What Is Pelvic Organ Prolapse?

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4 days ago

You know the feeling: You've just finished going to the bathroom, and you walk to the sink to wash your hands. Maybe you peek in the mirror and smooth down your flyaways or reapply lipstick. Then it hits you.
You have to pee again.
So why is this happening? There's no simple answer since bladder frequency can be caused by many things, from a UTI to pelvic floor disorders.
According to a 2025 study published in BMC Women's Health, nearly 50 percent of women will experience some form of pelvic disorder in their lifetime. But a significant education gap remains, starting with who can experience what. Many people assume that issues like urinary frequency and incontinence center around people who have given birth or those over 55.
This is especially true when the word 'prolapse' comes into play. The Oxford Dictionary defines prolapse as 'a displacement of a part or organ of the body from its normal position.' A pelvic organ prolapse refers to a displacement of any organ in the pelvic region, like the uterus, bladder, or rectum.
What is pelvic prolapse?
While a prolapse can only be diagnosed by a medical professional, it can happen to anyone with a vagina. They might be post-partum or post-menopausal, as young as 11 or as old as 92. Yes, women have been dealing with prolapse since the beginning of time, but 'that doesn't mean it's normal,' says Meghan Markowski, PT, DPT, a board-certified pelvic floor physical therapist at Brigham and Women's Hospital in Boston.
What causes pelvic organ prolapse?
How do one's organs shift? Some use the analogy of a house to explain the mechanics of the pelvic floor: the bones are like a foundation, the muscles provide the floor and stability, and the connective tissue functions like beams, linking everything together. It's when the muscles are weakened and instability occurs that prolapses begin to happen. Pregnancy, thanks to hormonal changes and the increased weight of the uterus, is one common cause. 'But prolapse is not exclusive to pregnancy and delivery,' says Markowski. Some people have a genetic predisposition, and anyone suffering from a condition that puts repeated stress on the pelvic floor, like a chronic cough or asthma, may also be susceptible.
Then there's the blessing (and occasional complication) of being hypermobile. A clear benefit to athletes like gymnasts and cheerleaders, hypermobility affects the entire body, including the
connective tissues of the pelvis. When these supportive beams are overstretched and weakened, the entire pelvic floor is destabilized. Karen Kowenski, a Houston-based pelvic floor physical therapist and owner of Empower Yourself PT, has seen children as young as 11 dealing with a weakened pelvic floor. There can also be a correlation between certain forms of aggressive exercise and incontinence. 'If we're constantly jumping and pushing, or lifting heavy weights, and we don't have a strong support system, little by little by little, our organs are going to start to change position,' says Markowski. 'Those types of activities can be good for you, but they could exacerbate these issues' if performed improperly or excessively.
You don't have to eschew this type of exercise, but a strong and coordinated pelvic floor will help prevent a possible prolapse or other pelvic floor disorders.
Reducing urinary frequency caused by prolapse
There are small changes you can make to reduce urinary frequency. Kowenski says the first order of business is to assess any lifestyle patterns. 'Are you constipated? Do you hold your breath when you lift weights? How do you move around?' Sometimes it's just about better body mechanics. Kowenski observed a teen horseback rider who would experience incontinence after she landed from a jump. Kowenski watched the way she positioned her body on the landing: 'Her back was arched, and this [impact] was putting extra pressure on the bladder.' A slight repositioning of her torso while jumping immediately eliminated the leakage.
'There's a lot that we can do about [pelvic floor issues],' says Markowski, but there are also things you can try on your own, like a technique called the double void.
Typically, when we go to the bathroom, we sit on a toilet and relax our pelvic floor muscles to release urine. If everything is in the perfect place, your bladder will naturally empty in one sitting; however, even a small prolapse can cause the bladder to become slightly askew. This displacement can cause a section of the organ to sit behind the urethra, making it impossible for the bladder to drain effectively in the typical seated position. This is why you may have the sensation of emptying your bladder, but after standing up and allowing gravity to move things around, you realize there's more urine waiting to be emptied. This is the thinking behind the double void; sometimes, we just have to physically encourage urine to leave the body by repositioning the bladder.
'If we're suspicious that there's a change in the position of your bladder, you can stand up and lean forward to try to reposition where your bladder is on top of the urethra,' says Markowski. After you stand briefly, you sit back down on the toilet and try again. All of this shifting and standing should take less than one minute. If necessary, you can add some rocking movements: Kowenski recommends 'sitting on the toilet, and rocking back and forth, side to side.' With that physical encouragement, any trapped urine should see the light of day.
A little movement and an extra minute will help ensure you're really done.
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