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Low Down on Pelvic Organ Prolapse

Pelvic Organ Prolapse is condition in which the pelvic organ are descending or have descended down into the vaginal wall or the rectum. It is typically abbreviated as POPS. This condition is typically diagnosed and graded for severity by your Obstetrician or Midwife. Pelvic floor therapists can screen for these issues as well. Let’s go into more detail about some of the different types of vaginal prolapse.


Prolapse is typically graded from 1-4. One being the least severe and grade four being the worst. Cystocele is when the bladder drops down into the vaginal wall. Rectocele is when the rectum descends down and forward in to the posterior vaginal canal. Uterine prolapse is when the uterus and cervix descends. Less commonly seen is enterocele, when the small intestine descends into the vaginal wall. Additionally there is vaginal vault prolapse is when the vaginal canal folds in on itself.


Some forms of prolapse are manageable with pelvic floor physical therapy using pressure management strategies. An additional strategy that can be helpful in some cases includes the use a pessary fitted by your obstetrician. Grade three or four prolapse is in some cases are a surgical procedure. Strengthening and mobility of the legs, hips, trunk, and coordination of these structures can assist with mitigation of some symptoms as well.


Prolapse can happen with or without previous birthing history. Commonly prolapse symptoms can begin during pregnancy which is why it is so important to begin addressing symptoms as early as possible. Symptoms can included but are not limited to urinary incontinence, decreased ability to hold in gas or stool, in complete emptying of stool or urine, and pelvic floor heaviness. In severe cases, you may feel sometimes coming out of vaginal wall.







Managing how you are pressurizing the system can assist with symptom modification. Re-training these things does take work and commitment re-learn how you are going about some of your daily tasks and exercises. If you are having any of the symptoms or struggling with anything discussed in the videos, please don't hesitate to reach out to your local pelvic floor therapist to get assessed and get some help!


References:


Carvalhais, A., Natal, J.R. , & Bo, K. (2017) Performing high-level sport is strongly associated with urinary incontinence in elite athletes: a comparative study of 372 elite female athletes and 372 controls. Br J Sports Med, bjsports-2017


de Mattos Lourenco, T.R., Matsuoka, P.K., Baracat, E. C., & Hadad, J.M. (2018). Urinary Incontience in female atheltes: a systematic review. International urogynecology journal, 1-7


Matthews, et al (1991) “Prevalence, Incidence and Correlates of urianry Incontinence in Healthy, Middle-aged Women” Journal of Urology 146: 1255-1259


McKenzi, S., Watson, T., Thompson, J., & Briffa, K. (2016). Stress urinary incontience is highly prevalent in recreationally active women attending gyms or exercises classes. International urogynecology journal, 27 (8), 1175-1184


Whitehead, W.E. (2017, 07). Symptoms & Causes of Fecal Incontinence. National Institute of DIabetes, Digestive, and Kidney Health. https://www.niddk.nih.gov/health-information/digestive-diseases/bowel-control-problems-fecal-incontinence/symptoms-causes


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