Pelvic Organ Prolapse
Prolapse is a common occurrence where any of the pelvic organs drop increasing pressure in the vagina and on the pelvic floor. There are many different causes of pelvic organ prolapse:
Pelvic floor muscle weakness
Hormonal imbalances
Repeated straining; which happens during childbirth, chronic constipation, and chronic cough
Some degrees of prolapse can be remedied through functional pelvic strengthening, corrected body mechanics when lifting, avoidance of straining, controlling and treating constipation, weight control, and kegels (performed initially under supervision of a physical therapist to ensure proper muscle recruitment).
Some forms of pelvic organ prolapse and symptoms include:
Cystocele: A cystocele is the decent or fall of the bladder into the vagina. This may result in incomplete emptying of the bladder and consequently urinary leakage or frequency.
A cystocele can be managed with pelvic floor physical therapy and possibly a pessary. A pessary is a small device, often donut shaped that is inserted into the vagina in order to provide support for the pelvic organs. Most often, you will want to find a healthcare provider to measure you for the proper fit.
Rectocele: A rectocele is the herniation of rectal tissue in the vaginal wall. This may result in constipation, feelings of incomplete emptying, and/or pelvic pain.
Enterocele: An enterocele is the herniation of the small intestine between rectum and vagina.
Uterine Prolapse: Uterine prolapse is the decent or fall of the uterus into the vagina.
All of these prolapses can cause pressure, heaviness, and discomfort with activity. Physical therapy treatment for pelvic organ prolapse will include assessment of the pelvic floor to ensure proper muscle contraction/relaxation, functional pelvic girdle strengthening, managing constipation, gentle core strengthening, and education on environmental changes in order to reduce symptoms.
