Pelvic Floor

Body: 

Thanks so much for that. I must admit I will need to read it another 3 or 4 times to understand it. Visualisation is not my strong point! Seems I have some more internet googling to do and a book to buy!

Do you know exactly what causes the bladder to prolapse? Is it just that the vaginal wall has been damaged and this no longer provides the support to the bladder? My physio said that as the vaginal wall is tissue it cannot be strengthened naturally (like a muscle). Does this mean it does not repair itself naturally at all? Isn't there some laser machine or something that can renew the vaginal wall tissue?

hi minimoo

I encourage you to take some time to read the faqs here, might help explain things a bit.
for right now, I will try to answer some of your questions as best I can..

Do you know exactly what causes the bladder to prolapse?
I think there are usually many reasons a woman experiences a prolapse, usually a combination of genetics, lifestyle, circumstance, etc. so while we never really know the answer to 'why me', we can probably say with certainty that a bladder prolapses when it no longer is supported in its natural position.

Is it just that the vaginal wall has been damaged and this no longer provides the support to the bladder?
the vaginal wall is only one of the structures/systems in the body that provides support to the bladder. in my understanding, it is not even the main player, but rather the last-ditch effort. the bladder, normally, is supported from above by fascia and ligaments and should be positioned in a pocket formed by the lower abdomen, and over the bony part of the pelvis. this shape is maintained by the posture described on this site and the pelvic organs are pinned in place by the forces in the body (breathing, movement, etc). when a woman is not holding herself in this way for years and years and years, the fascia gets stretched out, the abdomen no longer has room for the bladder and uterus, the pelvic organs are not being held over bone but suspended over a hole (vagina) and we are all hoping that the vaginal wall will compensate.
if there has been damage to the vaginal wall, this process is sped up or even created due to the acute injury. but even women with injured vaginal walls can reverse a prolapse to some degree by shoring up the other supporting systems.

My physio said that as the vaginal wall is tissue it cannot be strengthened naturally (like a muscle). Does this mean it does not repair itself naturally at all?

I will leave the anatomy to the pro's (louise? christine?) because I am rusty. but iirc, the muscles we call 'pelvic floor' are not the same as vaginal wall. iirc, your physio is correct that one cannot strengthen the vaginal wall the way one strengthens the biceps or quads.
however, strengthening is not the same as repair. I believe that so long as you are alive, your tissues - all of them - are capable of some degree of repair.

Isn't there some laser machine or something that can renew the vaginal wall tissue?
I have no idea and I think that is besides the point. a prolapse is rarely caused solely by vaginal tissue in need of renewal, and is unlikely to be reversed by renewal of vaginal wall tissue.