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What is pelvic organ prolapse?
Pelvic organ prolapse is when one or more of your internal pelvic organs drops into the vagina. The bladder, uterus or rectum can prolapse. The can sit just a little lower than normal or can prolapse enough to be seen or felt outside the vagina.
The most common symptom of pelvic organ prolapse is a feeling of heaviness or pressure in the pelvis or vagina. Most people do not have pain. There also may be an associated decrease in bladder or bowel control. Some people with rectal prolapse have difficulty emptying their bowels completely because their is no longer a straight line to the anal opening.
What causes pelvic organ prolapse?
The most common cause of pelvic organ prolapse is vaginal childbirth. It is possible to have prolapse after a cesarean section due to carrying the weight of the baby. A larger baby (over 8 pounds), a long second stage of labor (pushing phase) and vacuum or forceps assisted delivery all increase the risk of pelvic organ prolapse.
Can I prevent pelvic organ prolapse?
There is no known prevention, however you can decrease the factors that make prolapse worse and do restorative physical therapy to help prevent the prolapse from worsening.
What can I do to correct my pelvic organ prolapse?
First of all, control your weight. That is the number one recommendation by doctors and healthcare providers. Increased weight is increased pressure on the pelvic organs, which can make symptoms worse.
Second, don't smoke or stop smoking. Smoking can cause chronic coughing which creates pressure on the pelvic floor.
Pelvic floor physical therapy can help. Not only will you learn how to activate your pelvic floor muscles (kegel) properly to support the organs better, but you will learn how to exercise safely and safe exercises to help support the muscles around the pelvis to support the organs.
If those ideas are not helping enough a pessary may help. A pessary is a support inserted into the vagina to support the organs from below. It is usually plastic or silicone and comes in various sizes and shapes depending on how much support the individual requires.
The last resort is surgery. Surgery success rates vary. Mesh surgery has had a lot of side effects and recently was banned in Australia. It is still legal here in the United States. There are other forms of surgery as well where the surgeon can suspend the ligaments higher to bring the organs back into a better anatomical position.
Surgery is often more successful in conjunction with pelvic floor physical therapy and these other lifestyle changes (weight management and smoking cessation). Many women have surgery to correct their prolapse but don't learn exercises to support that surgery and don't manage their weight and coughing properly so the same pressures keep pressing down on the organs and eventually the prolapse returns again after months or years.
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As always, call or message if you are interested in physical therapy for your pelvic organ prolapse, either in person or online if you are not local to Southern California.
References:
https://www.webmd.com/urinary-incontinence-oab/pelvic-organ-prolapse#1
https://www.womenshealth.gov/files/documents/fact-sheet-pelvic-organ-prolapse.pdf
https://www.lhsc.on.ca/women-s-health/pelvic-organ-prolapse
Don't let your prolapse get you down, there are things you can do to control it and continue living your life!