How Pelvic PT Helps Prolapse: The 3 types

Understanding Prolapse Types, Stages, and How Pelvic Floor Physical Therapy Can Help

You’ve been diagnosed with a prolapse, but you’re not exactly sure what it means or what to do about it. So you Google. While scrolling through pages and images, you read words like: bladder prolapse, uterine prolapse, rectal prolapse—and they each have a number? You question, “What does the number mean? This isn't an algebra class.”

Understanding Pelvic Organ Prolapse:

Wait! What Do You Mean There Is More Than One Type of Prolapse?

You continue your search. Each article you pull up to gain some understanding only adds to the confusion. All you want to know is 

• “What type of prolapse do I have?” 

• “Is this something I will have to live with for the rest of my life? 

• “Can I do something about it?”

Confused and overwhelmed, you see a glimmer of hope called… pelvic therapy. This doesn’t sound as scary as surgery, so you consider it. You wonder, “How does pelvic PT help with each type of prolapse?”

Let's break it down:

Types of Pelvic Organ Prolapse

Within the pelvis, we have 3 major organs supported by the pelvic floor: the bladder, uterus, and rectum. When any one of these organs descends within the pelvis, this is called a prolapse. 

Bladder Prolapse (Cystocele):

A bladder prolapse, also known as a cystocele (sis-tuh-seel)

• Typical symptoms of a bladder prolapse include difficulty fully emptying during urination, needing to rock or bend to the side to empty, bladder incontinence, urinary urgency and frequency, or pain with urination. 

• A common treatment is the use of a ring or cube pessary plus pelvic floor muscle exercises. 

Uterus or Vaginal Vault Prolapse:

• Those with a uterus may experience the lowering of the uterus. This is very common immediately following a vaginal birth. 

• Those post-hysterectomy may experience the lowering of the vaginal vault—the lining of the vaginal wall where the cervix used to sit. 

• Typical symptoms include heaviness, pressure, a sensation of a tampon that isn’t inserted correctly, pain with intercourse, and low back pain. 

• A common treatment is the use of a ring or cube pessary plus pelvic floor muscle exercises. 

Rectal Prolapse (Rectocele)

A rectal prolapse also known as a rectocele (reck-tuh-seel)

• Typical symptoms of a rectal prolapse include constipation, difficulty passing a daily bowel movement, needing to strain to empty, feeling urge to void but not able to empty, and pelvic pain 

• A common treatment is the use of a cube pessary plus pelvic floor muscle exercises. 

For many women in the Keller and surrounding Fort Worth, TX areas, pelvic floor PT can offer hope to those suffering with these symptoms.

Overlapping Symptoms in Prolapse Types:

It is worth noting that these symptoms often overlap with each type of prolapse or within stages of prolapse explained below. These three types are the most common, but there are more rare types of prolapses that may occur, so seeing a pelvic PT is vital to ensure correct diagnosis and treatment. 

Prolapse Stages Explained

Now let’s return to the math part we discovered earlier. No, this isn’t an algebra class with 2x+y = 3z and you have to solve the equation to find the answer. The numbers assigned to a prolapse have a purpose—and this purpose actually brings us hope.

The numbers you see with a prolapse determine the stage of prolapse. Often Dr. Google will only show images of the extreme prolapse cases—this is where you can exhale because these cases are rare. 

The majority of prolapses are at a stage that doesn’t require surgery and can actually change stages with pelvic therapy. 

Let’s go further. 

What do prolapse stages and grades mean?

Prolapse stages range from Stage 0 to Stage 4. 

Before the Spice Girls became popular, prolapse stages were actually determined by a different scale called prolapse grades. This is where it gets muddy. Not all providers use the same stage and grade scale to diagnose a prolapse, and some might use the stage scale but call it a grade. 

Let me jump on my soapbox for a minute and acknowledge our profession needs to do better with this. We should all be standardized in the information we provide; therefore, you may hear different things so bear with us. 

I will also acknowledge that your prolapse may change its stage depending on the time of day, day of the week, and menstrual cycle. Prolapse is a puzzle, and we will work with you to put all the pieces together.

Ok back to the stages.

Stage 0 and Stage 1 Prolapse:

• Stage 0 means there is zero movement of your organ with increased intra-abdominal pressure. Some argue this stage is rare because our organs are made to move. 

• Stage 1 means there is minimal movement of your organ with increased intra-abdominal pressure. This is the most common stage and isn’t actually considered a prolapse because women are typically symptom-free. Movement within our organs is normal and needed. The whole pelvic system is dynamic and moves as a whole system. A PT will monitor symptoms in this stage and provide preventative education. 

Stage 2 Prolapse: When Symptoms begin

• Stage 2 is the beginning of a true prolapse because there is moderate movement. This is where symptoms typically begin. This stage is tricky because it has three different levels within it. Your pelvic PT will determine the specific measurement of your stage and recommend treatment such as:  

  • Pelvic floor muscle strengthening or relaxation

  • Proper breathing techniques and body mechanics

  • Internal or external supports

  • Pelvic floor exercises

Stage 3 and Stage 4 Prolapse:

• Stage 3 and 4 are commonly seen in Google searches. They are measured by how much of your prolapse is protruding outside of the vaginal canal. A pelvic therapist will: 

  • Help determine which internal or external supports work best for your goals

  • Provide education on lifestyle changes to avoid worsening symptoms

  • Treat pelvic floor muscle weakness

  • Prescribe exercises to help maintain participation in all desired activities

How Pelvic Floor Physical Therapy helps Prolapse

A Pelvic Health Physical Therapist will be your first go-to when understanding your type of prolapse and seeking treatment for relief. For women near Keller, Southlake, or Colleyville, TX who are looking for help with their prolapse, will find comfort in knowing that they have experts serving their area who can help guide them to an improved lifestyle. A pelvic PT understands the variability of each prolapse in each individual and will screen for a prolapse in functional positions that often cause the symptoms. Every manual technique and exercise in every session has an intentional purpose to help you reach your goals with confidence.

If you're looking for Non-Surgical options for Pelvic Organ Prolapse, continue reading more here.

If you’re experiencing symptoms of prolapse and are looking for pelvic floor physical therapy in Keller, TX, working with a pelvic PT who understands prolapse types and stages can make a meaningful difference. Our clinic serves individuals throughout Keller, Southlake, Colleyville, and surrounding Fort Worth communities.