What else can you do for Pelvic Organ Prolapse?

What else can you do for Pelvic Organ Prolapse?

What else can be done besides surgery to assist in the management of pelvic organ prolapse. Pelvic organ prolapse is defined as an anatomical change where the pelvic organs which are the bladder, uterus, bowel or rectum move downwards into the vagina causing symptoms like “something is coming down” or a feeling of vaginal heaviness. In some circumstances, a bulge maybe felt inside or outside the vagina. The pelvic organs are supported inside the pelvis by ligaments and muscles called the pelvic floor and like all other muscles in the body they can be strengthened to support the prolapse and possibly reduce the symptoms.

There are different types of prolapse which can present with different symptoms. The most common prolapse is when the bladder bulges down into the vagina. This can lead to strong more frequent urges to empty the bladder, leakage of urine related to coughing, problems emptying the bladder which may mean urinary tract infections. Prolapse symptoms tend to be worse towards the end of the day, with prolonged standing or at times of increased abdominal pressure i.e. coughing, lifting, straining to go to the toilet.

Pelvic organ prolapse is more common than we know and affects up to 1 in 3 women who have had children. However, there are other factors besides pregnancy and childbirth can cause prolapse. These include obesity and being overweight, heavy lifting, age, menopausal changes, constipation, chronic cough, previous pelvic surgery.

If you are suffering from a pelvic organ prolapse there are several habits you can adopt to help manage the symptoms. The first is to develop good bladder and bowel habits. It is very important to avoid constipation as this leads to straining which puts an added pressure on the pelvic floor muscles. Eating plenty of vegetables, fruit and avoiding processed food helps with this. Make sure you drink enough fluid per day. When using the toilet do not ‘hover’ and if having a bowel motion have your feet apart and raised up on a stool/support with the arms resting comfortably on your legs. After passing urine you may find it helpful to lean forward and back several times to help make sure your bladder is completely emptied. Do not try to reduce your daily fluids to avoid urine frequency. Being overweight puts extra pressure on the pelvic floor and your symptoms may improve if you lose weight. If you are doing a lot of lifting try to reduce the weight and check that you have a good technique that is not putting so much weight on the pelvic floor.

In regards to activities that make symptoms worse i.e. standing. Try to break up the day with periods of sitting. High impact exercises like jumping, running may make the symptoms worse if the pelvic floor muscles are not strong enough. Try to modify activities to reduce the pressure on the pelvic floor or swap for low impact exercises. Strengthening the pelvic floor muscles is very important. If you have been diagnosed with a pelvic organ prolapse seeing a Chartered Physiotherapist who specialises in pelvic health will be of great benefit. They can assess your pelvic floor muscle strength and endurance to provide an exercise program specific to your capabilities.