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  • Writer's pictureBrittany Sudbrook

From Every Angle: The Dangers of the False Negative Prolapse Screen

Unfortunately, it happens time and time again; patients will report a negative prolapse screen from their practitioner but know something is wrong. Even though your doctor might have given you a negative prolapse assessment, you could still be dealing with persistent symptoms affecting your daily activities. Prolapse symptoms typically worsen as the day progresses due to gravity, meaning the timing of your exam can impact the results. Also, the way you are assessed can impact the findings. This mismatch between clinical findings and your symptoms indicates the need for further exploration and perhaps a standing prolapse assessment.


A prolapse occurs when the pelvic organs, such as the bladder, uterus, or rectum, descend from their normal position into or through the vaginal canal due to weakened support structures. Accurately assessing this condition is crucial for effective diagnosis and treatment planning. A standing prolapse assessment is one of the most important methods for evaluating a patient’s prolapse.


The standing prolapse assessment is essential because it provides a realistic view of the prolapse's severity and impact on daily life. When a patient stands, the gravitational forces and increased abdominal pressure often exacerbate the prolapse, revealing its true extent. You don’t live your life on your back, and this dynamic assessment contrasts with a traditional supine (lying down) examination, which might understate the severity as the prolapsed organs can naturally retract when the patient is not upright.


Performing the assessment while the patient is standing allows healthcare providers to observe the actual degree of descent and any accompanying symptoms, such as discomfort or urinary incontinence. This information is vital for tailoring treatment options, which may include pelvic floor physical therapy.



standing, squatting prolapse assessment
Standing prolapse assessments can be completed in standing, squatting, lunging, and lifting positions (simulating lifting children).


Five common symptoms of Prolapse:


• Pelvic Pressure or Heaviness:


Many individuals experience a sensation of pressure or fullness in the pelvic area, often described as a feeling of something "falling out" or "bulging" in the vagina.


• Visible or Palpable Bulge:


A noticeable bulge or protrusion of tissue from the vaginal opening can be observed or felt, especially during physical activities or straining.


• Urinary Symptoms:


Prolapse can lead to urinary issues, including difficulty starting urination, frequent urination, a sensation of incomplete bladder emptying, or urinary incontinence.


• Bowel Symptoms:


Some individuals may experience difficulty with bowel movements, constipation, or a sensation of incomplete bowel evacuation. There can also be a need to apply pressure to the vagina or perineum to assist with bowel movements.


• Sexual Dysfunction:


Prolapse can cause discomfort or pain during sexual intercourse, and some may report a decrease in sexual satisfaction or a sensation of looseness in the vaginal canal.


Transform Your Pelvic Health with Empower Pelvic Health


Are your symptoms of prolapse affecting your quality of life? Empower Pelvic Health specializes in innovative solutions, including our advanced standing prolapse assessment. Unlike traditional approaches, this method offers a real-time evaluation of how gravity influences pelvic organ prolapse. With our team of experienced specialists, we create customized care plans tailored to meet your unique needs, providing comprehensive support at every stage. Take control of your health journey with Empower Pelvic Health and discover a renewed sense of comfort and confidence. Contact us today to schedule your consultation and begin your path to pelvic health empowerment!



discussing types of pelvic organ prolapse

About the Author:


Brittany Sudbrook, PT, MSPT, is the Founder of Empower Pelvic Health. She was a practicing Orthopedic Physical Therapist for 11 years prior to specializing in Ortho-Pelvic Floor Rehabilitation following the birth of her daughter in 2019. She has the highest level of education possible for Physical Therapists and is passionate about training other therapists in providing exemplary care. You can often find her sipping coffee, meeting with like-minded practitioners, and spending time with her husband, Mr. Empower, and their daughter.

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