Pelvic Organ Prolapse: Part 2


See Pelvic Organ Prolapse: Part 1 for information on what a prolapse is and some of the causing factors. 

 What can be done about it?
!!Prevention!!: As the support of the muscles underneath the pelvic organs decreases, the strain on the ligaments holding them increases and they eventually stretch beyond the point of no return. Ensuring good body alignment and maintaining pelvic health and function of the muscles is key at any stage of life, but essential during your pregnancy and leading up to delivery. Restoring optimal function of the core abdominal muscles and learning how to properly relax the pelvic floor muscles for bowel movements can help to decrease the overall pushing and strain required. Preparing your body for pregnancy to increase the space in the pelvic outlet (obstetrical conjugate) and yield of the pelvic floor muscles can help to decrease the amount of force required to get the baby out (read less Valsava-ing), as well as prevent perineal tearing for the best possible function of the pelvic floor muscles post-delivery (Check out Body & Birth Physiotherapy for a class or home visit in Calgary). 

 If you already have a prolapse, here are four things you must do immediately:

  • Stop wearing any positive-heeled shoes
  • Quit sucking in your stomach
  • Get off of your sacrum and tailbone (see Too Long, Too Short or Just Right)
  • Minimize any impact and downward-pressure causing activities (this includes any running, jumping, straining, sit-ups/crunches and heavy lifting)
Then go see a Pelvic Heath Physio or Restorative Exercise Specialist

Pelvic Health Physiotherapy: A physiotherapist is able to assess if you have a prolapse and provide a biomechanical assessment to determine what habits, movement patterns or muscular function may be contributing to your pelvic floor dysfunction. They will also teach you different techniques to manage the symptoms of prolapse eg. incomplete bladder or bowel emptying, pelvic pain, and begin an exercise program to begin improving your pelvic health and core function. 

Pessary: A pessary is a disc-like rubber device (similar to a menstrual Diva cup) inserted into the vagina to help support the vaginal walls and lift the prolapsed organ. This can be helpful in decreasing the pressure on the pelvic floor muscles and allow them to begin to recover and retrain their function. It can be a short-term solution for managing the associated symptoms until your pelvic floor function has improved or for longer-term use. There are many different types of pessaries and getting fitted by a continence nurse or pelvic health physiotherapist will often help you to achieve the best results. Since a pessary can be temporary and there are many less associated risks compared to surgery, I would advise any woman considering surgery for prolapse to try all conservative measures first. 

Surgery: Often (hopefully) a last resort as a treatment option, surgery for POP is a permanent intervention but not a guaranteed success and usually does not last for more than 10 years. It is only considered when the symptoms are very severe and usually if the prolapse is protruding outside of the body. Surgery involves reinforcing the vaginal walls with stitches or a type of mesh and following surgery, any impact or heavy lifting activities are limited for a number of months at the minimum. 

The bottom line (no pun intended) is that maintaining your pelvic health and alignment is imperative in prevention of pelvic floor dysfunction and conservative treatment should always be tried first before surgery. 

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