What is a prolapse?
A prolapse is when a part of the body has moved from its original position. In gynaecology, the term prolapse usually refers to the uterus (womb) starting to come down through the vagina (uterovaginal prolapse). It can also mean the bladder (cystocele) or the bowel (rectocele) has moved and is pressing on the vaginal walls.
Causes
Overstretching of the vaginal tissues and the underlying supporting structures, usually during childbirth, is the main cause of prolapse. Other causes include straining to empty your bowels, often due to constipation, persistent coughing and being overweight.
Signs and symptoms
- A feeling of something coming down.
- A dragging or heavy sensation either vaginally or deep
- within the pelvis, that worsens as the day progresses.
- A bulging in the vagina (made worse when squatting).
- A protrusion from the vagina.
- Difficulty or pain during intercourse.
Managing prolapse
In most cases, a mild to moderate prolapse can be well managed with an assessment and support from a specialist physiotherapist. They will give you general advice and teach you specific pelvic floor exercises to help strengthen the muscles that support the pelvic organs.
Some women are fitted with a pessary (a small plastic device) that helps support the prolapse, and in a small number of cases, surgery may be needed.
The following steps may also help:
- Avoid heavy lifting – this strains the pelvic floor further.
- Lose weight – extra weight places a greater strain on the already stretched pelvic floor.
- Stop smoking – a smoker’s cough will continue to damage the pelvic floor and smoking weakens the support fibres.
- Avoid constipation – this may mean a change in diet or learning the correct way to empty your bowels.