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Bulging Isn't the Only Symptom of Prolapse

Hi friends! A common symptom of pelvic organ prolapse is vaginal bulging, but did you know a bulge is not the only symptom of prolapse? Either at home on our own or at the physicians office we are often looking for a bulge to diagnose prolapse, but it can present with other symptoms as well.


Pelvic organ prolapse is the falling of one or more of the pelvic organs (bladder, uterus, small intestines, or rectum) into the vaginal canal. Sometimes the organ(s) stay inside the vaginal canal, but it can prolapse (bulge) outside of the vagina.

Many individuals that have prolapse actually don’t have symptoms because the prolapse is mild (Bo, 2015). While a vaginal bulge is one of the most common symptoms, here are some of the symptoms individuals with prolapse can experience:

  • Pelvic pressure/heaviness

  • Low back pain

  • Strong, sudden urges to pee

  • Urinary leakage

  • Frequent urination

  • Hesistancy with or weak urine stream

  • Feeling of incomplete bladder or bowel emptying

  • Need to apply pressure to pee or poop

  • Need to change position to start of complete peeing

  • Gas or stool incontinence

  • Straining to poop

  • Feeling of blockage while pooping

  • Pain with intercourse


If you experience any of these symptoms, your provider will likely want to check for prolapse. The person that performs your gynecological pelvic exam is usually the provider that will diagnose you, but most pelvic physical therapists and pelvic occupational therapists are also trained to assess and treat pelvic organ prolapse. Before an appointment, you can check for prolapse at home and discuss what you see with your provider.


To check for prolapse, find private space and get into a comfortable position with back support and leg support. Use a handheld mirror and point it so that you can see your perineum (the area around your vagina and anus). With your other hand, gently separate the lips of the labia so that you can clearly see the vaginal opening. Watch the vaginal opening and cough. As you cough, look to see if you can find a bulge in the vagina. If you see a bulge, you may have pelvic organ prolapse.


If you are experiencing symptoms but you do not see a bulge while lying down, it can be helpful to check for prolapse in other positions. In this quick video, Jeanice explains prolapse testing in different positions.

Many people think that if they have prolapse, all hope is lost, but that’s simply not true! The pelvic floor muscles are one of the key players that support the pelvic organs and help to counteract the myriad of downward forces that can occur. Like other voluntary muscles of the body, the pelvic floor muscles can be trained and strengthened! It’s never too late. In fact, pelvic floor muscle training is the #1 recommended treatment for pelvic organ prolapse. A pelvic floor physical therapist is a great resource to help guide pelvic floor muscle training based on your individual needs. If your access to a physical therapist is limited, our Power Over Prolapse E-Course is a great resource.


Remember, prolapse is not a death sentence. You can still exercise, you can still live and enjoy life, you can still have sex, and most importantly, you are still beautiful!


To learn more about your pelvic floor muscles, check out these great resources:

For providers, check out our online courses to help your clients. Consider joining our Ambassador Program and most of our courses are included with your membership!

  • External Support: The Missing Link with Jeanice Mitchell PT, MPT, WCS, BCB-PMD

  • Office and Surgical Management of Prolapse and Urinary Incontinence with Dr. Sarah St. Loius MD, FACOG, PFMRS


Written by Emily Reul, PT, DPT


References

  1. Bo K, Berghmans B, Morkved S, Van Kampen M. Evidenced-based physical therapy for the pelvic floor bridging science and clinical practice. 2nd edition. 2015.

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