What is Pelvic Organ Prolapse?
POP is a descent (prolapse) of one or more of the pelvic organs (bladder, bowel or uterus) into the walls of the vagina.
This can happen when the connective tissue, ligaments or pelvic floor muscles are too stretched or weakened to keep the vagina walls in place.
Symptoms of POP
Symptoms of POP may include:
- Sensation of pressure or fullness in the pelvic area.
- Feeling a soft tissue lump or bulge protruding from the vaginal opening.
- Problems with urination, such as difficulty emptying the bladder or urinary incontinence.
- Problems with bowel movements, such as a feeling of incomplete emptying and needing to go more than once to complete of bowel movements.
- Painful intercourse
- Backache or a dragging sensation in the pelvis.
Risk Factors or causes of POP
Pelvic organ prolapse (POP) can result from a combination of factors that contribute to the weakening of the pelvic floor support structures. These factors may include:
1. Childbirth:
The process of pregnancy and childbirth, especially vaginal delivery, can stretch and weaken the pelvic floor muscles and connective tissues. Multiple childbirths or traumatic deliveries may increase the risk of POP.
2. Aging:
The natural aging process can lead to a decrease in collagen and elastin production, causing tissues in the pelvic area to lose their elasticity and strength.
3. Hormonal Changes:
The decline in estrogen levels, particularly during menopause, can contribute to the weakening of pelvic tissues. Estrogen plays a role in maintaining the strength and flexibility of connective tissues.
4. Genetics:
Some individuals may have a genetic predisposition to pelvic floor disorders, including POP. A family history of pelvic organ prolapse may increase the risk for an individual.
5. Chronic Constipation and Straining:
Chronic constipation or conditions that lead to straining during bowel movements can put increased pressure on the pelvic floor, potentially contributing to the development of POP.
6. Obesity:
Excess body weight can contribute to increased intra-abdominal pressure, which places additional stress on the pelvic floor muscles and tissues.
7. Connective Tissue Disorders:
Certain genetic or acquired connective tissue disorders, such as Ehlers-Danlos syndrome or Marfan syndrome, may affect the strength and integrity of pelvic tissues.
8. Hysterectomy:
Surgical removal of the uterus (hysterectomy) can alter the support structures in the pelvic area, increasing the risk of prolapse. The risk is particularly associated with removal of the cervix during hysterectomy.
9. Chronic Coughing:
Conditions such as chronic obstructive pulmonary disease (COPD) or persistent coughing due to smoking can contribute to increased intra-abdominal pressure, potentially leading to POP.
10. Heavy Lifting and Straining:
Jobs or activities that involve heavy lifting or repetitive straining can contribute to the development of pelvic organ prolapse.
It's important to note that pelvic organ prolapse can be influenced by a combination of these factors, and not everyone with these risk factors will necessarily develop POP.
How can a Women’s Health Physio help you with Pelvic Organ Prolapse?
A women's health physiotherapist, also known as a pelvic health physiotherapist, plays a crucial role in the assessment, management, and treatment of pelvic organ prolapse (POP). These specialized physiotherapists have training in addressing conditions related to the pelvic floor and can offer a range of interventions to help individuals with POP. Here's how a women's health physiotherapist can assist in managing pelvic organ prolapse:
1. Assessment and Diagnosis:
- Conduct a thorough assessment to evaluate the severity and type of prolapse.
- Identify contributing factors, such as muscle weakness, connective tissue laxity, and lifestyle habits.
2. Education:
- Provide education on pelvic anatomy, the factors contributing to POP, and the role of pelvic floor muscles.
- Instruct individuals on lifestyle modifications, including proper lifting techniques, bowel habits, and weight management.
3. Pelvic Floor Exercises (Kegel Exercises):
- Teach and guide individuals in performing pelvic floor muscle exercises (Kegel exercises) to strengthen and support the pelvic floor.
- Monitor and provide feedback to ensure proper technique and progression of exercises.
4. Biofeedback:
- Use biofeedback techniques to help individuals gain awareness and control over their pelvic floor muscles.
- Provide visual or auditory feedback during exercises to enhance muscle activation.
5. Manual Therapy:
- Perform manual therapy techniques to address muscle imbalances, trigger points, and tissue restrictions in the pelvic floor and surrounding areas.
- Offer massage, stretching, and relaxation techniques to improve muscle function.
6. Pessary Fitting and Management:
- Assess the need for pessaries, if appropriate, to provide support to the pelvic organs.
- Educate individuals on the proper use and care of pessaries.
7. Develop Individualised Exercise Programs:
- Design personalized exercise programs tailored to the individual's specific needs and the type of pelvic organ prolapse.
- Incorporate a variety of exercises to address overall strength, flexibility, and coordination.
8. Collaboration with Other Healthcare Providers:
- Work collaboratively with gynecologists, urogynecologists, and other healthcare professionals to ensure comprehensive care.
- Provide input into treatment plans, including pre- and post-surgical rehabilitation.
9. Monitoring Progress and Adjusting Treatment:
- Regularly assess progress and make adjustments to treatment plans as needed.
- Address any concerns or challenges that may arise during the course of treatment.
The goal of women's health physiotherapy in managing pelvic organ prolapse is to improve symptoms, enhance pelvic floor function, and empower individuals with the knowledge and skills to manage their condition effectively. Individuals experiencing symptoms of POP should seek consultation with a women's health physiotherapist for a thorough assessment and personalized treatment plan.