Can we diagnose a prolapse?

What happens if we find a prolapse on your examination?

There is some very new consensus on our procedures at Preston Pelvic Health thanks to a new consensus on when to refer you back to your GP.

Anatomy

When we perform an internal vaginal exam, we are looking for movement of one of the walls of the vagina.

• If the front wall moves, we call that an anterior wall prolapse.

• If the back wall moves, we call that a posterior wall prolapse.

• If the top of the vagina moves down, we call that a uterine or vaginal vault prolapse (if you have had a hysterectomy)

We Stage this prolapse according to how far the wall moves. We measure this with something called a POP-Q stick, that has cm markings on it.

But do we know what is causing the bulge?? At the front wall, your bladder is there. So one could suggest that it is a bladder prolapse. At the back wall, your rectum is there. So one could suggest that is a rectal prolapse. BUT… we as physios can NOT know what is actually behind that prolapse, so it is not appropriate to label the exact type of prolapse.

What happens if we find a prolapse of one of the walls of the vagina?

If we are the first person to note this, we will write a letter to your GP, so that we can inform them of our findings. We will request the GP to investigate to ensure it is in fact the bladder causing the bulge.

What else could the bulge be?

There are many things that can result in the bulge (at the front for example). Most commonly, it is the bladder. However, the small intestines can also be the culprit, and in rare cases it could be something of a pathological nature. Hence, to be cautious, we will have you see your GP to ensure it is in fact, the bladder (for example).

What do we do next?

We always start treatment with a combination of exercises and education to start treating your prolapse. This can occur right away in 99% of cases, so that we can start working on improving your symptoms as soon as possible.