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Pelvic Organ Prolapse. What is it and how can physio help?

Posted by Melissa Davidson on 3 July 2013 | 5 Comments Tags:

Have you ever heard of a pelvic organ prolapse? The name can sound quite frightening, but it need not be, especially when there is help and effective treatment available.

If you are one of the 50% of women who suffer from a prolapse, perhaps in secret, then this blog post if for you.

What is it?

Pelvic organ prolapse (commonly shortened to POP) occurs when organs, such as the uterus, fall from their normal position. The organs can slip down and actually protrude in some instances. In other cases, you will feel a heaviness or dragging inside the vagina (often worse with exercise).

Risk factors for prolapse include pregnancy, childbirth, connective tissue disorders, occupations, or hobbies involving lifting, obesity and smoking. It occurs more often in women over the age of menopause; however, it can happen at any age and stage of life.

A prolapse may not always be painful; however, it can contribute to bladder and bowel disorders, chronic pelvic pain, and sexual dysfunction. In other words, you need to seek treatment!

What help is available?

It’s estimated around 10% of women in the population undergo surgery for prolapse or incontinence management. This is one option for treatment, but there has been some concern in the media around POP surgery, specifically the discussions around the mesh used in POP repairs. (See this article for more on the topic: Surgical Mesh, NZ Herald).

What is not often considered, possibly due to lack of knowledge, is a highly effective and cost efficient treatment called pelvic floor muscle training. This type of training can be taught by a pelvic floor physiotherapist who can provide assessment, education, training, and support. If you feel tempted to ‘go it alone’ then please consider that 30% of women who think they are doing the exercises correctly, are not!

I always suggest seeking help in the first instance from a qualified pelvic floor physiotherapist who can assess your pelvic floor fully – this may include an internal examination (vaginal). This internal examination is often needed to ensure that the muscles are assessed fully and you get the right information about your condition and state of your muscles. The examination is done in a private room with great care and usually takes only a few minutes. With this information, you pelvic floor physiotherapist can set your treatment for you personally, ensuring maximum benefit from treatment.

Most patients notice an improvement with their symptoms within 4-6 weeks if they are doing the exercises correctly. Building your pelvic floor to full strength will take approximately six months of daily exercise and after that you will need maintenance exercise to ensure strength is maintained for life. Think of it like any other muscle that you work out; if you don’t use it, you’ll lose it.

Will it work?

There is now very good evidence for pelvic floor muscle training as a treatment for prolapse. Randomised controlled trials over the last 10 years have shown a significant reduction in not only the complaints of symptoms, but also a significant improvement in the pelvic floor muscle strength and the severity of the prolapse.

More importantly for some; it is low cost, non-invasive and the majority of women can do the exercises.

How do I get started?

If you’re experiencing any of the symptoms I mentioned above then I strongly suggest seeking help. You can speak to your doctor or find a pelvic floor physio here using the online tool. I suggest searching for a pelvic floor physio with expertise in pelvic floor, prolapse or continence, who can do a full examination of your pelvic floor and give you the best outcome going forward.

For more on how physio can help prolapse have a look at Susan’s story below.  

By Melissa Davidson

    Melissa Davidson is Managing Director and Principal Physiotherapist at Remarkable Physios. Her special interests are in manipulation, acupuncture, cosmetic acupuncture, women's and men's health, breathing, work-site assessments, manual handling courses and NLP (neuro-linguistic programming). Melissa is currently working towards her PhD in Bioengineering at the University of Auckland investigating pelvic floor muscle stiffness during pregnancy. In her spare time she enjoys a variety of sports including running her black labrador and mountain biking.

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  • Does anyone have a success with physio for reversing a grade 1 cestocile/rectocile? Am looking online and there do not appear to be many success stories. Am currently seeing a physio but would love to hear if it has been successful for anyone.

    Posted by Cath, 14/07/2014 2:52pm (4 years ago)

  • Hi
    I am looking for a pelvic floor physio in North land. If you can help would be appreciated thanks georgie

    Posted by Georgina Atkin, 20/03/2014 7:44am (4 years ago)

  • Pelvic organ prolapse and stress urinary incontinence coexists in up to 80 percent of women with pelvic floor dysfunction. While these conditions are often concurrent, one may be mild or asymptomatic. It is necessary to first consult a specialist regarding the risk for postoperative urinary incontinence after undergoing surgery for prolapse.

    Posted by Ashling, 25/09/2013 7:28pm (5 years ago)

  • Hi Gaynor
    Thanks for your positive feedback and support of the PF exercise approach to POP issues.

    Posted by Melissa Davidson, 23/07/2013 12:29pm (5 years ago)

  • Really good helpful information. Even after a surgical producedure I would recommend to continue training with your WH physiotherapist.
    Not many physio's are trained to fit or size pessaries in the UK which is a shame. More pelvic floor physiotherapists are needed as so many women need their help.
    Your physiotherapist is the best person to speak to regarding correct, breathing and training. Get into good habits can save you a lot of problems later on trying to undo bad habits.
    If you have a pelvic organ prolapse, you need to look at a whole new lifestyle as some of the things you used to do may not be possible with POP issues. learn to take baby steps and take each day as it comes. Women with POP can have a good quality of life its finding whats best for you as an individual.

    Posted by Gaynor Morgan, 07/07/2013 9:31pm (5 years ago)

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