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Pelvic Organ Prolapse: Physiotherapy Top 5 Tips

Do you ever experience any of the following?

  • A feeling of a heavy or dragging sensation in the vagina
  • Feeling a bulge in the vagina
  • Experiencing some difficulty with bladder and/or bowel emptying? Not complete?
  • May experience back pain
  • Pain or discomfort with penetrative sexual intercourse

You may have a pelvic organ prolapse. This is a condition that affects up to 1 in 2 women after having a child. Conservative treatment such as physiotherapy may be an option that is recommended to help with your recovery. We shed some light on what this condition is and what are some tips you can consider.

What is pelvic organ prolapse?

​The pelvic floor muscles, fascia, and ligaments that support the organs within the pelvis can become weak. This can result in one or more of the organs moving in a downward direction. That can be the bladder, the bowels, and/or the uterus. The above-mentioned symptoms are commonly reported by women as a result.

What causes prolapse?

Prolapse is commonly caused by sustained pressure or activities that place significant pressure or strain on the tissues in the pelvic area. This can include things such as pregnancy, childbirth, repetitive lifting of heavy objects, constipation and repetitive straining, particularly sneezing, being overweight or obese, having very weak pelvic floor muscles, alongside any local surgeries such as hysterectomy.

So, what can be done?

  1. First thing is to look after your pelvic floor muscles. These muscles support the pelvic organs and it is important to look after these muscles so that they provide adequate support. Address any activities, positions that place an increase in intraabdominal pressure which in turn strains the muscles. Even weight gain can affect the support system. What are some of the ways to take care?
    1. Seek medical treatment for any persistent coughs/sneezes
    2. Maintain a healthy weight
    3. Bowel care (mentioned in 3)
    4. Regular pelvic floor exercises are also known as Kegels. It is important you exercise these muscles correctly and if not sure this can be shown to you by one of our women’s health physio. Details on appointment and contact are HERE 
  2. Next is to look after your bladder. This can be done by maintaining adequate fluid intake, avoiding drinks that irritate the bladder such as caffeine, fizzy drinks, or alcohol. Respond to urges when it comes to emptying out your bladder and avoiding going just in case. Avoid straining to empty your bladder and attempt to always sit down when you’re emptying.
  3. Looking after your bowels; in particular, avoiding constipation and straining that can put excessive pressure on the pelvic floor muscles and lead to having a prolapse. Looking after your general health. That is, staying within a healthy weight range, having a good exercise routine, and movement.
  4. Engaging in low-impact exercises such as walking, riding, swimming, or things like Pilates and Yoga.
  5. If you do have a prolapse, it’s important that you look after it. This means avoiding itchiness or irritation, avoiding the skin getting infected and that would entail also seeing a health professional for examination, alongside treatment.

How can Physiotherapy help?

A women’s health physiotherapist does a thorough assessment including a detailed history taking of your obstetric history, symptoms, and lifestyle habits with bladder and bowel care. A pelvic floor muscle examination may be necessary to identify the degree of prolapse, the type of prolapse, and the action of the muscles. A management plan is then devised by you and your therapist that is specific and individualized to your treatment and  goals.  A pessary may also be an option if your therapist considers this to be appropriate.

If you would like to find out further information about how physiotherapy can help you in managing your pelvic organ prolapse, please contact us at info@inneractivephysio.com.au or via this link. 

 

By Tafy Seade  Physiotherapist

References 

Dumoulin C, Hunter KF, Moore K et al. Conservative Management for Female Urinary Incontinence and Pelvic Organ Prolapse Review 2013: Summary of the 5th International Consultation on Incontinence. Neurourol Urodyn 2014;11. DOI: 10.1002/
nau.22677.

Resources

Treatment options for Pelvic Organ prolapse 2019 

Continence Foundation of Australia

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