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Pei-Jiun Cheah

Pei-Jiun Cheah

Pelvic Organ Prolapse

Women’s prolapse is something people rarely talk about; however, it is common in the community around us. In fact, according to the Continence Foundation of Australia, over half of all women who have had a child have some level of prolapse.

Pelvic organ prolapse affects one in five women in the United States and it happens more often in older women and in white and Hispanic women than in younger women or women of other racial and ethnic groups. Prolapse can have a substantial effect on a woman’s quality of life and up to one in five women who have a prolapse will need to seek medical help.

What is pelvic organ prolapse? 

The pelvic muscles and tissues support the pelvic organs like a hammock. The pelvic organs include the bladder, uterus and cervix, vagina, and rectum, which is part of the bowel. A prolapse happens when the pelvis muscles and tissues can no longer support these organs because the muscles and tissues are weak or damaged. This causes one or more pelvic organs to drop or press into or out of the vagina.

What are some symptoms of prolapse?

  • Seeing or feeling a bulge or “something coming out” of the vagina.
  • A feeling of pressure, discomfort, aching, or fullness in the pelvis
  • Pelvic pressure that gets worse with standing or coughing or as the day goes on
  • Leaking urine (incontinence) or problems having a bowel movement
  • Problems inserting tampons
  • Some women say that their symptoms are worse at certain times of the day, during physical activity, or after standing for a long time. 

What are some of the risk factors for prolapse?

  • Vaginal childbirth, which can stretch and strain the pelvic floor. Multiple vaginal childbirths raise your risk for pelvic organ prolapse later in life. 
  • Instruments during delivery, such as vacuum and forceps.
  • Long-term pressure on your abdomen, including pressure from obesity, chronic coughing, or straining often during bowel movements.
  • Heavy babies during pregnancy. 
  • Aging. Pelvic floor disorders are more common in older women. About 37% of women with pelvic floor disorders are 60 to 79 years of age, and about half are 80 or older.
  • Hormonal changes during menopause.
  • Family history.
  • You can come in for an assessment post delivery and post menopause to check your pelvic floor strength and perform some rehabilitation in the most optimal time frame. 
  • How is pelvic floor organ prolapse treated?

When prolapses are moderate to mild the first line of treatment is non-surgical, and may include some of the following:

  • Individual pelvic floor training, prescribed by a pelvic floor physiotherapist. Training the pelvic floor muscles helps support the pelvic organs.
  • Lifestyle modifications, appropriate exercises and healthy eating.
  • Using good bladder and bowel habits.
  • Managing constipation.
  • Pessary (physiotherapist will fit the pessary for you)

If prolapse is severe or simpler treatments have not improved symptoms surgery may be considered.  Surgery attempts to repair the connective tissues, fascia and ligaments.  Be aware that surgery usually requires rehabilitation and long term activity modifications. Additionally 1 in 3 women that has prolapse surgery will prolapse again.

Our own physiotherapists Martina and Pei-Jiun specialise in Women’s health, so book in a session if you need help managing prolapse. 

To make an appointment or speak with one of our understanding, highly trained physiotherapists, please phone us on 8068 4696.

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