DO I HAVE POP (Pelvic organ PRoLAPSE)?
POP - Pelvic Organ Prolapse
What is Pelvic Organ Prolapse (POP)?
The pelvic floor is composed of ligaments, fascia, muscles, nerves and other connective tissue that supports the bladder, uterus, vagina rectum and small intestine. Typically taut and strong, the pelvic floor acts like a hammock keeping all above organs in place.
Over time, and for many reasons (ie: child birth, birth with forceps, peri/post menopause, poor intraabdominal pressure management, chronic constipation, trauma) the pelvic floor muscles and connective tissue can weaken and the pelvic organs may begin to slip downwards, descending into the vagina or outside of the vagina in more advanced stages.
Nearly 75% of women with POP report a profound effect on quality of life.
Symptoms of the POP may include:
sensation of pressure, fulness in your vagina
sensation of pelvic floor heaviness
aching or pain in your lower back
feeling bulge inside or outside of the vagina
heaviness post exercises
may also be worse during menstruation
post intercourse pressure, as well as during intercourse sensation of "hitting something" that may be accompanied by pain (painful intercourse - dyspareunia)
bulge or pressure that worsens as the day progresses, worse with impact exercises, walking and lifting, lifting kids etc.
bulge or pressure that worsens with coughing, sneezing etc.
bulge/heaviness/pressure after being constipated
with or without incontinence
Types of POP :
Cystocele = Anterior vaginal/bladder prolapse
Uretrocele = dropped urethra, often accompanied by cystocele
Rectocele = posterior vaginal wall prolapse- rectocele
Enterocele- weakened muscles in your pelvic floor can cause your small intestine to bulge onto the back wall or to the top of your vagina
Uterine prolapse- Uterocele
Vaginal volt prolapse
Your pelvic floor may weaken for many different reasons and increase the likehood of POP. Here are the main risk factors for POP:
vaginal childbirth, multiple births, having twins/triplets or carrying large babies
use of forceps
the aging process due to hormonal changes including a decline in estrogen, as well as different peri and post-menopausal hormonal ratios contribute to connective tissues weakness
heavier BMI also increases the chances of developing POP
long term pressure in the abdominal cavity such us chronic constipations
genetics - family hx of POP
collagen disfunction in different genetic conditions such as Ehlers - Danlos Syndrome
How is POP diagnosed?
during pelvic floor exam, your provider will review your symptoms and perform pelvic floor examination to rule in/out the POP
Stages of POP
TREATMENT options for POP:
A Pelvic floor Physiotherapist trained in treating POP may assist you with the following treatment ;
pelvic floor intra-abdominal pressure management trough breathing and other techniques
pelvic floor strength exercises
visceral fascia mobilization if indicated
education about client factors that may be contributing to POP
may require vaginal estrogen based cream - your Physiotherapist will communicate with your GP if this is required,
may benefit from pessary - a removable vaginal device that supports organ/organs that prolapsed
in advanced stages of POP, surgery may be required
PREVENTION of POP:
Although many POPs are out of your control, putting healthy habits in place may reduce risks of POP getting worse .
if you are pregnant, getting a pelvic floor assessment and strategies for birth - labour breathing without forcefully pushing may be very beneficial in reducing the risks of POP
if your are active (ie running, weight lifting etc.), learning proper breathing techniques to manage intraabdominal pressure may be very beneficial in POP prevention
maintain heathy weight
prevent constipation
avoid smoking
respiratory illness prevention
managing your allergies to avoid frequent coughing and sneezing
peri/post menopausal hormonal management if required and directed by GP, OB, or Naturopathic Doctor
PROGNOSIS with POP:
Your prognosis depends on many factors; some of them include the severity/grade of your prolapse, hormonal imbalances, daily habits, bowel health and others.
An important first step is talking to your health care provider and/or Physiotherapist about any symptoms which could be indicative of POP, so you can be referred to health care professionals who understand POP and can help.
Resolution’s Pelvic floor Physiotherapy team will be happy to assist you if you have any questions or concerns.
In health
Beata .....
