Prolapse

Pelvic organ prolapse is usually (but not always) a consequence of childbirth. It may happen as a result of chronic straining as well. It occurs at a rate of approximately 30% in the general female population. 

HOW DOES IT MANIFEST?

Prolapse through the vagina can be of any of the following:
  • Urethrocele – prolapse of the urethra through the vagina
  • Cystocele – prolapse of the bladder through the vagina
  • Uterine Prolapse – prolapse of the uterus through the vagina
  • Rectocele – prolapse of the rectum through the vagina
The rectum can also prolapse through the back passage (rectal prolapse)

TYPES OF PROLAPSE

Prolapses are staged according to how far they come down. Stage II (two) is the most common and this is where the part comes down as far as or even to 1 cm just outside the entrance to the vagina. This measurement is on straining (Valsalva manoeuvre). Typically prolapses behave differently depending on the time of day and on what is in the bladder and in the bowel.

The pelvic floor muscles may be weak as a result of damage to part of the pelvic floor. The remaining muscles then become overloaded as a result of the damage to the neighbouring muscle. This is in part because of how hard the muscles have to work in compensation and in part because of how the woman holds herself in response to the feeling of something coming down.

 

TREATMENT

Rehabilitation involves postural alignmentaddressing dietreleasing any negative pelvic floor muscle tension and intensive strength training