Pelvic organ prolapse (POP) occurs when the uterus, bladder, urethra, gastrointestinal tract and/or rectum prolapse through the vaginal walls. People can also develop rectal prolapse, which is when the rectum, or part of the rectum, drops down or slides out of the anus. Weakness in fascia and pelvic floor muscles are two of the primary contributors in the development of POP. Risk factors, such as obesity and vaginal delivery, can cause weakness and damage to the pelvic floor muscles and fascia, thereby resulting in herniation of the organs.
The Facts
- 50% of all women develop pelvic organ prolapse
- Prolapses are graded on a scale of I – IV, with Grade IV being completely out of the vagina
- Roughly 20% of women will undergo pelvic floor reconstruction for POP
- There is a 30% recurrence rate of POP after surgery, thereby requiring a second procedure
- Pelvic floor physical therapy improves pelvic floor muscle function and reduces pelvic organ prolapse symptoms
Pelvic organ prolapse (POP) occurs when the uterus, bladder, urethra, gastrointestinal tract and/or rectum prolapse through the vaginal walls. People can also develop rectal prolapse, which is when the rectum, or part of the rectum, drops down or slides out of the anus. Weakness in fascia and pelvic floor muscles are two of the primary contributors in the development of POP. Risk factors, such as obesity and vaginal delivery, can cause weakness and damage to the pelvic floor muscles and fascia, thereby resulting in herniation of the organs.
The Facts
- 50% of all women develop pelvic organ prolapse
- Prolapses are graded on a scale of I – IV, with Grade IV being completely out of the vagina
- Roughly 20% of women will undergo pelvic floor reconstruction for POP
- There is a 30% recurrence rate of POP after surgery, thereby requiring a second procedure
- Pelvic floor physical therapy improves pelvic floor muscles function and reduces pelvic organ prolapse symptoms
Symptoms
- Feelings of heaviness or bulging in the vagina
- Urine and/or fecal leaking (incontinence)
- Abnormal bowel and bladder emptying
- Bladder and bowel urgency, frequency
- Nocturia (nighttime urination)
- Frequent bladder infections
- Pelvic pain
- Painful sex
Symptoms
- Feelings of heaviness or bulging in the vagina
- Urine and/or fecal leaking (incontinence)
- Abnormal bowel and bladder emptying
- Bladder and bowel urgency, frequency
- Nocturia (nighttime urination)
- Frequent bladder infections
- Pelvic pain
- Painful sex
Causes of Pelvic Organ Prolapse
- Genetics
- Obesity
- Menopause
- Childbirth, with vaginal deliveries causing higher risk
- Age-related pelvic floor and girdle changes
- Previous Hysterectomy
Causes of Pelvic Organ Prolapse
- Genetics
- Obesity
- Menopause
- Childbirth, with vaginal deliveries causing higher risk
- Age-related pelvic floor and girdle changes
- Previous Hysterectomy
Associated Diagnoses
- Urethrocele
- Cystocele
- Rectocele
- Enterocele
- Rectal prolapse
Associated Diagnoses
- Urethrocele
- Cystocele
- Rectocele
- Enterocele
- Rectal prolapse
Diagnostic Challenges
Studies show that women under report symptoms of pelvic organ prolapse and are not always offered pelvic floor physical therapy as a treatment option. Over-the-counter and medically prescribed pessaries may be helpful. Studies show that women with pelvic organ prolapse that undergo pelvic floor physical therapy have reduced symptoms, improved function, and better surgical outcomes. Typically women with Grades III and IV POP are advised to consider surgery. In these cases pelvic floor physical therapy can help before and after surgery.
Diagnostic Challenges
Studies show that women under report symptoms of pelvic organ prolapse and are not always offered pelvic floor physical therapy as a treatment option. Over-the-counter and medically prescribed pessaries may be helpful. Studies show that women with pelvic organ prolapse that undergo pelvic floor physical therapy have reduced symptoms, improved function, and better surgical outcomes. Typically women with Grades III and IV POP are advised to consider surgery. In these cases pelvic floor physical therapy can help before and after surgery.
Treatment:
How We Can Help You
POP can be associated with pelvic floor muscles that are too tight, and/or too weak, or they are discoordinated and do not function properly. It is important to understand that historically people were told to ‘do kegels’ upon getting diagnosed with POP. If your pelvic floor muscles are too tight, kegel exercises may actually make your symptoms worse, which is why we advise working with a pelvic floor physical therapist to ensure proper rehabilitation. The pelvic floor muscles may need to be lengthened before they are strengthened. In addition, our pelvic floor muscles should work with our entire core. As women age and sustain day-to-day micro-injuries and normal body wear-and-tear, our pelvic floor and core muscles start working against each other, leading to things like incontinence and pelvic organ prolapse. During the pelvic floor physical therapy evaluation, the physical therapist reviews your history and symptoms with you, what you have been diagnosed with in the past, the treatments you have undergone and how effective or not effective these treatments have been.
Treatment:
How We Can Help You
POP can be associated with pelvic floor muscles that are too tight, and/or too weak, or they are discoordinated and do not function properly. It is important to understand that historically people were told to ‘do kegels’ upon getting diagnosed with POP. If your pelvic floor muscles are too tight, kegel exercises may actually make your symptoms worse, which is why we advise working with a pelvic floor physical therapist to ensure proper rehabilitation. The pelvic floor muscles may need to be lengthened before they are strengthened. In addition, our pelvic floor muscles should work with our entire core. As women age and sustain day-to-day micro-injuries and normal body wear-and-tear, our pelvic floor and core muscles start working against each other, leading to things like incontinence and pelvic organ prolapse. During the pelvic floor physical therapy evaluation, the physical therapist reviews your history and symptoms with you, what you have been diagnosed with in the past, the treatments you have undergone and how effective or not effective these treatments have been.
How Can We Help You?
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At its heart, Pelvic Pain Explained is the story of how patients develop pelvic pain, the challenges patients and providers face throughout the diagnosis and treatment process, the difficult task of sifting through the different available treatment options, and the impact that an “invisible” condition has on a patient’s life and relationships, and much more.