Pelvic Organ Prolapse Physical Therapy
Pelvic organ prolapse is a condition that affects about a third of all women during their lifetime. At OneRehab multispecialty center, we help patients regain normal function through individualized physical therapy.
What is Pelvic organ prolapse?
Pelvic organ prolapse occurs when tissues and muscles that support the pelvic organs (rectum, bladder, or uterus) weaken or loosen. As a result, one or two organs drop into or out of the vagina. It is common for one to be embarrassed to talk to a doctor about it. However, the condition is treatable. At OneRehab, we create a conducive environment for pelvic organ prolapse physical therapy.
What is Pelvic Floor Disorder?
Pelvic organ prolapse is a type of pelvic floor disorder. The pelvic floor comprises several muscles and tissues that keep the pelvic organs intact. The pelvic organs include the bladder, vagina, uterus, rectum, and small bowel. Sometimes the muscles experience problems leading to disorders such as:
- Pelvic organ prolapse
- Anal incontinence
- Urinary incontinence
Types of Prolapse
Types of pelvic organ prolapse include:
Uterine Prolapse
Uterine prolapse conditions happen when pelvis tissues and muscles weaken. In this case, the uterus drops or presses into the vagina. In some cases, it can come out through the opening of the vagina. Our physiotherapists put you through various exercises such as Kegel to rectify the condition. Symptoms of uterine prolapse include:
- Urine leakage
- Heaviness or fullness in the pelvis
- Bulging within the vagina or a distinct lump
- Aching and lower back pain
- Painful sexual intercourse
This condition is described in various pelvic organ prolapse stages. These conditions include:
- Stage I- In this stage, the uterus collapses into the upper half of the vagina.
- Stage II – The uterus descends near the vagina opening.
- Stage II – The uterus bulges out of the vagina.
- Stage IV – It's where the uterus is completely out of the vagina.
What Causes Uterine Prolapse?
There are many ways in which the pelvic floor linked to the connective tissues can be damaged. These include:
- Pregnancy, especially multiple births such as triplets or twins. Several pregnancies can also cause the condition.
- Vagina birth where the baby is large, prolonged pushing, or quick delivery.
- Obesity
- Pelvic tumor
- Straining oneself during a bowel movement
- Low estrogen levels after menopause.
Anterior Wall of the Vagina Prolapse (Cystocele or Urethrocele)
It is a common condition that occurs in women who have gone through a hysterectomy. The prolapse occurs due to stretching of the bladder’s supportive tissues or fascia, leading to detachment from the pelvic bones. The loss of this support causes the bladder to fall into the vagina. If the condition becomes worse, the prolapsed pelvic organs bulge outwards of the vagina opening leading to discomfort, pain, and pressure. You can also experience other symptoms such as:
- Urinary frequency, loss of bladder control, and nighttime voiding. You can also get recurrent bladder infections for lack of proper emptying of the bladder.
- SUI or stress urinary incontinence, especially when you laugh, cough, sneeze, or exercise. It can be due to weakened urethra support.
Posterior Wall Prolapse (Rectocele or Enterocele)
Posterior wall prolapse, including rectocele or enterocele, occurs when the thin wall of fibrous tissue separating the rectum from the vagina weakens, allowing the rectal wall to bulge into the vagina. This condition can cause discomfort and complications in bowel movements, and is often related to childbirth, aging, or chronic straining.
Paraneoplastic syndromes
This prolapse occurs when the fascia or support tissues between the rectum and the vagina stretch or separate from the attached pelvic bones. Losing this support leads to prolapse of intestines or rectum into the vagina, making it bulge. It can lead to bowel movement problems and a bulge sensation.
Rectal Prolapse
When the supporting muscles and tissues of the pelvis that support the rectum become weak, it can lead to rectal prolapse. This condition results in the rectum falling out through the anus. You can notice a big soft red tissue hanging from the anus in the early stages after a bowel movement. Often, it is confused with a big hemorrhoid. If you have this condition, you can experience loss of control of the bowel, blood or mucus discharge, or pain during bowel movement. Pelvic organ prolapse physical therapy is one of the ways to treat the condition.
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Pelvic Organ Prolapse Treatment
There are several treatment options for patients with pelvic organ prolapse conditions. However, the chosen treatment mode depends on:
- Symptoms severity
- Prolapse severity
- Patients health and age
- Also, if a patient plans to have any more children.
Making Lifestyle Changes
If you have mild pelvic organ prolapse, this is an ideal form of treatment. Making some changes to your lifestyle can help stop the progress of the condition. Additionally, they can reduce the risk of developing prolapse. These lifestyle changes include:
- Losing weight if you are overweight.
- Avoiding lifting heavy weights
- Eating healthy meals rich in fiber to avoid constipation.
- Exercising also helps reduce the symptoms.
- Manage chronic coughs and stop smoking.
- Avoiding high impact exercises.
Surgery
In severe cases, patients can go for surgery to help restore pelvic support. There are several surgical treatment options that you can go through to repair pelvic organ prolapse.
- Surgical Repair: These surgeries involve lifting and supporting the pelvic organs.
- Vaginal mesh surgery: This pelvic organ prolapse surgery can repair the condition from the stomach.
- Hysterectomy: This is a treatment option for uterine prolapse. The removal of the uterus helps relieve pressure from the vaginal, reducing the chances of the problem recurring. However, you cannot get pregnant after this procedure. You can also go through early menopause.
- Closing the vagina: In some cases, the doctors can recommend closing part or all of the vagina. It is an option for women with severe prolapse conditions, and they are sure they do not want to have sex again.
Pelvic Organ Prolapse Exercises
If you do pelvic floor exercises, you can help strengthen the muscles and reduce the symptoms. At OneRehab, we will take you through a series of pelvic floor muscle strengthening exercises. Once we perform a detailed assessment, we create a personalized treatment plan to manage the pelvic organ prolapse. With time, the pelvic muscles tighten and become stronger, which repairs the conditions.
Vagina Pessaries
Under this treatment option, the doctor inserts a rubber or latex device in the vagina, which holds the walls and the pelvic organs in place. If you are planning to get pregnant, this device gives you a chance to do so in the future. Additionally, the device is effective in reducing the pelvic organ prolapse symptoms for mild and severe stages. It is ideal if you do not prefer surgery.
These devices have been made into various shapes and sizes to accommodate various needs. However, the ring pessary is the most common device. However, this treatment has various side effects:
- Unpleasant vaginal discharge that smells due to infection.
- Sores and irritation inside the vagina or bleeding.
- A urinary tract infection
- Stress incontinence, where you can pass small amounts of urine when working out, coughing, or sneezing.
- It interferes with sex, but most women can have sex with the device still intact.
Hormone Treatment
It is an ideal treatment if you have gone through menopause and have mild prolapse. Estrogen treatment helps to ease the symptoms.
Can You Prevent Pelvic Organ Prolapse?
There are various things that you can do to prevent pelvic organ prolapse. These include:
- Doing regular pelvic floor exercises. You can engage our physical therapists for guidance.
- Having a healthy weight or losing weight if you have excess weight.
- Avoiding heavy lifting
- Stopping to smoke
- Eating foods rich in high-fiber content, fresh fruit, vegetables and wholegrain to avoid constipation or straining during bowel movement.
OneRehab | Richardson
1761 International Pkwy Suite 135, Richardson, TX 75081, United States
OneRehab | Dallas
6080 N Central Expy #125 Dallas, TX 75206
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