pelvic organs move out of position and down into the walls of the vagina. The bladder, bowel and/or uterus can all prolapse into the vagina.
These Physiotherapy exercise videos and information help you:
- Exercise safely with a prolapse
- Reduce your risk of prolapse worsening
- Recover after prolapse surgery
Pelvic Prolapse Videos and Information
Pelvic Prolapse Exercises Saver Pack
Prolapse Exercises saver pack is for women seeking to exercise with a prolapse or after prolapse surgery.
This Physiotherapist guided workout information helps you:
- Exercise safely
- Reduce your risk of repeat prolapse or prolapse worsening
- Increase your general strength and fitness
- Strengthen your pelvic floor and core abdominal muscles
- Lose weight
What is a Pelvic Prolapse?
A pelvic prolapse occurs when the pelvic organs move out of position.
The pelvic organs (shown right) include the bladder, uterus and rectum. Prolapse involves one or more of these pelvic organs moving out of position and downwards into the vagina.
Pelvic organ prolapse occurs when the strong tissues (including ligaments and muscles) that support the pelvic organs become weak and stretch.
As a result of the loss of support, the pelvic organs are no longer suspended or held up in their normal position within the pelvis.
Pelvic Organ Prolapse Symptoms
Prolapse symptoms can vary depending upon the type of prolapse and prolapse severity.
Commonly occurring pelvic prolapse symptoms include:
- Pelvic heaviness increased towards the end of the day
- Visible bulge at the entrance of the vagina (shown right)
- Sensation of bulge within the vagina
- Difficulty emptying the bladder or bowel
- Ache or dragging sensation in lower back and/or lower abdomen
- Symptoms increased with straining, heavy lifting, prolonged standing or high impact exercises
- Symptoms relieved with rest
Pelvic Floor Physiotherapy Treatment for Pelvic Prolapse
Prolapse treatment depends on the severity of the prolapse and predisposing factors.
Mild to moderate prolapse are most likely to respond to conservative treatment.
Severe prolapse conditions are more likely to require surgical intervention.
1. Mild to Moderate Prolapse Treatment
Pelvic Floor Physiotherapy may involve:
- Kegel exercises (pelvic floor exercises)
- Modifying contributing lifestyle factors e.g. body weight, high impact exercises
- Fitting a support pessary
2. Severe Prolapse Treatment
Severe prolapse usually requires:
- Prolapse repair surgery (with or without a hysterectomy)
- Vaginal pessary for prolapse support
Pelvic floor physiotherapy treatment for severe prolapse involves:
- Kegel exercises before and after prolapse surgery
- Modifying relevant lifestyle factors e.g. body weight, high impact exercises
- Fitting a support pessary
Physiotherapy management of prolapse usually involves 2 types of exercise:
A. Kegel exercises
B. General pelvic floor friendly health and fitness exercises
Pelvic prolapse treatment from a pelvic floor physiotherapist will usually involve prescription of both of these types of exercises to help you manage your prolapse, health and fitness.
A. Kegel Exercises for Prolapse
- Using the correct technique for doing your Kegel exercises with a pelvic organ prolapse involves:
- Locating your pelvic floor muscles around your pelvic openings
- Squeezing and lifting at the same time, in and around your three pelvic openings
- Release and relax your pelvic floor muscles
- Rest briefly before repeating this exercise again
Physiotherapy Tips for Kegel Exercises with a Prolapse
Tips for improving your pelvic floor training with a prolapse include:
- Exercising your pelvic floor muscles when you’re well rested (i.e. morning)
- Positioning your body so that you can best feel your pelvic floor exercises
- Trying to do your Kegels lying down if your pelvic floor is feeling tired or if you’re having problems with prolapse symptoms such as pelvic heaviness or bulging
- Using a support pessary to lift your pelvic floor tissues and take the load off your pelvic floor muscles
B. Pelvic Floor Safe Exercises for Health and Fitness
Physical activity is an important part of prolapse management. Some women with prolapse problems cease exercising altogether when this isn’t necessary. This may be owing to the fear of prolapse worsening or because of the symptoms they suffer when they exercise.
Many women with prolapse can continue to exercise safely and with comfort by choosing pelvic floor friendly exercises.
Pelvic floor safe exercise can help you manage your prolapse by:
- Managing your body weight and reducing the load on your pelvic floor
- Maintaining your overall physical strength and fitness
The correct approach to staying active with prolapse problems involves:
1. Choosing pelvic floor safe exercises
2. Improving your pelvic floor support (e.g. pessary and/or pelvic floor muscle training)
Pelvic floor safe (modified) exercises for pelvic prolapse include:
Continence Foundation of Australia https://www.continence.org.au
Li C, Gong Y and Wang B (2015). The efficacy of pelvic floor muscle training for pelvic organ prolapse: a systematic review and meta-analysis. International Urogynecology Journal. 27(7), pps. 981-992.
Piya-Anant M, et. al. (2003) Integrated health research program for the Thai elderly: prevalence of genital prolapse and effectiveness of pelvic floor exercise to prevent worsening of genital prolapse in elderly women. Journal of the Medical Association of Thailand, 86(6) pps. 509-515.
Brækken I. et. al. (2010) Can pelvic floor muscle training reverse pelvic organ prolapse and reduce prolapse symptoms? An assessor-blinded, randomized, controlled trial. American Journal of Obstetrics & Gynecology, Volume 203, Issue 2, 170.e1 – 170.e7.