Pelvic organ prolapse is a subjective disorder described as an annoying protrusion (bulge) at or near the vaginal opening, which may or may not be accompanied by perineal pressure (pressure between your vagina and anus) which is aggravated by standing, and relieved by lying down.
Significant pelvic organ prolapse is often asymptomatic, and is usually not associated with pain.
Additional symptoms may also be urine retention and alterations in bowel function.
Pelvic Organ Prolapse is a functional problem, and needs to be treated functionally in order to reverse the effects. Many conservative strategies including postural correction, constipation management, toileting positions, and pelvic floor exercise can correct and reverse the problems associated with prolapse. A well-fitted pessary may also be helpful. Most surgeons would agree that surgical correction of a prolapse should be the last resort.
Take a moment to ask yourself:
- Do you have heaviness in your vagina or rectum?
- Do you have difficulty initiating your urine flow?
- Do you have to strain in order to have a bowel movement or to urinate?
- Do you have discomfort/pain during intercourse?
- Does it feel like your “insides” are falling out?
- Has your doctor said that you have a prolapsed pelvic organ?
- Are you constipated?
Then you may have a prolapse. Prolapse is described by the organ which is protruding into the vaginal canal. They include:
- Cystocele: Prolapse of the bladder
- Rectocele: Prolpase of the rectum
- Urethrocele: Prolapse of the urethra
- Uterine prolapse: Prolapse of the uterus
- Vaginal Vault prolapse: Prolapse of the top of the vagina after a hysterectomy
- Enterocele: Prolapse of the intestines
Symptoms of Different Types of Prolapse:
The following are symptoms that are specific to certain types of prolapse:
- Difficulty emptying bowel: this may be indicative of an enterocele, vaginal vault prolapse or prolapsed uterus. A woman with difficulty emptying her bowel my find that she needs to place her fingers on the back wall of the vagina to help evaluate her bowel completely. This is referred to as splinting.
- Difficulty emptying bladder: this may be indicative of a cystocele, urethrocele, enterocele, vaginal vault prolapse, or prolapsed uterus
- Constipation: This is the most common symptom of a rectocele
- Urinary Stress Incontinence: This is a common symptom of a cystocele
- Pain that increases during long periods of standing: This may be indicative of an enterocele, vaginal vault prolapse, or prolapsed uterus
- Protrusion of tissue at the back wall of the vagina: this is a common symptom of a rectocele
- Protrusion of tissue at the front wall of the vagina: This is common symptom of a cystocele or urethrocele
- Enlarged, wide, and gaping vaginal opening: This is a common symptoms of a vaginal vault prolapse
You should be evaulated by your family doctor, gynecologist, or pelvic health physiotherapist if you suspect that you have a prolapse. Most prolapses can be treated conservatively through exercise, lifestyle modifications and pessaries. Surgery may be necessary in some cases.
Pelvic Floor Safe Core Exercises:
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