Pelvic Organ Prolapse: What is it and what can you do?
A common postpartum dysfunction that many women face is pelvic organ prolapse. What is it, how can you prevent it, and how can it be managed?
What is Pelvic Organ Prolapse?
Pelvic organ prolapse occurs when the pelvic organs such as the bladder, uterus, and rectum, slip down from their normal position and push against a collapsed aspect of the vaginal wall. Symptoms such as discomfort, pressure and incontinence can occur.
In proper functioning anatomy, the pelvic floor muscles and ligaments hold the organs in place. During pregnancy, the pelvic floor is constantly under pressure from things like gravity, internal pressure, and the weight of the growing baby. During labor, these muscles stretch and move to accommodate the baby, which can cause strain and injury if there is trauma or tearing. During pregnancy, the body also produces a hormone called relaxin which increases the elasticity of these tissues to prepare the body to give birth. These factors can cause weakening to the pelvic floor structures which can then cause the organs to displace.
There are several different types of Prolapse that can occur:
Cystocele: when the bladder drops down and pushes against the front vaginal wall
Rectocele: when the rectum pushes against the back vaginal wall
Uterine: when the uterus slips down into the vaginal canal
Enterocele: when the small intestine pushes against the top of the vaginal wall
Prolapse can be graded on 1-4 scale generally as follows:
Grade 1: Prolapse descends 50% of the vaginal canal when bearing down
Grade 2: Prolapse reaches the opening of the vaginal canal when bearing down
Grade 3: Prolapse extends beyond the opening of the vaginal canal
Grade 4: Prolapse extends 50% outside of the vaginal canal
How to PRevent Prolapse
There is strong evidence that appropriately prescribed pelvic floor muscle training is very effective at managing and treating prolapse as long as you have a correct pelvic floor contraction, correct exercise dose, and are consistent. Find a pelvic floor kinesiologist or physiotherapist to create a plan with you!
Tips for Managing Prolapse
Avoid straining or bearing down while lifting heavy items and exhale as you do so to reduce excess pressure
Engage and coordinate your pelvic floor, abdominal muscles, core, and breath