Pelvic Organ Prolapse

Illustration of uterine prolapse
Illustration of bladder prolapse
Illustration of rectal prolapse

Pelvic organ prolapse (POP) occurs when one or more of the pelvic organs (bladder, uterus, or rectum) descends or pushes into the vaginal wall due to weakened or damaged pelvic floor muscles and connective tissues. Approximately 1 in 3 women will experience POP in their lifetime and can happen after pregnancy, childbirth, menopause, or as a result of chronic pressure on your pelvic floor (such as from constipation or heavy lifting). 

Types of Pelvic Organ Prolapse:

  • Anterior Vaginal Wall Prolapse (Bladder Prolapse/cystocele): The bladder bulges into the front wall of the vagina.

  • Posterior Vaginal Wall Prolapse (Rectal Prolapse/rectocele): The rectum bulges into the back wall of the vagina.

  • Uterine/Vault Prolapse (apical prolapse): The uterus or vaginal vault descends into the vaginal canal.

  • Enterocele: The small intestine pushes into the upper vaginal wall.

Symptoms of Pelvic Organ Prolapse:

  • A feeling of heaviness, pressure or dragging in the pelvic area.

  • A bulging or "dislodged tampon" sensation in the vagina.

  • Urinary symptoms such as incontinence, frequent urination, or difficulty fully emptying the bladder.

  • Bowel symptoms, including constipation or difficulty with bowel movements.

  • Lower back or pelvic discomfort.

  • Painful intercourse or vaginal dryness.

Women’s health physiotherapy can play a key role in managing and treating POP. Treatment can include education, lifestyle modifications, bowel management, addressing vaginal tissue health, prescription of pelvic floor muscle training exercises, and the use of vaginal pessaries. The goal of physiotherapy when managing POP is to reduce symptoms, improve quality or life, and avoid or delay the need for surgical intervention. A tailored treatment plan can help restore confidence and quality of life.