Support for Your Pelvic Organ Prolapse (POP)
What is Pelvic Organ Prolapse?
POP is a condition where one or more of pelvic organs descends lower than its normal anatomical position in the pelvis, but not all prolapse is the same. The bladder, uterus, and/or bowel can change position due to abdominal pressure, muscle weakness, ligament/tissue laxity, or obstetric injury.
Symptoms of Pelvic Organ Prolapse
Symptoms may include pelvic pain, pressure, incontinence, back or hip pain, and others. Though prolapse cases are more common with women who have had multiple deliveries, it is certainly not limited to that population. Predisposition can include increased age, increased Body Mass Index (BMI), connective tissue disorders (like EDS or hypermobility), poor pressure management strategies, chronic coughing, and frequent straining with bowel movements (chronic constipation).
Risk factors for Pelvic Organ Prolapse
Risk factors related to birth experience include increased incidence with obstetric injury from instrumented delivery (vacuum or forceps), prolonged second stage (“pushing”) of labor greater than 2 hours, a larger sized baby, and sustained tissue (including neural) stretching or tearing during delivery.
3 Types of Prolapse
-
Cystocele - The bladder descends into the vaginal canal and a bulge may be seen/felt at the top of the vaginal opening (behind the urethra). Symptoms can include sensation of heaviness, pressure or dragging in the pelvis, urinary incontinence, dripping urine after you stand when you have completed voiding, feeling of incomplete emptying, pressure worse at end of the day
-
Rectocele - The rectum descends into the vaginal canal and may bulge at the bottom of the vaginal opening. Symptoms can include constipation, feeling of incomplete emptying of the bowels, heaviness/dragging or pressure sensation in the pelvis (may feel more posterior), pressure typically worse at end of the day. Feeling like you need to add pressure to the perineum is called splinting and it can be a useful strategy to reduce organ decent when trying to complete a bowel movement and lingering symptoms afterwards.
-
Uterine - The descent of the uterus/cervix into the vaginal canal. You may feel something firm in your vagina very low in your pelvis (less than a finger length) or may be at/past the opening. Symptoms include pressure and heaviness which is typically worse at the end of the day and some experience discomfort with intercourse.
How is Pelvic Organ Prolapse Diagnosed?
Each prolapse is typically graded 1-4. This grade can vary depending on many factors including the time of day you were examined, the position you were examined in, how much you've moved or been upright already that day. Other variables affecting the severity of your symptoms can be degree of muscle fatigue, amount of muscle strength/endurance, too high or too low of muscle tension, posture, type of exercise/movement, breathing patterns, joint mobility, and more.
Solutions for Pelvic Organ Prolapse
The important thing to know is that symptoms of prolapse do not necessarily correlate to the grade. The type of treatment is typically individualized to the symptom and patient's body. So treatment for prolapse can look very different between people. Grades 1-2 do the best with therapy intervention, however if you have been diagnosed with grade 3-4, therapy should always be the first line of defense before surgical repair.
There are devices called pessaries, which are assisted devices to help reduce prolapse. Beginning in Spring/Summer 2024 therapists at Gaia Women’s PT will be able to diagnose, treat, and fit pessaries in our clinic.
Choose Gaia Women’s PT to Help your Pelvic Organ Prolapse Symptoms
By choosing Gaia Women’s Physical Therapy and Wellness to guide your postpartum rehabilitation and address your POP symptoms you will find how strong and resilient your body is! We take pride in being able to keep women moving and doing the activities that bring them the most joy. You can guarantee by working with Gaia Women’s PT you will be able to remain active while understanding how to manage your new postpartum body.
