Pelvic Organ Prolapse
Pelvic organ prolapse occurs when the bladder, uterus or rectum slips out of place down into the vagina.
Bladder prolapse, also called a cystocele or anterior vaginal wall prolapse is when the bladder loses its support and slips down and bulges into the front wall of the vagina, pushing it down.
Uterine prolapse is when the uterus loses support and slips down into the vagina.
A rectocele, also called a posterior vaginal wall prolapse, is when the rectum looses its support and slips down and bulges into the back wall of the vagina, pushing it down. It then forms a pocket that stool can get trapped in.
Symptoms can include:
- Incomplete bladder or bowel emptying
- sensation of vaginal or rectal heaviness or pressure
- Something bulging at the vagina or perineum
Correctly performed pelvic floor muscle (Kegel) exercises can help prolapse. Research shows that based on verbal and written instruction, 75% of women are doing these exercises incorrectly. Research also demonstrates that supervised, correctly performed pelvic floor exercises (Kegel’s) result in a higher resting position of the bladder, bowel and pelvic floor! At Dayan Physiotherapy, we use both Biofeedback and Real Time Ultrasound to assess your ability to contract and to teach you how to contract and strengthen your pelvic floor (Kegels). Once you can do this and have enough strength in your pelvic floor, we help you learn how to use your pelvic floor to return to activities that caused your prolapse to be bothersome.
At times pelvic floor exercises (Kegel’s) do not completely alleviate the prolapse. As an alternative to surgery, many women choose to use a pessary, an internal assistive device that supports your prolapse. These can be used just for activities when the prolapse is bothersome, such as running or jumping, or kept in all day long if needed. The pessary cannot be felt when using it and is easy to insert and remove. At Dayan Physiotherapy, we fit and prescribe pessaries.