Studies show that nearly 50% of women who have had children have a pelvic organ prolapse (POP)! A pelvic organ prolapse is when there is the descent of the bladder, cervix, uterus, or rectum through the walls of the vagina. POP can occur for reasons other than childbirth and may be due to long periods of increased intra-abdominal pressure such as coughing, heavy lifting, straining, problems with the connective tissue, poor pelvic floor muscle strength and increased age. A prolapse is graded by how close the organ is to the vaginal opening and there can be more than one prolapse organ at any given time. A grade one prolapse is when some tissue can only just be seen descending, a grade two is if the tissue descends further but not outside of the opening of the vagina and a grade three is if the tissue descends below the opening of the vagina.
HOW DO YOU KNOW IF YOU HAVE PELVIC ORGAN PROLAPSE?
Most women will report symptoms of heaviness, a dragging feeling in the vagina, sometimes bladder or bowel problems or even sexual difficulties. Often, women themselves are the first to recognize that they have a pelvic organ prolapse. This is most often discovered when women see or feel tissue descending down near or through the vaginal opening. Initially, it may be quite scary however it is a very common occurrence and thankfully it can be treated!
THE TREATMENT OPTIONS
The three main ways of treating a pelvic organ prolapse are through conservative, mechanical or surgical methods. Conservative treatment has been considered the first line of defense when it comes to treating POP. Conservative treatment is where we, as pelvic floor physiotherapists can help. A Pelvic Floor Physiotherapist will first assess and create an individualized treatment plan to improve the strength of the pelvic floor muscles. Increasing this muscle strength will help support those internal organs that are falling down.
Another tool that can be used to improve the symptoms of POP are Hypo-pressive exercises. These exercises focus on creating negative internal pressure to assist with lifting up the pelvic organs. These types of exercises, as well as pelvic floor strengthening, need to be done on a regular basis. Just like brushing your teeth daily is a habit, regular pelvic floor exercises also need to become something that is done every day.
Mechanical intervention involves wearing a pessary. A pessary is a solid or elastic device that can be inserted into the vagina to support those structures in need. This support can be fitted and inserted by a gynecologist or a pessary-trained pelvic floor physiotherapist. These can either be inserted and left in for months at a time or inserted and removed depending on the activity (e.g. running).
As a last resort, there are Surgical interventions that are aimed at supporting the organs or repairing the vaginal wall.
If you are experiencing any of these symptoms you are not alone. Book and appointment today with our Pelvic Floor physiotherapist, who can help you can back on track!
