Pelvic Organ Prolapse – What Is It and Why Does It Require Specialist Therapy?
Pelvic organ prolapse is a disorder of pelvic floor support involving the displacement of the uterus, vagina, bladder, or rectum towards the vaginal opening. This issue affects women of various ages—both postpartum and perimenopausal—and is directly related to the weakening of the pelvic support structures.
It is not merely a matter of aesthetic discomfort or a "feeling of heaviness." It is a real functional disorder that impacts quality of life, physical activity, intimate life, and urinary control. Early diagnosis and properly conducted urogynecological physiotherapy can, in many cases, halt the progression of changes and prevent the need for surgical treatment.
What does the prolapse of reproductive organs involve?
To understand the problem, one must look at the anatomy and biomechanics of the pelvis. The organs of the lesser pelvis are supported by a complex system of muscles, fascia, and ligaments. When these structures lose tension, flexibility, or integrity, an imbalance occurs.
The following processes occur in the mechanism of pelvic organ prolapse:
- weakening of the pelvic floor muscles, which no longer properly stabilize the organs
- stretching or damage to the fascia and ligaments during natural childbirth
- chronic increase in intra-abdominal pressure (coughing, constipation, obesity, heavy physical work)
- reduced tissue elasticity due to estrogen deficiency
- disruption of muscular coordination between the respiratory diaphragm, deep abdominal muscles, and pelvic floor
As a result, there is a downward displacement of structures. Depending on which vaginal wall weakens, we may encounter:
- anterior vaginal wall prolapse (often accompanied by bladder prolapse – cystocele)
- posterior vaginal wall prolapse (rectocele – rectal protrusion)
- uterine prolapse
- vaginal vault prolapse (in women post-hysterectomy)
This process usually progresses gradually. The earlier therapy is initiated, the greater the chances for stabilizing the condition and improving function.
WHO IS PELVIC ORGAN PROLAPSE THERAPY INTENDED FOR?
Pelvic organ prolapse does not exclusively affect women who have had multiple childbirths. In clinical practice, the issue arises in various groups of patients.
Therapy is particularly recommended for women:
- experiencing a sensation of "pulling," heaviness, or fullness in the vaginal area
- feeling the presence of a foreign body in the vagina
- having difficulty emptying the bladder or bowels
- with accompanying stress urinary incontinence
- after natural childbirths, especially complicated ones
- in the peri-menopausal and post-menopausal periods
- after gynecological surgeries
- planning subsequent pregnancies
- wanting to avoid or postpone surgical treatment
The key point is that urogynecological physiotherapy can be effective both in preventing and treating first and second-degree prolapse. In more advanced cases, it serves as significant support before and after surgical procedures.
THERAPY EFFECTS - WHAT CAN YOU REALLY EXPECT?
Well-conducted therapy does not rely on "exercises from the internet". It is an individual program that includes manual therapy, muscle reeducation, breath work, and in selected cases, the support of modern technologies (e.g., medical radiofrequency therapy).
The most commonly observed effects are:
- reduction of heaviness and discomfort in the pelvic area
- improvement in the tension and elasticity of the pelvic floor muscles
- better control of urination and reduction of urinary incontinence episodes
- improvement in central stabilization and body posture
- reduction of pain in the pelvic and lumbar spine areas
- improvement in the quality of intimate life
- halt in the progression of prolapse in its early stages
- preparation of tissues for potential surgical treatment and faster recovery after surgery
It is important to emphasize one thing: the effectiveness of therapy depends on regularity and proper diagnostics. There is no room for a schematic approach here. Each patient requires precise functional assessment.
CONTRAINDICATIONS TO THERAPY
Although urogynecological physiotherapy is a safe method, there are situations that require postponement or modification of the procedure.
Contraindications include:
- active infections of the reproductive and urinary tracts
- recent bleeding of unknown etiology
- unregulated cancer diseases
- recent postoperative period (without doctor's consent)
- acute inflammatory conditions within the pelvis
Every patient undergoes a detailed interview and clinical assessment before starting therapy.
RECOMMENDATIONS AND SUPPORTIVE PROCEDURES
Therapy does not end in the office. Maintaining the effects requires conscious personal effort and changing some habits.
It is recommended to:
- regularly perform individually tailored exercises
- learn proper breathing techniques and activation of deep muscles
- avoid chronic constipation and excessive straining
- control body weight
- modify lifting techniques
- limit activities that excessively increase intra-abdominal pressure
These are the elements that determine the durability of the effects. Therapy for pelvic organ prolapse is a process – not a one-time visit.
PROFESSIONAL DIAGNOSTICS AND THERAPY IN WARSAW
Urogynecological physiotherapy at the Ambasad Urody Clinic & Spa in Warsaw is based on medical functional diagnostics, manual work, and an individualized therapy plan.
We do not use simplified schemes. We work on the cause, not just the symptom. This is a fundamental difference that translates into the effectiveness of treatment and patient safety.
If there is a feeling of heaviness in the vagina, discomfort during physical activity, or bladder control issues, it is not worth waiting for the problem to worsen. In pelvic floor static disorders, time works against you. Early intervention provides a real chance for improvement in function and quality of life.