Pelvic Organ Prolapse (POP)

What is a “falling out feeling”?

I hear this a lot at my office! When women fill out paperwork at their first visit there is a question that asks “Do you have a falling out feeling?” and at times I get a puzzled look! I tell them they would know if they have it!

Pelvic organ prolapse (POP) is common condition among women. POP occurs when the pelvic floor and/or connective tissue weaken and cannot support the pelvic organs as they were designed. Therefore, the bladder, uterus or rectum will begin to descend (or fall down) into the vaginal canal and give a woman the feeling that something is falling out. This may occur after childbirth or be seen many years down the road. Though obesity, pelvic surgery, menopause, and chronic constipation can also play a role in developing POP.

Some women I treat have no symptoms and do not realize this may be a factor as to why they are seeing me. Common complaints are the inability to use a tampon, urinary or fecal incontinence, and pain with intercourse.

Though more severe POP shows up as:

A heavy pressure in the vagina that worsens with standing activity or during bowel movements
Feeling as if one is “sitting on a ball”
Needing to push stool out of the rectum by using one’s fingers near the vagina during a BM
Difficulty starting a stream of urine
Feeling unable to empty the bladder well
Low back discomfort
Urinary leakage with intercourse

What can do if I have a prolapse?

For starters, I always teach my patients to have soft and easy to move stools. Preventing constipation will help most urinary and bowel conditions. Learning how to lift properly and prevent increased intra-abdominal pressure can help as well. Strengthening your pelvic floor and hip muscles to provide added support is crucial (though it’s more than just kegels ladies! People will often say, “Oh, I tried that and it didn’t work”. Please don’t give up after just trying kegels!)

How can I prevent prolapse?

Again, avoid straining with bowel movements. Try not to squat while urinating and learn how to properly support your pelvis and low back through exercise.

Some women really need surgery to help with POP. PT can be a great support prior to and following surgery by teaching proper strengthening, function and movement that will improve one’s outcomes.