Pelvic floor prolapse: Causes, symptoms and treatment

In this informative article, we hear from revered consultant colorectal surgeon Mr Kawan Shalli on the causes and most common symptoms of pelvic floor prolapse. The esteemed specialist also sheds light on the function of the pelvic floor and which types of treatment may be indicated for pelvic floor prolapse.

What is the pelvic floor? What is its function?

The pelvic floor is a group of muscles and connective tissues that support important organs in your pelvis, like your bladder, bowel (large intestine) and internal reproductive organs. The main functions of the pelvic floor muscles are:

• to support the abdominal and pelvic viscera
• to maintain continence, so leaking doesn’t occur
• to assist with some bodily functions, including going to the toilet or having sex
   

Why does pelvic floor prolapse occur?

Pelvic floor prolapse occurs when the pelvic floor becomes weakened and cannot hold the organs firmly in place. A number of things can weaken your pelvic floor and increase your chance of developing pelvic organ prolapse, including:

• pregnancy and childbirth
• menopause
• ageing
• chronic coughing or constipation
• heavy lifting or strenuous exercise
• obesity
• previous pelvic surgery, such as hysterectomy
   

What are the symptoms of pelvic floor prolapse?

The symptoms of pelvic floor prolapse include:

• a feeling of heaviness around your lower tummy and genitals
• a dragging discomfort inside your vagina
• feeling like there’s something coming down into your vagina – it may feel like sitting on a small ball
• feeling or seeing a bulge or lump in or coming out of your vagina (known as rectocele)
• difficulty emptying the bowel and/or a feeling of incomplete evacuation with or without soiling
• partial or full thickness rectal prolapse
   

How serious is pelvic floor prolapse?

Pelvic floor prolapse is not usually a serious condition, but it can cause discomfort and affect your quality of life. In some cases, it can lead to complications such as urinary incontinence or infections, bowel problems (in the form of not to be able to defecate easily without helping it) and/or faecal incontinence and internal rectal prolapse that, if left with time, can lead to full external rectal prolapse. It’s important to see your doctor if you experience any symptoms of pelvic floor prolapse.
 

How is pelvic floor prolapse treated?

The treatment for pelvic floor prolapse depends on the severity of the condition. In mild cases, pelvic floor exercises (Kegel exercises) may help strengthen the muscles and improve symptoms. In some cases, biofeedback training is required.

In more severe cases, surgery may be necessary depending on the underlying main causative factor. This may be to repair the weakened muscles and tissues or in bowel dysfunction with rectal prolapse would require special keyhole surgery such as laparoscopic ventral mesh rectopexy.

If you are concerned about the symptoms of pelvic floor prolapse, you can schedule a consultation with Mr Shalli by visiting his Top Doctors profile.