What’s A Prolapse?
Let’s get right to it. What is a prolapse? You might hear the words pelvic prolapse, uterine prolapse, rectocele, cystocele, enterocele or urethrocele. All of those words mean prolapse, just in different structures of the body.
A prolapse is when one or more pelvic organs, including the bladder, uterus or rectum (or in some cases the small intestine or urethra) are falling into the vagina. This happens when the ligaments supporting these organs become overstretched, allowing them to descend further into the pelvis. Oftentimes, sustained, increased intra-abdominal pressure is to blame.
Here’s a quick definition of the types of prolapse mentioned above:
Rectocele: A prolapse of your rectum
Cystocele: A prolapse of your bladder
Enterocele: A prolapse of your small intestine
Urethrocele: A prolapse of your urethra
Uterine prolapse: A prolapse of your uterus
So what’s intra-abdominal pressure? And how can you limit the stress it places on your pelvic floor?
Intra-abdominal pressure is the pressure that exists within your abdominal cavity. It changes as we breathe, move and even poop. It increases when we hold our breath to dive under water and it decreases when we exhale as we emerge from the depths. These changes are normal and healthy and good.
Where intra-abdominal pressure can cause trouble for our pelvic floor is when it’s frequently or consistently elevated for extended periods of time. This can happen because of chronic constipation, poor weightlifting form and during vaginal childbirth.
Fortunately, there is so much that can be done to protect your pelvic floor. Pelvic floor physical therapists can teach you techniques to lessen the stress on your pelvic floor when you poop, lift and give birth. These techniques can help reduce the likelihood of developing a prolapse and reduce aggravation to a prolapse that is already present.
If you’re wondering if you have a prolapse, common symptoms of prolapse include:
having a sensation of vaginal heaviness
urinary leakage
difficulty emptying your bladder or bowels
even back pain.
Some people describe heaviness as feeling pressure in the vagina or a falling sensation, or having the sensation that a golf ball is stuck vaginally. Some people will even feel that air or air bubbles can get trapped vaginally.
Prolapse severity is graded on a I-IV scale, however symptoms don’t always correlate to severity. Some people have significant heaviness with a grade 1 (the lowest) prolapse and some don’t even realize they have a prolapse but have almost a grade 3.
It’s so important to remember that whatever you’re feeling does not need to be forever. Seeing a physical therapist can help you control your symptoms as well as improve the prolapse itself. While PT can’t 100% reverse the prolapse itself, it can help reduce the severity and help folks can get back to all the activities that they love doing, including running, weightlifting and chasing their toddlers across the playground.
Getting a personalized assessment is the best way to know what you can do to improve your symptoms and work towards a healthier future!
To learn more about prolapse and working with a PT, call us at 512-766-2649 or contact us here. Follow @jessicachastka_dpt and @ladybirdpt for more pelvic health education!
By Dr. Jessica Chastka, PT, DPT, WCS
Jessica (she/her) earned her Bachelor’s in Exercise Science from the University of Louisiana at Monroe, while playing softball. She received a Doctorate in Physical Therapy from University of Texas Medical Branch in Galveston in August 2015. In 2019 she became Board Certified in Women’s Health, through the American Board of Physical Therapy Specialists.
For the last five years she has been working as a pelvic floor physical therapist, treating people who have pelvic pain, leakage, urgency, frequency and constipation. This includes the pregnant and postpartum population as well as people with chronic pain. She is passionate about making her patients feel heard and seen, validating those who feel that their problems are not worth mentioning because everyone has them or because embarrassed to talk about them.