What is pelvic organ prolapse and how do we treat it?

What is pelvic organ prolapse?

Put simply, it is the descent of any pelvic floor organ through the vaginal canal or anus. These organs include the rectum, small bowel, bladder, uterus, and vagina. There are 4 stages of pelvic organ prolapse. Stages 1 and 2 typically respond well to pelvic floor PT while stage 3 typically warrants a multifactorial plan. Stage 4 typically warrants a primarily medical-based approach (surgery, pessaries, etc.). A common denominator in the cause of pelvic organ prolapse is pressure in your abdomen overpowering your pelvic floor and deep core muscles that help hold your organs in place. This can be due to multiple factors including weakness of the pelvic floor and core, increased laxity of tissues, poor pressure management, or situations where increased pressure occurs such as pregnancy/labor/birth. Therefore, when we see pelvic organ prolapse, we see it more commonly in those with a history of pregnancy, labor, childbirth, obesity, EDS, etc. Symptoms of prolapse include feeling of heaviness in lower abdomen and genital area, feeling like something is coming down your vagina or rectum, feeling a bulge in your vagina or rectum, difficulty emptying bowel or bladder, and/or feeling pressure in your vagina or rectum when exercising.

How do we treat pelvic organ prolapse?

We treat what we find! Some of the treatments often included are intra-abdominal pressure management, strengthening of your pelvic floor/core/hips, scar tissue mobilization, and breathing patterns at rest and when doing functional things like having a bowel movement, household work, exercising, etc. Big tip right here- DO NOT HOLD YOUR BREATH when having a bowel movement, lifting, etc. This creates a ton of pressure down below. We also will make recommendations on appropriate exercises taking into account hormonal changes and tissue laxity if you were recently pregnant.

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