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

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

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

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. 

Importantly, we understand what you have been going through and that most people are frustrated by the time they get to see us. During the physical examination the physical therapist examines muscles, tissues, joints, nerves, and movement patterns. Once the examination is complete your therapist reviews your findings with you. The physical therapist creates an assessment which explains how you developed your symptoms and creates short and long-term goals for your treatment plan. Typically, the frequency of physical therapy treatment is one time per week for roughly 12 weeks. We can help you prepare for surgery, or possibly delay or avoid it. We are here for you after surgery to prevent recurrences and help you restore function. You are given a home exercise program to compliment your in-person sessions, and your physical therapist will help to coordinate your recovery with the other members of your treatment team, including your surgeon if you are working with one. We are here to help you recover and live your best life!

Treatment:

How We Can Help You

3031 Telegraph Ave Ste 144, Berkeley, CA 94705

Phone:    (510) 922-9836
Fax:         (510) 922-1417
Hours:     Mon-Fri 8am – 5pm
Email:      info@pelvicpainrehab.com
Staff:        Maryssa Steffen, Karah Charette, Lisa Topete

Realizing the need for pelvic health services and the difficulty of crossing the Bay Bridge to San Francisco, Liz and Stephanie opened their second location in the East Bay in 2010. We are conveniently located minutes from highways 24, 80, 580 and 880 making us

easily accessible from anywhere in Berkeley and Oakland. We are a short walk from the Ashby BART station, or you can reach us via the MacArthur BART station and take the free Alta Bates Hospital Shuttle Bus to the Alta Bates Medical Campus which is one block from PHRC. There is also a AC Transit bus stop in front of our building as well as bus lines 6, 80, and 81 within a short walking distance to our office. There is hourly parking available in our building parking lot as well as metered street parking.

3031 Telegraph Ave Ste 144, Berkeley, CA 94705

Phone:    (510) 922-9836
Fax:         (510) 922-1417
Hours:    Mon-Fri 8am – 5pm
Email:     info@pelvicpainrehab.com
Staff:       Maryssa Steffen, Karah Charette, Lisa Topete

Realizing the need for pelvic health services and the difficulty of crossing the Bay Bridge to San Francisco, Liz and Stephanie opened their second location in the East Bay in 2010. We are conveniently located minutes from highways 24, 80, 580 and 880 making us

easily accessible from anywhere in Berkeley and Oakland. We are a short walk from the Ashby BART station, or you can reach us via the MacArthur BART station and take the free Alta Bates Hospital Shuttle Bus to the Alta Bates Medical Campus which is one block from PHRC. There is also a AC Transit bus stop in front of our building as well as bus lines 6, 80, and 81 within a short walking distance to our office. There is hourly parking available in our building parking lot as well as metered street parking.