Pelvic Organ Prolapse
What is Pelvic Organ Prolapse and its common symptoms?
Prolapse is defined as a descent of the pelvic organs to or through the vaginal opening. There are 6 types of pelvic organ prolapse, all of which are treated with pelvic floor physical therapy: cystocele (bladder prolapse), urethrocele (urethral prolapse), uterine prolapse, rectal prolapse, rectocele, and enterocele.
The common symptoms of prolapse include:
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pelvic pressure
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vaginal bulging
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low back ache/pain
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vaginal bleeding or discharge
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symptoms getting worse in standing and better in gravity-reduced positions
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symptoms getting worse with straining
What are the common of causes of Pelvic Organ Prolapse?
Prolapses develop due to pelvic floor connective tissue laxity, muscle weakness, or pelvic nerve dysfunction.
Some of the most common causes of Prolapse include:
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physical trauma of vaginal childbirth
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obesity
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older age - may be due to menopause estrogen deficiency
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prior hysterectomy
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conditions that chronically increase intra-abdominal pressure - asthma, chronic cough, or chronic constipation
How long should I wait before I seek treatment for Prolapse?
Regardless of the cause of pelvic organ prolapse, the sooner you start therapy the better. It is crucial to start treatment as soon as possible in order to learn symptom management and start utilizing important behavioral modification strategies to prevent worsening of the prolapse.
How can physical therapy help resolve symptoms of Prolapse?
Your physical therapist will perform a detailed examination and will individualize treatments to strengthen your pelvic-floor muscles and improve their function.
Many women find relief from Pelvic Organ Prolapse symptoms by performing targeted exercises. Typically, a physical therapist trained in this area can help create a customized plan that includes finding and strengthening the pelvic floor muscles.
Treatment strategies for prolapse include:
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Behavioral modification strategies to prevent symptom worsening
Your physical therapist will:
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Show you how to "find" the right muscles and use them correctly.
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Help you understand your condition and gain control over your symptoms.
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Use pelvic-floor exercises to help you strengthen your muscles so that you can better control your bladder.
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Instruct you in exercises to stretch and strengthen other important muscles, so that they can support proper bladder function.
Depending on your symptoms and level of discomfort, your physical therapist may use biofeedback to make you aware of how your pelvic-floor muscles work and how you can control them better. Electrodes attached vaginally or rectally will provide measurements of muscle activity and display them on a monitor, and the therapist will work with you to help you understand and change those readings. The therapist also may use electrical stimulation to improve your awareness of your muscles and increase muscle strength.
Remember: Knowledge Is Power!
What are my therapy sessions going to be like?
Your physical therapist will perform a detailed examination to identify the causes of your symptoms. Your therapist also will determine whether you should be referred to a physician for additional tests.
The treatment for pelvic organ prolapse will mainly focus on strengthening all of the muscles around the pelvis to help support the organ from further descent and help to alleviate your symptoms. We will also provide education on how to modify your every day activities to prevent symptom worsening. This may include lifting techniques, protection techniques with sneezing/coughing/getting up from a chair and providing education on specific intercourse positions. We also use a variety of manual therapy techniques to treat scars, connective tissue, and abdominal/pelvic organs.
Depending on your symptoms and level of discomfort, your physical therapist may use biofeedback to make you aware of how your pelvic-floor muscles work and how you can control them better. Electrodes attached vaginally or rectally will provide measurements of muscle activity and display them on a monitor, and the therapist will work with you to help you understand and change those readings. The therapist also may use electrical stimulation to improve your awareness of your muscles and increase muscle strength.
How soon can I expect to see improvements?
Each patient is unique, so this time frame can vary greatly. Research shows that depending on the severity of your condition, it takes from 2 weeks to a few months of treatment to improve symptoms of prolapse. We most often request a frequency of 2-3 times a week for 12 total visits. That is why our office staff will ask you to schedule all 12 of your sessions before starting therapy. If you need more than 12 sessions, your therapist will discuss this with you after you have completed 12 visits and you will decide together whether continuing with therapy would benefit you or not. If so, your therapist will reevaluate you and send a progress note to your physician requesting an extension.
What are the credentials of my uro-gynecologycal physical therapist?
Uro-gynecological physical therapists have been trained in internal vaginal and rectal evaluation and treatment techniques and are by our state license legally allowed and qualified to perform these procedures.
All licensed physical therapists have had to apply and be selected to attend Physical Therapy school. It is a very competitive process and only those will the highest grades and best potential are selected. Doctors of physical therapy have invested a minimum of 7 years into their undergraduate and graduate training at universities. Once they graduate, they have to sit for a State Board Exam and pass to receive their license to practice. In order to keep their license active, they must dedicate a certain number of hours to continuing education each year.
At Anchor Physical Therapy we also require that therapists attend multiple post-graduate continuing education courses every year to stay up to date with latest research and continuously enhance their treatment skills in order to achieve the best possible treatment outcomes for our patients.