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Pelvic Organ Prolapse

Ayelet Keinan, PT

Pelvic organ prolapse (POP) is the descent of one or more of the anterior vaginal wall, posterior vaginal wall, uterus (cervix), or apex of the vagina. Prolapses are primarily associated with pregnancy and vaginal delivery but can be caused by other reasons such as the number of times a woman has given birth to a baby, age, body mass index (BMI), and more. Occurrence increases with age [1].

It has been reported that in the general population 40% of women between 45 and 85 years old have an objective POP on examination, but only 12% of these women are symptomatic [2].

Symptoms may include:

  • Heaviness around lower abdomen and or vulva.

  • Feeling something is coming down into your vagina.

  • Difficulty controlling urination.

  • Discomfort with penetration.

Symptoms become more bothersome as the bulge protrudes past the vaginal opening [3].

At the FunctionSmart, we will:

  • Ask you about any relevant history.

  • Assess any contributing factors and symptoms such as urinary incontinence, bladder outlet obstruction, and fecal incontinence.

  • Perform ultrasound imaging to observe your bladder, pelvic floor muscles, and rectum and treat you according to findings.

  • Perform an internal examination of the vaginal walls and perform releasing techniques if needed.

  • Help you find what increases pressure on your pelvic floor muscles and organs and help you find ways to better manage your day to decrease pressure on the prolapse.

  • Teach you how to strengthen your pelvic floor muscles to work against gravity and pressure from daily, recreational, and sport activities.

  • Help you learn how to manage symptoms and contributing factors.

 See “What exactly is pelvic floor physical therapy” for more information:


In some cases, we will advise you to consider fitting a Pessary to support your prolapse. Pessaries are usually fitted by a gynecologist or a specialist nurse. “Pessaries are devices that are placed in the vagina to restore normal pelvic anatomy and decrease prolapse symptoms and treat stress incontinence. They are primarily made from medical-grade silicone” [4].


If symptoms are affecting your daily life and activities, give the FunctionSmart Front Desk a call at 858-452-0282 to schedule an Initial Evaluation with one of our Pelvic Floor specialists.



2.   Slieker-ten Hove MC, Pool-Goudzwaard AL, Eijkemans MJ, Steegers-Theunissen RP, Burger CW, Vierhout ME. Prediction model and prognostic index to estimate clinically relevant pelvic organ prolapse in a general female population. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(9):1013–1021. doi: 10.1007/s00192-009-0903-0.

3.   Pelvic Organ Prolapse CHERYL B. IGLESIA, MD, and KATELYN R. SMITHLING, MD Georgetown University School of Medicine, Washington, District of Columbia.

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