Kaitlyn Swartz, MPT, B.H.K (Hons), RMT, CAT(C)

Pelvic organ prolapse is a common yet often misunderstood condition affecting many individuals, particularly women, during and after pregnancy. This blog post aims to demystify pelvic organ prolapse, explaining what it is, how it occurs, and how pelvic health physiotherapy can provide relief and rehabilitation. Additionally, we’ll explore self-help strategies that can empower individuals to take charge of their pelvic health. 

What is Pelvic Organ Prolapse?

Pelvic organ prolapse occurs when the pelvic floor muscles and supporting tissues weaken, causing one or more pelvic organs—such as the bladder, uterus, or rectum—to drop (or "prolapse") from their normal position into the vaginal canal. This condition can lead to a variety of pelvic floor symptoms, including urinary incontinence, pelvic pain, and issues with bowel movements.

According to research, pelvic organ prolapse affects about 30-50% of women who have given birth, highlighting the significant impact of pregnancy and childbirth on pelvic health. Common types of prolapse include:

- Cystocele: A bulge of the bladder into the front wall of the vagina.

- Rectocele: A bulge of the rectum into the back wall of the vagina.

- Uterine prolapse: Descent of the uterus into the vaginal canal.

How Does Pelvic Organ Prolapse Occur?

Pelvic organ prolapse often results from a combination of factors that contribute to the weakening of the pelvic floor. Key contributors include:

- Pregnancy and childbirth: The physical stress of carrying and delivering a baby can stretch and weaken pelvic floor muscles.

- Aging: As women age, hormonal changes can decrease muscle tone and elasticity in pelvic tissues.

- Obesity: Excess weight can put additional pressure on the pelvic floor.

- Chronic cough or straining: Conditions that cause frequent coughing or heavy lifting can weaken pelvic support.

- Genetics: A family history of pelvic health disorders may increase the risk.

Individuals experiencing pelvic floor dysfunction may notice symptoms such as feelings of heaviness or pressure in the pelvic area, leakage of urine (stress incontinence), or pain during sexual activity (sexual dysfunction).

The Role of a Pelvic Physiotherapist in Treatment

Pelvic health physiotherapy is a specialized area of physiotherapy focusing on the assessment and treatment of pelvic health disorders. A pelvic floor physiotherapist is trained to perform a thorough pelvic floor assessment, including an internal exam (if appropriate), to evaluate the strength and function of pelvic floor muscles.

Treatment Plans and Interventions

A pelvic physiotherapist may implement a variety of treatment strategies, including:

- Pelvic floor rehabilitation: This may involve targeted exercises to strengthen weak pelvic floor muscles or relax tight pelvic muscles. A balance between strengthening and relaxation is crucial.

- Kegel exercises: These exercises specifically target the pelvic floor muscles, helping to improve bladder function and reduce symptoms of incontinence. A pelvic physiotherapist can provide guidance on the correct technique to ensure effectiveness.

- Biofeedback: This technique uses sensors to help patients become aware of their pelvic floor muscle activity, promoting better control and coordination.

- Manual therapy: Techniques such as myofascial release may be utilized to relieve tension and improve mobility in the pelvic region.

- Education: Understanding pelvic health, body mechanics, and lifestyle modifications can significantly aid recovery. A pelvic physiotherapist can create a personalized treatment plan that aligns with the patient’s needs and goals.

Self-Care Strategies for Pelvic Health

While professional intervention is invaluable, individuals can also take proactive steps to support their pelvic health. Here are several strategies:

Strengthening the Pelvic Floor: Engaging in regular Kegel exercises can help strengthen pelvic floor muscles. To perform Kegels effectively:

1. Identify the correct muscles (try stopping urination mid-flow).

2. Contract the muscles for five seconds, then relax for five seconds.

3. Gradually increase the duration of contractions as strength improves.

Maintaining a Healthy Weight: Managing body weight can relieve excess pressure on the pelvic floor. A balanced diet and regular physical activity can contribute to overall health and well-being.

Postural Awareness: Being mindful of posture during daily activities can support pelvic floor function. Avoiding positions that excessively strain the pelvic area, such as heavy lifting or prolonged sitting without movement, is essential.

Managing Chronic Pelvic Pain: For individuals experiencing chronic pelvic pain, seeking help from a pelvic health physiotherapist can provide tailored strategies for pain management and rehabilitation. Techniques such as relaxation exercises, stretching, and mindfulness can also be beneficial.

Regular Check-ups: Routine assessments by a pelvic health physiotherapist can help monitor pelvic floor health, especially during pregnancy and the postpartum period. This proactive approach can identify issues early and facilitate timely intervention.

Conclusion

Pelvic organ prolapse is a significant health issue that can affect quality of life, but it is manageable with the right approach. Engaging a qualified pelvic physiotherapist from a specialized facility like the Proactive Pelvic Health Center can provide essential support through comprehensive assessments and personalized treatment plans. Additionally, incorporating self-care strategies can empower individuals to maintain and improve their pelvic floor health.

By prioritizing pelvic health, individuals can enhance their well-being, manage symptoms, and regain control over their lives.

Resources: 

1. Bo, K., & Hunskaar, S. (2013). **Pelvic floor muscle training for urinary incontinence in women.** Cochrane Database of Systematic Reviews.

2. Hay-Smith, E. J. C., et al. (2011). **Pelvic floor muscle training for preventing and treating urinary incontinence in women.** Cochrane Database of Systematic Reviews.

3. Smith, M. D., & Caughey, A. B. (2017). **Pelvic Organ Prolapse: An Overview.** American Family Physician.