What is Pelvic Organ Prolapse?
Pelvic Organ Prolapse is a subjective disorder described as an annoying protrusion at or near the vaginal opening, which may or may not be accompanied by perineal pressure or heaviness that may be aggravated by standing and relieved by lying down.
Urethrocele – Prolapse of the urethra through the vagina
Cystocele – Prolapse of bladder through the vagina
Uterine Prolapse – Prolapse of uterus through the vagina
Rectocele – Prolapse of rectus through the vagina
Enterocele – Prolapse of the small intestine into the lower pelvic cavity. When this occurs, the small intestine pushes on the top part of the vagina, creating a bulge.
Vault Prolapse – Occurs when the upper portion of the vagina loses its normal shape and sags or drops down into the vagina canal or outside the vagina. It may occur alone or along with any of the above examples of prolapse. This is a common complication following vaginal hysterectomy.
Benefits of Chartered Physiotherapy
Your pelvic floor muscles are the basket of muscles that support your organs against gravity and intra-abdominal pressure and your vaginal/rectal walls. These muscles may become weak as a result of childbirth or damage to part of the pelvic floor. As the pelvic floor becomes weak then it is no longer able to support your pelvic organs and these organs may then prolapse into the vagina. As well, the remaining muscles may become overloaded due to compensation and may develop some negative tension. We will assess the muscles of your pelvic floor for both weakness and tension to determine the appropriate treatment plan to restore the function of your pelvic floor.
Correctly performing specific pelvic floor strengthening exercises can help relieve the symptoms of the prolapse and result in a higher resting position of your bladder and bowel. Research shows that based on verbal and written instruction, 75% of women are doing their pelvic floor exercises incorrectly. At Galway Physio Clinic, we use both palpation and real-time ultrasound ( http://galwayphysioclinic.ie/real-time-ultrasound-in-pelvic-health/ ) to assess your ability to contract your pelvic floor muscles and teach you how to correctly strengthen your pelvic floor.
What the research says
50% of parous women have some degree of symptomatic or asymptomatic pelvic organ prolapse (Hagen & Stark 2011)
Of those women who have a surgical repair of their prolapse, 50% will experience a recurrence (Whiteside et al 2004)
One delivery increases pelvic organ prolapse risk by 4,2 or more by 8.4 (Mant et al 1997) and, if forceps are used, the chances of incurring a major tear in pubococcygeus or iliococcygeus (two pelvic floor muscles with anterior attachments) is 53%