The Pelvic health team is located in South West Acute Hospital, Omagh Hospital and Primary Care Complex and Altnagelvin Hospitals.
Our team of specialised Physiotherapists provide a range of services to pregnant and postnatal women, as well as women attending urogynaecology services for bladder, bowel or pelvic pain issues.
Pelvic organs include your bladder, womb (uterus) and rectum. Pelvic organ prolapse occurs when one or more of these organs bulges against, or sags down into the vagina and the muscles and ligaments in the pelvic floor become stretched, or too weak to hold the organs in the correct place. Prolapse can occur in the front wall of the vagina (cystocele), back wall of the vagina (rectocele), uterus (uterine) or top of the vagina (vault). You can have prolapse of more than one organ at the same time.
Vaginal prolapse is common, affecting up to half of adult women.
Causes include; pregnancy and childbirth, aging and menopause, obesity, chronic cough, chronic constipation, and heavy lifting. Prolapse can also occur following hysterectomy and other pelvic surgeries.
Prolapse is usually not life-threatening, but it can significantly affect your quality of life.
Symptoms of POP
The symptoms of POP can vary for each individual and can be dependent on which organ is slipping out of place. Some symptoms which women often describe include:
Pressure, heaviness or discomfort in the vaginal or pelvic area (often made worse by long periods of standing, exercise or lifting)
Low back ache
Change in control of bladder or bowel, including urgency or frequency
Slow urine stream or initiation of urine flow
Incomplete emptying of bowel or difficulty with evacuation
Discomfort during intercourse
Does POP need to be treated?
If your POP is not causing you any discomfort and is not bothersome then it does not need to be treated, however it is important that you are aware of it and take care not to put too much pressure through your pelvic floor and performing pelvic floor exercises regularly to prevent symptoms from arsing is beneficial. If you are experiencing symptoms that are affecting your quality of life, then there are treatment options available.
What are the Treatment Options for POP?
There are several conservative treatment options available, which have been shown to be very effective in reducing the symptoms of POP, however success rates will often depend on the type of POP and its severity.
Mild prolapse can be managed by changes to your diet and lifestyle (e.g. Reducing heavy lifting, managing constipation, losing weight) as well as strengthening the pelvic floor muscles which provide the integral support for your pelvic organs. The advantage of this type of treatment is there is no risks associated, but it may not be effective in more advanced forms of POP.
In moderate to severe prolapse it is likely that damage has not only occurred to the muscles but also the connective tissue which provides support to the organs. Successful support and treatment can occur with the insertion of a vaginal pessary. A discussion about surgical options may be necessary if symptoms if conservative management has failed.
Endometriosis (pronounced en- doh – mee – tree – oh – sis) is the name given to the condition where cells similar to the ones in the lining of the womb (uterus) are found elsewhere in the body.
Each month these cells react in the same way to those in the womb, building up and then breaking down and bleeding. Unlike the cells in the womb that leave the body as a period, this blood has no way to escape.
In the UK, around 1.5 million women and those assigned female at birth are currently living with the condition, regardless of race or ethnicity. Endometriosis can affect you from puberty to menopause, although the impact may be felt for life. (Endometriosis UK)
For most women, menopause is marked by the end of monthly menstruation (also known as a menstrual period or ‘period’) due to loss of ovarian follicular function. This means that the ovaries stop releasing eggs for fertilisation.
The regularity and length of the menstrual cycle varies across a woman’s reproductive life span, but the age at which natural menopause occurs is generally between 45 and 55 years for women worldwide.
Natural menopause is deemed to have occurred after 12 consecutive months without menstruation for which there is no other obvious physiological or pathological cause and in the absence of clinical intervention.
Some women experience menopause earlier (before 40 years of age). This ‘premature menopause’ may be because of certain chromosomal abnormalities, autoimmune disorders, or other unknown causes.
Menopause can also be induced as a consequence of surgical procedures that involve removal of both ovaries or medical interventions that cause cessation of ovarian function (for example radiation therapy or chemotherapy).
Many women have already stopped menstruating before menopause, for example those who have had certain surgical procedures (hysterectomy or surgical removal of their uterine lining) as well as those using certain hormonal contraceptives and other medicines that cause infrequent or absent periods. They may still experience other changes related to the menopausal transition. (WHO 2024, WWW.WHO.INT)
The Pelvic health team is located in South West Acute Hospital, Omagh Hospital and Primary Care Complex and Altnagelvin Hospitals.