↵
Pelvic Organ Prolapse (POP) is one of the most common complications with childbirth and affects up to 50% of women in the United States1. Pelvic organ prolapse is the descent of the pelvic organs. There are several different types, depending on which organ has descended. Some of the most common ones we see are:
- Cystocele: anterior wall prolapse, dropped bladder
- Rectocele: posterior vaginal wall prolapse: the rectum bulges into the vagina
- Uterine prolapse: the uterus drops into the vagina
Prolapse is also classified based on the severity of the prolapse:
- Stage 1 prolapse: bulge into the upper part of the vagina
- Stage 2 prolapse: bulge into the lower part of the vagina
- Stage 3 prolapse: the organ bulges outside of the body
- Stage 4 prolapse: the organ bulges completely out of the body
You may have prolapse if:
Pelvic organ prolapse is more common after multiple pregnancies, with increased weight, and as women age1. You may have prolapse if you have a feeling of pressure, dropping, or fullness in the vagina or rectum, especially after activity or being up on your feet OR having to insert a finger into the vagina to have a bowel movement or to pee. We often see that women who have incontinence or constipation can have pelvic organ prolapse, so it is important to see a pelvic floor physical therapist or urogynecologist to determine if pelvic organ prolapse is present and playing a role in your symptoms.
Treatment for prolapse:
Treatment for prolapse depends on the severity of the prolapse, the health of the ligaments and muscles in the pelvis, and your overall health.
Stage 1 and 2 can typically be resolved with pelvic floor physical therapy and research shows that pelvic floor physical therapy can improve prolapse by one grade. Treatment for pelvic organ prolapse that is grade 1 or 2 can usually benefit from:
- Diaphragmatic breathing and pelvic floor retraining: The core, including the pelvic floor, diaphragm, and transverse abdominis (the deep abs) play a huge role in keeping our organs in place and getting them back into place if they have prolapsed. Working with a pelvic floor physical therapist to ensure your muscles can lengthen, tighten, and coordinate together is vital to improving symptoms and the position of the prolapsed organ. Don’t just start doing kegels! Sometimes that can make things worse.
- Hip strengthening: Often the pelvic floor muscles become the scapegoat when we have issues with the pelvic floor. The hip muscles including the glutes and groin muscles need to be strong and flexible to allow the pelvic floor to do its job and get a prolapsed organ back in place
- Stress management: When we’re stressed, our breathing patterns change and muscles tense, which can make prolapse worse. If we want to make sure prolapse gets better and stays better, we need to address why our breathing patterns and muscles tense in the first place. Getting things into our routine like moving meditation (yoga, tai chi, etc.), adding in mindfulness practices throughout the day, and addressing faulty or non-optimal thinking patterns can have a big impact.
- Improving sleep and diet: Our muscles and bodies cannot heal if they don’t have adequate sleep and nutrients. Getting the supports in place to make this happen is vital.
Stage 3 and 4 prolapse typically need treatment from a Urogynecologist along with a pelvic floor physical therapist and can be managed with a pessary or surgery.
Prolapse is not life threatening, but can cause problems with mood, body image, and the ability to stay active throughout your life. If you’re having any feelings of pressure, bulging, or falling out in the vagina or rectum, you may have prolapse, and our pelvic floor physical therapists can help. If you’re leaking urine or experiencing constipation, you may also have prolapse. A full exam with our pelvic floor physical therapists is the best way to find out for sure and your next best step. Click here to book your appointment with us in Wexford, PA or Greensburg, PA.
