A pelvic organ prolapse (POP) is a protrusion or bulge at the vaginal opening caused by weakness of the pelvic floor or stretched pelvic floor muscles and connective tissue. This may happen after childbirth or as we age and our pelvic floor weakens. The POP is defined by which organ is protruding through the vaginal canal and may include:
- Cystocele: bladder prolapse
- Rectocele: rectum prolapse
- Urethrocele: urethral prolapse
- Uterine Prolapse: Prolapse of the uterus
What Does a Pelvic Organ Prolapse Feel Like?
It can be described as:
- Feeling like you have a bowling ball between your legs.
- A “bulge” down there.
- Difficulty emptying your bladder or having to strain while having a bowel movement.
- Feeling like your insides are coming out.
Specific symptoms vary depending on the type of prolapse but may include: pressure or pain around the vagina or perineum with prolonged standing or activity, difficulty evacuating one’s bowel and or bladder, or a visible protrusion at the vagina opening. These symptoms can very annoying and can limit everyday functional activities.
What can a Pelvic Health Physiotherapist do for a Pelvic Organ Prolapse?
If you suspect you may have a POP it is important to be assessed by your physician or gynaecological specialist so you can be properly diagnosed.
Once you have been diagnosed with a POP, the first line of defense is conservative management, or Pelvic Floor Physiotherapy. According to a study conducted in the UK, pelvic floor muscle therapy was effective at reducing women’s prolapse symptoms and the improvement was maintained at 6 and 12 month after treatment. This study demonstrated that with pelvic floor muscle therapy women’s symptoms were less frequent, women reported feeling better and were less likely to seek further treatment.
In some POP cases surgery may be necessary. However, many surgeons agree that surgical intervention is usually the last resort.
What Type of Treatment will a Pelvic Health Physiotherapist Provide?
Conservative management with your pelvic floor physiotherapist may include:
- Postural education
- Pelvic floor muscle strengthening and core exercises
- Lifestyle modifications
What Exercises Should You Perform with a Pelvic Organ Prolapse?
It is important that you preform appropriate core engagement exercises for your injury.
Gentle activation of the deep core while lying on your back, feet flat, knees bent. On an exhale draw up your muscles in your pelvis like you are picking up a blueberry with your vagina and or anus. Hold this sensation while continuing to breath for 10 seconds and release, repeat 10x/3day.
It’s important to note, that you may not be performing the exercise correctly and you may need some feedback and help from a pelvic floor physiotherapist. Pelvic floor physios are specially trained to assess your pelvic floor internally so they can assess and feel the actual pelvic floor (right at the source of dysfunction). They will be able to assess whether you are contracting your pelvic floor symmetrically and evenly. They will also be able to cue you with internal feedback so that you can better engage your pelvic floor.
Your physiotherapist will help you advance your exercises as it is indicated with your ability to activate correctly while taking into consideration your level of pain and severity of your condition.
What exercises should be avoided with a pelvic organ prolapse?
- Sit ups
- Heavy weight lifting
- High impact, jumping
- Any intense exercises where you tend to hold your breath
- Any exercise that involves leg raises or lifting your head and shoulders off the floor.
These maneuvers tend to increase pressure in your abdominal cavity and push down on your pelvic organs and pelvic floor. This can further aggravate your pelvic organ prolapse and may weaken the ligaments that support your pelvic floor.
If you have been diagnosed with a pelvic organ prolapse and are looking for a gentle and knowledgeable pelvic floor physiotherapist in downtown Toronto, be sure to book an appointment with one of our amazing pelvic floor physios.
- Pelvic Health Solutions Course Material and Website
- Hagen, S., Stark, D., Glazener, C., Sinclair, L., Wilson, D., Norrie, J., … & Walker, A. (2011, January). A multicentre randomised controlled trial of a pelvic floor muscle training intervention for women with pelvic organ prolapse. In Neurourology and Urodynamics (Vol. 30, No. 6, pp. 983-984). COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA: WILEY-BLACKWELL.