The main function of our pelvic floor muscles is to provide structural support for the internal pelvic organs on top of them; such as the uterus, bladder and rectum. Imagine your pelvic floor muscles as a hammock that needs to be strong enough to keep things lifted and stabilized. If these support structures are weakened over time by either disuse, misuse, or trauma then the pelvic organs can bulge (prolapse) from their natural position into the vaginal opening.
Risk factors for POP include:
· Advanced age
· Chronic constipation
· Childbirth (multiple vaginal deliveries, increased baby size, speedy labor, use of
forceps)
· Obesity
· Prior pelvic surgery (ie hysterectomy)
There are different types of POP depending on what structure is involved: Cystocele: bladder, Rectocele: rectum, Uterine prolapse: uterus, Enterocele: everted vaginal wall. You can also stage the severity of POP (stage 1-4) based on how far the involved structure has moved from its resting position with stage 1 being the uterus is in the upper ½ of the vagina to stage 4, the uterus is completely out of the vagina. 55% of women over the age of 35 have a grade 1 cystocele. While it is not normal, it does become more common as you age.
Common signs and symptoms may include feeling of vaginal pressure or heaviness, sensing or seeing a “bulge” at the opening of the vagina, urinary incontinence or feeling like you can’t empty your bladder fully and constipation. If you are having any of these symptoms and it is affecting your daily life talk about with your doctor. There are things that can be done to correct it and prevent further issues.
The good news is that pelvic floor physical therapy has been proven to be a safe and effective treatment for pelvic organ prolapse (in its early stages). A pelvic floor PT can perform an assessment of your pelvic floor muscles and provide recommendations for a personalized home exercise program. Some things that we will likely focus on are pelvic floor strengthening exercises, core stabilization, toileting habits and pressure management (ie diaphragmatic breathing).
If pelvic organ prolapse is left untreated and progresses to Stage 3 or beyond, surgery may be indicated. At Diversified Physical Therapy we specialize in the treatment of pelvic floor dysfunction. If you are having POP contact us to see what we can do to help you.
