What is pelvic organ prolapse?

Pelvic organ prolapse is the descent of one or more of the pelvic organs in the pelvis. There are several classifications of pelvic organ prolapse as well as varying severity of prolapse. 

Pelvic organ prolapse can occur after child birth, menopause, or hysterectomy. This usually occurs due to loss of integrity of the ligaments, pelvic floor muscles, or both. Prolapse is staged 1-4, with stage 1 being classified as minimal descent of the pelvic organs, while stage 4 prolapse is classified by the organs visibly descended externally. 

Prolapse can be worsened by a variety of things, such as breath holding and constipation, and is typically treatable via simple lifestyle modifications, a pessary, or surgery, with earlier stages less likely to require surgery than a stage 4 prolapse. 

The most common classifications of prolapse I see and treat in the clinic include a cystoceles, rectoceles, and uterine prolapse, with enterocoele and uterocele being less common.  A cyctocele is the descent of the bladder into the vaginal canal, while a rectocele is the descent of the rectum into the vaginal canal. A uterine prolapse is decent of the uterus. Though less common, a urethrocele is a type of prolapse that occurs when the urethra moves from its normal position and presses against the front wall of the vagina, and an enterocoele occurs when the small intestine prolapses into the back of the vaginal canal. 

How might you know if you have a prolapse? Most patients either feel heaviness or like something is about to fall out of their pelvis, while some state they van visibly see a bulge. 

As state above, pelvic floor PT is a great treatment option for pelvic organ prolapse and uses both exercises and lifestyle modifications with the goal of non-invasive treatment to get you back to living your best life symptom free. 

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