Pelvic floor physical therapy (PFPT) is the first step in treating uterine prolapse without surgery. Rigorous research shows a clear benefit of physical therapy as a first-line treatment for specific women’s health issues. In the PFPT approach, the physical therapist gives instruction on muscle strengthening, relaxation, and coordination exercises. Strategies also include manual therapy, biofeedback, and home exercises.

What Causes Uterine Prolapse?

Uterine prolapse happens when weak pelvic floor muscles allow the uterus to descend into the vagina. This abnormal descent can cause a feeling of heaviness or fullness in the pelvic region. It can also cause back pain and problems using the restroom. Causes include:

• Pregnancy and vaginal childbirth 
• Weakening of pelvic muscles and tissue with advanced age and menopause
• Conditions that put additional strain on the abdomen and pelvic area including obesity, chronic cough, and constipation.
• Major surgery that causes decreased support in the pelvic region.

Is Treating Uterine Prolapse with PFPT Effective?

In 2014, the International Consultation on Incontinence report cited level 1, grade A evidence supporting the effectiveness of physical therapy in treating uterine prolapse. For example, a large study found PFPT improved prolapse symptoms after 12 months compared to those who received an educational leaflet or no treatment. Likewise, women who participated in a large Norwegian study showed improvement after pelvic floor muscle training under the supervision of a physical therapist. In addition, a meta-analysis published in the International Urogynecological Journal concluded that patients who received PFPT subjectively and objectively improved their pelvic organ prolapse symptoms and severity. 

Treating Uterine Prolapse without Surgery 

Uterine prolapse is not going away on its own. The best scenario is to treat it early and avoid surgery. Physical therapy can prevent pelvic organ prolapse from worsening and correct underlying causes. Pelvic floor muscle training such as Kegels strengthens the supporting structures around the uterus. An additional treatment option includes support pessaries—flexible devices inserted into the vagina. 

Physical Therapy for Uterine Prolapse

Physical therapy takes a multi-faceted approach to treatment. First, the therapist assesses the patients’ symptoms and lifestyle to develop an individual plan. The therapist begins with patient education, teaching them to avoid heavy lifting, reduce intra-abdominal pressure and engage core muscles when coughing, sneezing, and laughing. PT also includes core strengthening exercises and pelvic floor muscle training.

At COR, we have experts on staff to create and implement PFPT treatment plans. If your patients are interested in treating uterine prolapse without surgery, contact our referral office at 201-833-1333.