What is a Pelvic Prolapse? Prolapse Video for Women

What is a pelvic prolapse? A pelvic prolapse is like a hernia in the vagina where supporting tissues in the pelvis are unable to retain the pelvic organs in the correct position. One or more of the pelvic organs can move out of position with a pelvic prolapse. Your pelvic organs include your bladder, vagina, uterus and rectum.

This short Physical Therapist video by Michelle Kenway answers “What is a pelvic prolapse?” and explains the most commonly occurring types of pelvic prolapse in women.

Read on now to learn:

    • What causes a pelvic prolapse
    • Risk factors for pelvic prolapse
    • Different types of pelvic prolapse explained:

- bladder prolapse
- bowel prolapse
- uterine prolapse

What Causes a Pelvic Prolapse?

A pelvic prolapse results when the pressure within the abdomen and pelvis overcomes the pelvic floor support structures causing them to fail. The pelvic organ support structures are the pelvic floor muscles and strong tissues that wrap around and support the pelvic organs suspending them from the walls of the pelvis. When these pelvic supports become strained, they stretch and weaken so that they become unable to retain the pelvic organs in position. This results in one or more pelvic organs moving down into the vagina, or what is referred to as a pelvic organ prolapse.

Risk Factors for Pelvic Prolapse

Common risk factors for pelvic prolapse include:

      • Pregnancy and childbirth
      • Increasing age
      • Pelvic floor weakness
      • Being overweight
      • Heavy lifting
      • Constipation and/or straining to empty the bowels

Different Types of Pelvic Prolapse

The different types of pelvic prolapse are names according to the structures involved. Some types of pelvic prolapse involve the pelvic organs moving into the walls of the vagina. Others involve the uterus or upper most part of the vagina descending into the vagina. It is quite common for women to have pelvic prolapse involving more than one pelvic organ for example a woman mat have and bladder and uterine prolapse.

Anterior Vaginal Wall Prolapse (bladder prolapse or cystocoele)

Bladder prolapse is one of the most commonly reported forms of pelvic prolapse. A prolapsed bladder involves the bladder moving into the front wall of the vagina. A bladder prolapse can become visible as a bulge at the entrance of the vagina and this one of the frequently reported prolapse symptoms. When a bladder prolapse becomes severe the front wall of the vagina can bulge out of the entrance to the vagina, and cause problems with bladder emptying.

Posterior Vaginal Wall Prolapse (rectocoele)

A posterior vaginal wall prolapse is a prolapse of the rectum (lower bowel) into the back wall of the vagina. A posterior prolapse can also be seen as a visible bulge at the entrance to the vagina as it becomes more severe. Women often report constipation and bowel movement problems with a posterior vaginal wall prolapse. This type of bowel prolapse into the vagina is not the same as a rectal prolapse which involves prolapse of the rectum within the rectum not the vagina.

Uterine prolapse

Uterine prolapse occurs when a woman’s uterus (womb) and cervix move down and descend into the vagina from above. Uterine prolapse is often accompanied by a sensation of pressure or fullness within the vagina, lower abdominal discomfort and/or low back ache. The uppermost part of the vagina can prolapse in women who have had a hysterectomy and have no uterus, and this is known as a vaginal vault prolapse.

What is a pelvic prolapse? In summary a pelvic prolapse occurs with the failure of the pelvic supports to retain the pelvic organs in their correct position within the pelvis. Pelvic prolapse in a woman can involve one or more of the pelvic organs moving downwards within and sometime out of the vagina.

prolapse exercisesABOUT THE AUTHOR, Michelle Kenway

Michelle Kenway is a Pelvic Floor Physiotherapist and author of Prolapse Exercises Inside Out. Prolapse Exercises is a complete exercise guide for women with prolapse and after prolapse surgery seeking to exercise safely and protect their pelvic floor.

Comments

  1. about squatting and defecating
    this is the way i have had to go with my prolapsing.
    i no longer can open my bowels seated on a toilet.
    is there any way to do the brace in this position?
    if the faeces pouches into the vagina before its release
    and can need manual evacuation and assistance.
    how can pressure be taken off the pelvic floor in
    this position? thankyou for your reply

    • Michelle Kenway says:

      Hi Carol

      Yes I understand the issue you are facing. This position is helping you to increase pressure to open your bowels however it is very difficult to relax the anal sphincter in this position so the faeces bulge into the prolapse in the back wall of the vagina. Once again there is no problem in using the hand to manually support or lift the perineum up or to support the back wall of the vagina. You may like to refer to this video on bowel movement technique – it is very important to bulge the abdomen forwards to relax the anal sphincter Carol.

      Be mindful of the fact that deep squatting is not helpful for prolapse – this position will increase the pressure on your prolapse however as already stated this is a tricky issue for you and I understand why you are doing this. I also suggest you read this information on getting the right stool consistency for emptying too.

      Kindest regards
      Michelle

      • thank u so much for your reply,
        my stool consistency is managed by macrogol stool softner. good news is i have been trying the mmm-oo and have found it helpful so far even in a squatted position. i am worried that i am making the pressure on prolapse worse as you confirmed.
        do you think long term that i would be better re-learning to sit on the toilet again, although it may not be possible? unless that is just fear or is it anatomical?
        i notice that if the call to stool comes and the rectum is full due to my anus being abnormal because of the massive hemorrhoidectomy i once had i fear that i cant release the stool in this position anymore. but i will try the mm-ooo on the toilet when i feel more confident. so if you have any other thoughts to add i thank you :) have a wonderful day – both me and my mum really enjoy your exercises

        • Michelle Kenway says:

          Hi Carol
          Yes I do think it is a good idea to learn the correct sitting position – squatting will undoubtedly increase pressure on your pelvic floor whereas sitting correctly and learning to release your anal sphincter with “moo” sound or “ssss” sound will help you empty your bowels more effectively without straining. I am glad to hear you and your mum enjoy the exercises!

          All the best and stick with it if you can Carol
          Cheers
          Michelle

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