Prolapse

Prolapse

Article by Nadine Stewart

Prolapse

What is Prolapse?

Women generally have three organs in the pelvic cavity (the space inside the hip bones and the tailbone), including the bladder, uterus, and rectum. A prolapse is where one or more of these organs slip downwards away from their usual position.

What are the Different Types of Prolapse?

There are many different types of prolapse, which include:

  • Apical / Uterine Prolapse – A prolapse where the uterus falls downwards, collapsing into the vaginal canal.
  • Cystocele / Cystourethrocele – A form of prolapse where the bladder and/or urethra falls down and backwards into the anterior wall of the vagina.
  • Rectocele – A form of prolapse where the rectum falls down and forwards into the posterior wall of the vagina.

The degree to which one or more of these organs slip downwards determines the severity of the prolapse.

What Causes a Prolapse to Occur?

Several factors can lead to prolapse, including:

  • A weakness of the pelvic floor muscles
  • Damage to connective tissue in the pelvis
  • Pregnancy
  • Childbirth esp. involving prolonged labour or use of forceps
  • History of chronic respiratory conditions
  • History of chronic constipation or straining when making a bowel movement
  • Regular heavy lifting
  • Elite / high-level athletes involving high impact and high load sports. E.g. running, gymnastics and weight lifting.
  • Obesity
  • Age
  • Hormonal changes. E.g. menopause

What are the Symptoms of Prolapse?

The symptoms present for each type of prolapse vary slightly, but generally, prolapse symptoms include:

  • A feeling of fullness in and around the vagina, or in some cases an observable bulge extending from the vagina
  • A feeling of pressure in the lower abdomen
  • Low back pain
  • A feeling of being unable to empty the bowel or bladder, potentially leading to assisted digital emptying.
  • Bleeding, discharge or infection

How is Prolapse Diagnosed?

Usually, a clinical diagnosis can be made using the information you have given and a physical examination. During this examination, your physiotherapist may need to perform an internal exam to assess the potential weakness of the pelvic floor or damage to connective pelvic tissue and gain an idea of the position of the pelvic organs.

What Treatments are available for Prolapse?

Often, physiotherapy is considered the first line of treatment for prolapse and can include:

  • Education
  • Lifestyle Recommendations
  • A pelvic floor exercise program
  • Ultrasound to assist with pelvic floor activation
  • Electrical stimulation to assist with pelvic floor activation
  • Internal support devices, e.g. pessary
  • Adjustment of usual toileting habits
  • Advice to modify or manage lifting and exercise habits
  • Controlled coughing

What Results Can You Expect?

A large proportion of people with prolapse will have their symptoms improved or resolved with physiotherapy treatment. However, if left untreated, often the problem continues to worsen gradually.

Will You Need Surgery?

A percentage of people who may not experience enough improvement with physiotherapy alone, or depending on the severity of their prolapse, may need to have surgery to resolve their symptoms.

For more information please consult your physiotherapist with a special interest in pelvic floor conditions.

Article by Nadine Stewart

Women's Health Physiotherapy Conditions

Addressing a diverse range of women-specific concerns, Women’s Health Physiotherapy focuses on assessing and treating various conditions. These encompass issues like constipation, faecal incontinence, mastitis, pelvic floor exercises, pregnancy-related back pain, and massages, along with concerns such as prolapse, abdominal separation, stress incontinence, and underactive pelvic floor. Moreover, the discipline encompasses managing urge faecal incontinence, urgency/overactive bladder (OAB), and urge incontinence, while also offering pre and post-pregnancy exercise prescription and rehabilitation.

More Information

FAQs

Women's Health Physiotherapy Appointment FAQs

Women's Health Conditions

Women’s Health Physiotherapy incorporates the assessment and treatment of a large number of women-specific conditions including:

Q: What Should You Bring To Your Women's Health Appointment?

A: Please bring any information about your condition from your GP, medical specialists, or other healthcare providers to your appointment. Arrive 10 minutes early to complete paperwork. Alternatively, we can email you information before your appointment.

Q: What's the Appropriate Attire for Your Appointment?

A: Wear comfortable clothing for ease of movement.

Q: Will Your Appointment Information Be Kept Confidential?

A: Yes, your appointment details remain confidential. Your physiotherapist will only share with other healthcare providers if you consent. Appointments are held in private rooms for confidentiality. An exception is rectus diastasis, which may be treated in a separate area if requested.

Q: How Long Does the Appointment Last?

A: The appointment duration varies based on your condition. Initial women's health appointments usually take an hour. Mastitis and rectus diastasis appointments are typically 30 to 40 minutes. Contact our receptionist for specific details.

Q: What's the Cost of Women's Health Physiotherapy Appointment?

A: Session costs vary depending on your condition. Contact our reception for more information.

Q: Can You Claim Women's Health Physiotherapy Under Private Health Insurance?

A: Yes, bring your private health insurance card for on-the-spot claim processing.

Q: Is Your Appointment Covered by EPC/Medicare Referral?

A: Yes, we accept GP referrals under EPC guidelines. A gap payment is required after applying the Medicare rebate due to extended consultation time with your women's health physiotherapist. Contact our reception for details.