Non-Surgical Options for Pelvic Organ Prolapse
- Stefanie Long
- Nov 19
- 5 min read
If you’re searching for effective prolapse therapy or wondering whether pelvic organ prolapse can improve without surgery, you’re in the right place.
What you’ll learn: signs of prolapse, how conservative prolapse therapy works, helpful breathing techniques, lifestyle changes to reduce prolapse symptoms, and when to see a pelvic floor therapist.
You feel a bulge.
Uh oh, now what?
You just spent 10 minutes straining on the toilet to finally pass a large bowel movement because you haven’t pooped in two days. At first you feel relieved, but now you’re noticing a bulge that wasn’t there before. Your stomach drops. Somewhere in the back of your mind, you remember your mom or grandma saying something about having a prolapse. You wonder, “Do I have a prolapse too? I remember how they struggled with theirs. Oh, I hope this is not that.”
You quickly jump onto Google to search for “prolapse symptoms.” You read: “heaviness,” “bulge,” “bladder incontinence,” “lower back pain,” “pelvic pain.” Oh no—you experience ALL of these things. So you quickly click to the Image tab to look at the pictures. You’re suddenly bombarded with words like: “Bladder Prolapse,” “Uterine Prolapse,” “Rectal Prolapse,” “Prolapse Stages", "Prolapse rehab", “AVOID Straining,” “BLADDER SLING SURGERY.” Now panic and fear sets in. You have no idea what you are feeling, and the only option you’re reading to relieve this sensation is… surgery.
You definitely know you don’t want surgery. So now what?
How do you manage a prolapse without surgery?
Well, I’m glad you asked! As a Pelvic Health Physical Therapist, I’m here to share non-surgical options for pelvic organ prolapse relief that can provide you hope and confidence again!
To understand more about pelvic organ prolapse signs and causes check out our blog here. Understanding Prolapse
The main focus of conservative care for all types of pelvic organ prolapse is proper intra-abdominal pressure management. Yes, those words may sound confusing—so let me break it down for you.
Our abdomen contains our lungs, diaphragm, digestive organs, reproductive organs, and pelvic floor muscles. The diaphragm is the “top” and the pelvic floor is the “bottom.” They need to work together in coordination. When one moves down, the other follows. When one moves back up, the other rises—like two people dancing in sync. This is proper intra-abdominal pressure management.
The problem we often see with pelvic organ prolapse symptoms is that these two structures are not on the same page.
Pelvic Floor Self Assessment
Here’s your first homework assignment:
Find a comfortable lying position where you can bring your attention to your breath.
Take a 4-second inhale and 4-second exhale. Repeat 3 times.
Now bring your attention to your pelvic floor muscles. Notice what you feel the muscles doing when you breathe in and when you breathe out.
Do you feel a lift?
Do you feel a squeeze?
Do you feel a lengthening?
Do you feel a bulge?
Do you feel pressure?
Do you feel nothing?
If you feel nothing, this is your cue to see a Pelvic Floor Therapist to help you identify these sensations and rebuild this mind-body connection.
If you do feel movement, are these two movements coordinated?
When you take a breath in, your pelvic floor muscles should relax or release some tension.
When you breathe out, your pelvic floor muscles should contract or kegel.
Remember the dance? When one moves down, the other should follow.
It’s often easier to do the opposite; when you breathe in, your pelvic floor contracts, but that means these two dance partners aren’t in sync which can lead to prolonged pelvic organ prolapse symptoms.
So try practicing this new dance with your pelvic floor muscles and your breath. This is the first step in beginning pelvic organ prolapse therapy.
Lifestyle Changes to Improve Prolapse
Ready to progress?
What other non-surgical prolapse treatments are there? Well, let’s chat about how this coordination works during our daily activities and a few things we can change in our daily lives. Two common causes of sudden pelvic organ prolapse heaviness are: straining while on the toilet and lifting without proper breathing mechanics.
Some lifestyle changes to decrease the risk of worsening a prolapse are:
Avoid straining on the toilet. If it’s not time yet, don’t force it. Try going for a walk, performing an abdominal massage, or adding in more fluids and fiber into your diet.
Those “just in case” pees before leaving the house, are creating overactivity of your muscles and weakening their ability to support your organs. A normal bladder habit is urinating every 2-4 hours. Let’s keep those muscles happy.
Coordinating your breath with lifting during exercise. Exhale on exertion aka the hardest part of the move. For example, during a squat: inhale on the way down, exhale on the way up. Your pelvic floor muscles will follow your breath and give you support.
Daily movement is a must! 30 minutes of moderate intensity walking daily is all you need to develop a healthier lifestyle.
Non-surgical Options for Prolapse
Now, let’s go back to your initial Google search, when you learned there are many different types of prolapse and the only option you saw for treatment was a bladder sling surgery. I’m here to tell you that’s NOT the only option!
The first person you should see is a pelvic floor therapist who specializes in Prolapse.
A Pelvic Floor Therapist will help you determine which organ is sitting a bit lower in the vaginal canal. Then, depending on the type of prolapse, the stage of prolapse, and your individual exercise goals, the therapist will talk with you about prolapse exercises, manual therapy techniques to improve organ positioning, and possible use of internal and external supports.
Internal supports are called pessaries. A pessary is a soft, silicone support that you insert into the vagina to lift the organs back to their upright position. Your therapist will discuss with you the size, shape, timeline for use, how to insert and remove, and answer any other questions you may have.
Scared to insert anything in your vagina yourself? That’s ok! There are external garments available for support too. Talk with your Pelvic Health Therapist to determine which brand fits your needs and to ensure proper sizing.
Either of these options are used in conjunction with prolapse exercises and treatment by a physical or occupational therapist who specialize in prolapse rehab. Together, they create an environment for healing. Many of our patients become symptom free after treatment! Without surgery!
"I'm here to tell you that [surgery] it NOT your only option!"
Still feeling overwhelmed? That’s ok too! You don’t have to and shouldn't navigate this alone. Find a Pelvic Health Therapist near you to gain the information and tools you deserve to find non-surgical relief. If you're near the Fort Worth/Dallas area, check out our clinic Concept Pelvic Health!
Your Next Read:
Comments