Vaginal Prolapse

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Vaginal Prolapse Prevention and Treatment - The Fix Program

Vaginal Prolapse Prevention and Treatment

What is a vaginal prolapse or pelvic organ prolapse?

Inside a women's pelvis are organs including the bladder, uterus and rectum (back passage). These organs are held in place within your pelvis from above via tissues called "fascia" and "ligaments". The pelvic floor muscles also provide upward support acting as a sling-like structure holding the weight of these organs from below.

Problems can occur due to stretching, tearing or weakening of the fascia tissue, or pelvic floor muscles. This can often be caused by vaginal child birth, chronic constipation or menopause. What may happen is the pelvic organs may bulge down into the vagina. This is known as a vaginal prolapse, or pelvic organ prolapse.

Early signs of vaginal prolapse can be difficulties with good bladder control, it is painful to insert a tampon, or have sex.

How do you know if you have vaginal prolapse?

Early on, it may be hard to know if you have a vaginal prolapse and your GP at a routine PAP smear, or a women's health physiotherapist during an internal examination who may first detects early signs.

You may notice some of the following changes to your pelvic floor area that may indicate early signs of vaginal prolapse:

  • Do you feel a heavy feeling in your vagina, often worse at the end of the day?
  • Do you notice or feel a lump in your vagina?
  • Do you experience pain or less feeling with sex?
  • Do you experience difficulty in emptying your bladder, or notice a weak urine stream?
  • Do you suffer from recurring urinary tract infections?
  • Do you find it hard to empty your bowel?

How do you treat a vaginal prolapse?

Depending on the degree of the prolapse, management can be as simple as pelvic floor muscle training and a change to good bowel and bladder habits. Early stages of vaginal prolapse can be corrected through insertion of a pessary. Pessaries serve as a prop or support for your vagina to bring your organs back to a higher position. Our women’s health physiotherapists can determine the need for this through our initial assessment of your pelvic floor function and structure.

More complicated or progressed prolapses will often need surgical correction with follow up pelvic floor muscle training.

How is The Fix Program different in treating vaginal prolapse?

Our women's health physiotherapy assessment will always involve an internal vaginal examination. This, along with extensive questioning about your pelvic floor function and habits will allow for the best diagnosis of the cause of your symptoms. The internal examination will also allow for the physiotherapist to properly assess any weakness, spasm or change to your pelvic floor muscles and get the best picture of your vaginal structure and presence of any "bulges" or prolapses.

Our women's health physiotherapists are extensively trained in the prescription and fitting of a pessary if it is felt to be the essential in your management. This is a very specialised field and not offered by many women’s health physiotherapists.

What should I expect?

You do not need a referral to see our women’s health physiotherapists, but you may be referred by your GP or gynaecologist. After speaking with you over the phone about your pelvic floor problem, we will book you an hour long assessment.

The assessment will involve taking a very detailed history about your pelvic floor habits, from bladder and bowel control, to sex, to lower back and pelvic pain. The internal vaginal examination will follow and a management plan decided together with you. The structure and degree of any 'bulges' in your vagina can be measured through this internal examination. Measurements for a pessary fitting are also done if it is thought this is the best management for you.

Treatments after this time will be different for each woman, but may involve a weekly or fortnightly treatment session to teach you exercises (some to strengthen and others to relax) and educate you on good pelvic floor habits and use of the pessary , if prescribed.

Incontinence symptoms associated with your vaginal prolapse, bulging feelings, pelvic pain, and back pain have all been shown to improve in most women with management or vaginal prolapses in this manner. If symptoms do not improve, we can discuss with you the pros and cons of surgical repair and refer you to a Surgical Gynaecologist.

Did you know

Vaginal prolapse can be caused by vaginal child birth, chronic coughing, repeated heavy lifting and chronic constipation. Prolapse also tends to run in the family and is more likely after menopause.

What do I do next?

If you have any questions about pelvic floor dysfunction, or any of its presentations such as incontinence, vaginal prolapse or pelvic pain, please call us on 02 9264 0077 to discuss your concerns with our women's health physiotherapists. We will be very happy to talk privately with you or to arrange your initial assessment.

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