Let’s Talk Prolapse - Part 1 - What is it?

Pelvic organ prolapse, aka POP, is common, probably more common than you think. Estimates suggest that up to 50% of women will experience a prolapse after childbirth. This figure includes women who birth vaginally and via cesarean. Yep, contrary to popular belief, birthing via caesarean section does not protect you against pelvic floor dysfunction and prolapse.

Unfortunately, a prolapse diagnosis is often handed out by medical professionals without adequate explanation or guidance. The result is that women feel frightened and unsure what to do. They turn to google for answers and see images of all sorts of prolapse horrors and end up wondering if this is their fate. This diagnosis can be a traumatic experience and women are commonly spiraled into a world of uncertainty, exercise avoidance and fear, with little to no advice on how to manage or prevent their symptoms from worsening. 

We feel you mama. It’s not a pleasant diagnosis, but we’re here to tell you that in most cases, you can make a HUGE difference to your symptoms and you can return to doing the things you love!

So let’s talk about prolapse and demystify this diagnosis a bit. 

What Is Pelvic Organ Prolapse?

Pelvic organ prolapse is defined as downward displacement of one or more of the pelvic organs (which are the bladder, uterus or bowel) into the vagina due to a lack of support from the pelvic floor muscles and surrounding tissue.

Not every woman feels the symptoms of her prolapse (you may be asymptomatic) or your prolapse may occur months or years after childbirth.

There are different types of prolapse. Following pregnancy and childbirth, the most common prolapse is a bladder prolapse, followed by bowel and uterus. 

There are different types of prolapse:

Anterior vaginal wall prolapse

Also known as a cystocele or bladder prolapse. The bladder causes a bulge in the front wall of the vagina.

Posterior vaginal wall prolapse

Also known as a rectocele or bowel prolapse. The end of the bowel, known as the rectum, bulges forward into the back wall of the vagina.

Uterine prolapse: prolapsed uterus

The uterus (womb) and cervix (opening to the womb) drop down towards the vaginal entrance and may protrude outside the vagina.

Small bowel prolapse

Also known as an enterocele or a prolapse of the small intestines. The small bowel descends into the lower pelvic cavity and bulges into the top part of the vagina.

Stages of Prolapse

Prolapse can range from Stage 1 where you do not see (and often do not feel) anything coming out of your vagina to Stage 4 where an entire organ can protrude outside the vagina. The different stages of prolapse depending on severity:

Stage 1: the organ descends to >1cm above hymen (vaginal opening).

Stage 2: the organ descends to just above or below the hymen (within 1cm)

Stage 3: the organ descends >1cm below the hymen

Stage 4: the organ descends completely out of the vagina

If you are diagnosed with a prolapse, you should ask your practitioner what type of prolapse you have and what grade your prolapse is, and make sure they explain what this means. They should also refer you to a pelvic floor physiotherapist if you are not already seeing one.

In next week’s blog we will discuss the symptoms, causes and aggravating factors of a prolapse.

P.S. If you haven’t already downloaded our FREE ebook, grab it now! It’s got our 5 top tips for a safe, comfortable and injury free pregnancy.