Pelvic Organ Prolapse

Pelvic organ prolapse (POP) occurs when one or more of the pelvic organs shift downward and place pressure on the walls of the vagina or rectum. This may include the bladder, uterus, small intestine, or rectum. While prolapse can feel scary or uncomfortable, there are many treatment options available—and pelvic floor physical therapy can be an important part of managing symptoms and improving your quality of life.

At Phocus Physical Therapy, we provide individualized pelvic floor physical therapy for people experiencing pelvic organ prolapse in Wilmington, NC.

What Does Pelvic Organ Prolapse Feel Like?

Pelvic organ prolapse symptoms can vary from person to person. Some people have little to no discomfort, while others experience symptoms that affect exercise, work, parenting, sexual activity, and everyday life.

Common symptoms may include:

  • A feeling of vaginal or pelvic heaviness

  • Pressure or a sensation that something is falling or bulging

  • A visible or palpable bulge in or at the vaginal opening

  • Symptoms that worsen with prolonged standing or physical activity

  • Difficulty emptying the bladder or bowels

  • Urinary leakage or changes in urinary urgency or frequency

  • Difficulty with bowel movements

  • Pain or discomfort with sexual activity

  • Pelvic, hip, or low back discomfort

It is important to remember that the severity of prolapse seen on an examination does not always match the severity of a person's symptoms. A comprehensive evaluation can help identify what may be contributing to your specific symptoms and which treatment options may be most appropriate for you.

What Causes Pelvic Organ Prolapse?

Pelvic organ prolapse is often influenced by multiple factors rather than one single cause. Pregnancy and vaginal delivery can affect the pelvic floor and supportive tissues, but prolapse can also occur in people who have never been pregnant or given birth.

Contributing factors may include:

  • Pregnancy and childbirth

  • Chronic constipation and repeated straining

  • Frequent heavy lifting or increased pressure on the pelvic floor

  • Aging and hormonal changes

  • Genetics and connective tissue differences

  • Chronic coughing

  • Previous pelvic surgery

  • Changes in strength, coordination, and function of the pelvic floor muscles

Pelvic floor dysfunction is complex, and treatment should consider the whole person—not simply the presence of a prolapse.

Do I Need Pelvic Floor Physical Therapy If I Am Having Prolapse Surgery?

Yes—pelvic floor physical therapy can still be extremely valuable before and after surgery.

Surgery can help address the anatomical position of prolapsed organs, but it may not address every factor that contributed to the prolapse or symptoms in the first place. Pelvic floor physical therapy before surgery can help you improve your awareness of the pelvic floor, optimize strength and coordination, address bowel and bladder habits, and prepare for recovery.

After surgery, physical therapy can help guide your safe return to daily activities, exercise, lifting, and other activities that are important to you.

Our Treatment Approach

Every patient receives a thorough evaluation to understand the factors contributing to their symptoms. Treatment may include:

  • Pelvic Floor Muscle Training

    Pelvic floor muscles need to be able to do more than simply squeeze. Depending on your individual needs, treatment may focus on improving strength, coordination, endurance, relaxation, and your ability to appropriately use these muscles during everyday activities.

  • Breathing and Pressure Management

    Your pelvic floor works together with your diaphragm, abdominal muscles, and other parts of your core. Physical therapy can help you learn how to better manage pressure during activities such as lifting, exercising, coughing, and bowel movements.

  • Strength and Movement Training

    You should not have to stop exercising simply because you have pelvic organ prolapse. Your physical therapist can help you continue—or return to—the activities you enjoy by evaluating your movement patterns and developing a personalized exercise program based on your symptoms and goals.

  • Bowel and Bladder Habits

    Constipation, straining, and certain bladder habits can contribute to pelvic floor symptoms. Your physical therapist can provide education and strategies to help support healthy bowel and bladder function.

  • Education and Self-Management

    Understanding what prolapse is—and what it is not—can be incredibly empowering. Pelvic floor physical therapy can help you understand your symptoms, learn strategies to manage flare-ups, and feel more confident moving and participating in the activities you enjoy.

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