Jul 07, 2018

So. Ladies. Let’s get really honest here. Everyone, hopefully, has heard of the term “prolapse” but who truly knows what it is? Do you? Are you able to explain exactly what is happening, what is causing it, or what it is? If not, have you heard of anyone suffering from prolapse? Yes, suffering. Prolapse can be very dysfunctional to a person's life due to mental, emotional, or physical impairments caused by it. I feel this is something that needs to be addressed not only to our ladies whom are pregnant, but elderly, and even our young teens.
The most interesting thing is:

You do not have to be pregnant, or older to have a prolapse. It can happen at any age, male or female. 

Yes. I said it. It can happen in a child. A 15 year old. An 18 year old. A 25 year old. A new mother. A mother of 5. Men. It is unfortunately not rare. Let’s discuss a few things about what it is, types of it, what may cause it, and possible things to do for improvement.
A prolapse is defined as, “a slipping forward or down of one of the parts or organs of the body,” by the dictionary. The way I describe it to patients is as so,
“When something internally moves, causing tissue to push to the outside of your body.” 
Sounds intense, I know. But unfortunately it happens and it can happen. It can happen with a movement of your bladder (cystocele), your rectum (rectocele), or even your cervix (apical). The symptoms are as follows:

  •  pressure in the lower abdomen

  • actual protrusion (ball like structure) on the outside

    • you can actually feel as if you are sitting on a ball)

  • bleeding or reddened/irritated tissue

  • increased discharge

  • problems with sex

    • pain

    • feeling as if something is in the way

  • heavy pulling in the pelvis

  • constipation

If you have 2 or more of the above, get in to see a pelvic PT! You do not have to suffer. There is help!
Let’s talk about some causes of prolapse.

  • Pelvic floor muscle weakness and inability to support the organs.

  • pregnancy

    • large baby

    • long and hard labor

    • long period of time with pushing

    • position during delivery

  • increased pressure in the pelvic floor (coughing, sneezing) when there is not support or strength

  • bearing down during trying to have a BM

  • increased surgical procedures performed in the lower abdomen or pelvic region

You can hopefully at this point see the importance of being educated on your pelvic floor. Everyone is different. So as mentioned before, you do not have to go straight into kegels because that may not be the best option for you.
I know you all have the same questions, “How can I treat it?” “can I make it go back in?” “can I fix it?” “what do I do with it?” Well, first and foremost:
This post is not intended for medical instruction or use. You need to see a pelvic PT for proper diagnosis and treatment of YOUR prolapse.
But. The treatment varies. We discuss behavioral modifications, eating habits, water habits, positioning while on the toilet, positioning during intercourse, how to “put it back in” when necessary, and so many other things. It also depends on what “grade” of prolapse you are given. This ranges from 1-4: 1 is nothing, 2 is where the tissue comes to the whole of the vagina but not out, 3 is where it comes halfway out, 4 is completely out. The later grades sometimes will require a surgical repair, and PT can only assist along the way. However, the lower grades have been shown to really help! I always say if you can function, don’t have the surgery!! 
As far as everything else, we treat the constipation first. If you have a weak pelvic floor, we will certainly address that. But we must also look at how you breathe, how strong your core and low back is, your hip strength and mobility, etc. There is not one treatment approach that works, you must work on everything as a whole for a full treatment approach.
First and foremost. ACCEPT it. This has happened. You are not prolapse though, you just have it. Keep your mindset in the proper place and try your best to limit negativity and fear/anxiety of the unknown.
Get into a Pelvic PT for assessment and treatment and GET IT ADDRESSED!


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