Pelvic Organ Prolapse: It’s time to start talking.

Written By Jackie Giese

Ladies! Do you dribble urine on the toilet seat after you stand up? Maybe you are feeling a lot of pressure or bulging in your nether regions??? Addressing pelvic organ prolapse can be uncomfortable, but we want you to know more about this condition and how it affects many women.

WHAT IS PELVIC ORGAN PROLAPSE?

Prolapse is the descent of one or more pelvic organs into an abnormal position. For women, this can include the bladder, uterus/cervix, and/or the rectum. Symptoms that women may experience when dealing with prolapse include:

  • pelvic pressure

  • vaginal bulging

  • low backache-often worse towards the end of the day

  • vaginal bleeding/discharge

  • spraying of the urine stream or weak stream of urine

  • difficulty with complete elimination of bladder or bowel

  • need to “brace” the vaginal wall to complete bowel movements, which may include placing a finger or thumb into the vaginal canal to support the wall of the vagina during bowel movements

  • needing to change positions to fully empty the bladder, or experiencing “dribbling” of urine when standing up after urinating.

WHAT MAY CAUSE PROLAPSE OR CONTRIBUTE TO IT WORSENING?

Most commonly, prolapse occurs due to the following:

  • childbirth related pelvic floor muscle trauma (tearing, use of instruments during delivery)

  • loss of estrogen (peri-menopausal)

  • collagen disorders (Ex: Ehlers Danlos syndrome, Marfan syndrome)

  • chronic cough (frequent increase in intra-abdominal pressure)

  • chronic constipation

  • heavy lifting or heavy occupational work

  • Pelvic surgery - prolapse can still occur, even after hysterectomy surgery or removal of the uterus

Although only 3-6% of women experience symptoms with prolapse, on vaginal exam roughly 50-60% of women have some degree of prolapse present. Women with prolapse symptoms often feel their symptoms worsen as the day goes on. This is generally due to gravity which has been pulling downward for longer periods of time. Rest or laying down can often relieve symptoms for women with prolapse.

WHAT CAN PHYSICAL THERAPY DO FOR PELVIC ORGAN PROLAPSE?

This is such a great question! Physical therapy can help to provide education regarding proper toileting posture and other ways to reduce straining, as well as education on pelvic floor muscle strengthening in the right way based on the type of prolapse involved. There are also medical devices that can be prescribed to assist in supporting the walls of the vagina when necessary. Physical therapists can help patients gain awareness of their breathing patterns and use of proper breathing during lifting or other movements in order to help reduce the chance of the prolapse worsening. In severe cases, surgical referral may be necessary, but pelvic floor physical therapists are specially trained to identify these conditions and make referrals to other providers when necessary.

I want to stress that although this topic may be uncomfortable to talk about, we are here to provide a safe place for you to openly talk about what you are experiencing. You are not alone. If you have additional questions or suspect you may be experiencing symptoms of pelvic organ prolapse, don’t hesitate to reach out. You can email, call, or submit a request for a consultation.

Email: info@shiftptwell.com
Phone: (763) 645 - 1113
Free Consultation

Written by: Dr. Renee Hancock, Physical Therapist

Jackie Giese
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