Pelvic organ prolapse is a dropping of any of the pelvic organs (uterus, bladder, or rectum) down into vaginal canal or through the vaginal opening. You can have prolapse of one or multiple pelvic organs at a time.
There are multiple treatment options available if you are experiencing pelvic organ prolapse
Symptoms of pelvic organ prolapse usually present as a feeling of pressure, heaviness, or feeling of something falling out around the vaginal area. Other symptoms can include pain in the vaginal or pelvic region, urinary issues such as leakage, unable to empty your bladder, or urgency, or bowel trouble such as constipation. If you want more information on the symptoms of pelvic organ prolapse check out our Blog Post: What is Pelvic Organ Prolapse
Seeking medical help for pelvic organ prolapse does not mean that you have to commit to surgery. All women can benefit from conservative treatment options like physical therapy to help with their prolapse symptoms, and potentially only to go on the surgery if those symptoms for prolapse don’t get under control with the conservative treatment options. Treatment options for prolapse depend on what your individual problem is and the symptoms that you are experiencing.
Treatment for prolapse should be there to help you improve your quality of life and get you doing the activities that you want to be doing. Therefore, the type of treatment options should be recommended based on your goals. With most pelvic organ prolapse, you have conservative and non-surgical treatment options– not all prolapses require invasive treatments. So depending on if the prolapse is causing you any discomfort or interfering things that you enjoy, your doctor may suggest that you hold off on treatment or not. We believe that no matter if you have an asymptomatic prolapse, it is still a good idea to work with the pelvic physical therapist for even a visit or two to sure that you stay symptom-free.
So, what can you do for conservative management if you have a symptomatic prolapse?
The first thing you can do is adjust your physical activities so that your not straining or placing stress down through the pelvis. Now, we always want women to be as active as they can be comfortably, but sometimes we have to adjust what they are doing exercise-wise or how they’re doing the exercise to make sure that it is still appropriate and not putting too much pressure down through the pelvic area. This is again where partnering with a pelvic physical therapist could be very helpful to make sure that you are making the appropriate adjustments.
Another thing you can do is stop smoking if you are a smoker. Smoking causes damage to tissue throughout our body. When you are trying to heal a pelvic organ prolapse, you want the healthiest quality tissue possible.
Avoid constipation. Being constipated causes a lot of extra strain and pressure in the pelvic area and onto the pelvic organs. Dietary changes, the addition of fiber, and drinking plenty of water can help your bowel stay soft. If you need more help in this area, speak with your physician about ways that might work best for you.
Be sure you are at or working towards being a healthy weight. Carrying extra body weight will add extra strain and pressure through the pelvic cavity and onto your prolapse. If you are struggling with losing weight, we recommend speaking with your physician about what weight loss programs are best suited for you. Pelvic physical therapists can also help guide what exercises or exercise programs would be safest for you.
Another thing that you can do is potentially get fitted for a vaginal device called “pessary”. A pessary provides support for the vaginal canal to keep the prolapse in a position closer to where it should be. A pessary can be a great conservative option, for women of all ages, who don’t want surgery, who aren’t good surgical candidates, who want to be active or working out the way that they want, or a simply be able to take care of kids the way that they want to be without having symptoms as their doing their day to day activities.
There are many different types of them and you need to be fitted for one that’s going to work well for you. We recommend, that if you are dealing with pelvic organ prolapse, to talk about this with your gynecologist. You can also seek an assessment by a urogynecologist that focuses on treating pelvic organ prolapse. Partnering with your gynecologist or a urogynecologist to talk about your prolapse symptoms and potentially the use of a pessary would be a great idea.
Another conservative treatment option which we’ve already mentioned above is pelvic physical therapy. At Legacy Physical Therapy we have helped a substantial number of women with pelvic organ prolapse. Many times we can help get women symptom-free without any type of surgery or medication simply by retraining or modifying activity, strengthening their pelvic support muscles, and teaching them ways to move so that they’re not placing too much pressure down to the pelvic area. We highly recommend partnering up with the Pelvic Physical Therapist to make sure that you are addressing your prolapse symptoms appropriately and safely.
We highly recommend women with pelvic organ prolapse explore conservative treatment options before jumping into a surgical repair. We also know that in some cases, conservative management might only help to a certain point. Depending on the severity on the symptoms and your general health, pelvic organ prolapse surgery may be recommended in the end. Regardless, starting with conservative management and working with a pelvic physical therapist can definitely be of help.