Pelvic organ prolapse
Pelvic organ prolapse is the downward movement of one or more walls of the vagina. This may be the front (anterior), back (posterior) or the uterus (womb).
50% women and people, who have had children will experience pelvic organ prolapse to some degree.
The symptoms that women tend to report are:
- Heaviness in the vagina and perineum
- Something coming down
- A lump or ball in the vagina
- Dragging sensation
Other common symptoms of the bladder and bowel can be caused by pelvic organ prolapse but may also be unrelated to the prolapse:
- Not being able to fully empty the bladder or bowel
- Difficulty starting the flow of urine or need to change positions
- Standing up and leaking urine when getting up off the toilet
- Stress urinary incontinence
- Bladder or bowel urgency
- Overactive bladder symptoms
- Bladder frequency
What causes pelvic organ prolapse in pregnancy or after childbirth?
- Pregnancy and childbirth are the most common reasons for a prolapse particularly after a vaginal delivery
- The weight of the growing baby puts a strain on the pelvic organs and pelvic floor muscles
- Hormone changes during pregnancy cause relaxation of supporting ligaments in preparation for delivery
- An episiotomy, vaginal tear or forceps delivery can weaken the supporting structures
- Obesity puts extra strain on the pelvic floor
- Heavy lifting
- Family history
- Chronic constipation and straining
- Chronic cough
How can I treat prolapse?
Pelvic organ prolapse is not a life threatening condition, and not all prolapses get worse;
some may improve. You may choose to do nothing if your prolapse is not bothersome.
Research suggests you can prevent your prolapse getting worse or improve it by doing your pelvic floor muscle exercises and following the advice below:
- Drink 2 litres of water and eat a varied diet
- Do regular pelvic floor exercises 3 times a day. For guidance on how to correctly perform pelvic floor exercises please click on the video below.
- Modify your activities and make sure you build back to full activities gradually
- Try a vaginal pessary which will support the vaginal walls (see glossary)
- Avoid constipation and straining on the toilet
Sit on the toilet a with a stool under your feet, as shown in the picture. Do not strain and keep your tummy muscles relaxed. It is helpful to take a slow breath in through your nose so that your stomach moves outwards, and your chest remains still and then exhale through pursed lips.
You may also find it useful to support your perineum (the area between your back passage and your vagina), when opening your bowels. Please see the picture below.
For further information and advice please click on the video and leaflets below.
Videos:
Pelvic floor exercises
Links:
POGP pelvic organ prolapse booklet:
20xxx-POGP-ProlapseUpdated (csp.org.uk)
RCOG pelvic organ prolapse leaflet: