Pelvic organ prolapse refers to the lowering or dropping of the uterus, bladder (cystocele), vagina, or rectum (rectocele). Many women who have some degree of pelvic organ prolapse do not even know they have it until it becomes symptomatic, if it ever does. If you are experiencing symptoms that interfere with daily self-care activities and your sex life, you’ve come to the right page.
Symptoms
– Vaginal bulge and/or pressure felt upon palpation when wiping or sitting
– “Falling out feeling” in pelvis
- Difficulty or pressure with sex
- Feeling as if you are sitting on a ball
- Increased frequency of urination/stronger urges
- Aching throughout the low back
- Pain during bowel movements
- Difficulty/straining to have bowel movements
Causes
The pelvic floor muscles are designed to support the reproductive organs and bladder. Imagine a sling running from your pubic bone to the “tailbone” and one perpendicular to this running from each side of your sit bones. Although the pelvic floor muscles do not follow this exact pattern, the idea of these slings provide a good visual for where the muscles are located and what they do, which is support the bladder, uterus, and rectum amongst other sexual functions. When the muscles are unable to support due to inflammation, irritation, weakness, spasm, or trauma, the muscles, or slings, become weak and predispose the organs to lower. The ligaments also play a huge role. Ligamentous laxity, or what is common during pregnancy, can largely contribute to pelvic organ prolapse.
Diagnosis
Your physical therapist will perform a thorough evaluation to assess your symptoms. Being the evaluation will be internal and external, you and your therapist will work together to ensure your comfort throughout the entire process. Your therapist will assess the prolapse, muscular strength, and surrounding tissue. If your therapist feels you may need further examination or testing, she will refer you to an MD.
Treatment
Treatment will depend heavily on the reason for your pelvic organ prolapse. For example, if the prolapse occurred due to weakness of the muscles your treatment will consist of strengthening of the pelvic floor muscles, core, and surrounding musculature. In the case of ligamentous laxity, once the ligaments are stretched, they cannot return to their original length. Therefore, strengthening the muscles becomes the priority, which can help tremendously with improving symptoms. Once the term “strengthening” is used, many women think kegels. However, there are many ways to strengthen the pelvic floor muscles and in some cases, kegels may not be the best option. In all cases, your physical therapist will educate you on simple lifestyle changes, such as toileting techniques to help avoid straining when eliminating.