What is pelvic organ prolapse (POP)?
Pelvic organ prolapse is defined as a weakening in the connective tissue of the pelvic floor resulting in the descent of one, or more, of the following pelvic structures into the vagina:
- Small intestine
Below are some images for prolapse (bladder, uterus and rectum):
Bladder Prolapse, Uterus Prolapse, Rectal Prolapse
The pelvic floor muscles pull back on pelvic organs and fascia in 3 different directions providing support and form. Injury or weakening of one or more of these muscles will cause the organ to drop depending on the location of the injury and what the cause of the pelvic organ prolapse is.
Who does POP affect?
- more than 50% of women over the age of 50
- 19% risk of needing surgery by the time women reach the age of 80
- risk of a re-occurrence after surgery is 30%.
With the population aging, these statistics may grow even higher.
What are the symptoms of POP?
- Pressure in the vaginal area
- Vaginal bulge
- Voiding issues (inability to empty, overactive bladder, recurring UTI’s, vaginal splinting to empty)
- Bowel problems (constipation, fecal incontinence, vaginal splinting to have a bowel movement)
What are the risk factors of POP?
- Being overweight
- Straining with constipation
- Chronic coughing
- Heavy lifting/straining
- Multiple vaginal births
What are the treatments?
At Durham Pelvic Health Physiotherapy, we want you to understand this condition and what you can do to treat it before it gets to the point of needing surgery.
1.Pelvic Floor Muscle Training (PFMT).
This is where we train the pelvic floor muscles in strength and endurance, (just like the other muscles in the body), which can help decrease the severity and frequency of POP symptoms.
The gold standard of PFMT is Kegel Exercises.
How do you do a proper Kegel?
Take a deep belly breath in and relax your pelvic floor muscles. As you do this, imagine a flower blossoming in the vaginal area. On the exhale, contract your pelvic floor muscles and practice exhaling like you are blowing flower petals off your hand. Make sure you are doing the Kegel contraction on your exhale and releasing the contraction all the way on the inhale.
- perform 10-20 Kegels 2-3x a day
- Do them either lying, sitting or standing
- Hold them between 2-10 seconds
It is important to have a pelvic physiotherapist check that you are doing them correctly (internal pelvic floor muscle exam). Many women often use other muscles like their abdominal muscles, buttocks or squeeze their legs together which is not the muscles you want to squeeze at this point.
Did you know there’s an APP for that?! Check out some of these apps to help with Kegels:
Kegel Trainer PFM Exercises
2. Biofeedback Devices.
These connect to your phone through Bluetooth and an APP. They have a device that you insert to measure your pelvic floor muscle contractions. Check these out:
3. Vaginal Weights (may not be recommended for you- check with health care provider)
Weights are used to compliment traditional manual Kegels by adding resistance and making the workout more effective. Check these out:
Intimina Laselle Weighted Exercise Balls
4. Vaginal Supports
These can include a Pessary, Femicusion, and Fembrace.
Above are some options for what pessaries look like. Depending on the type of prolapse you have will determine which one is appropriate for you.
There are 2 types of surgery done for POP.
- Native Tissue Repair – This is for patients that have a primary prolapse or less severe, stage 1-2 prolapse.
- Mesh Repair – Generally done for patients with more severe/recurrent prolapse
At Durham Pelvic Health we believe in treating the whole patient and not just their symptoms. We will have educational discussions about several health issues in your appointment as it pertains to your program of care. We would love to meet you and discuss any concerns your have in regards to pelvic floor health. Check out our website or call us to book an appointment today!
Whitby Office: 905-444-2282
Newcastle Office: 905-987-4533
PLEASE NOTE: The information on this website is intended for educational purposes only. It should not replace or be relied upon in the place of medical advice given by a doctor.