POP, Pelvic Organ Prolapse, is experienced by almost 70% of women, yet fewer than 28% of us know what it is! Let’s define it, unravel its causes and most importantly, learn how to assess, stabilize, prevent and reverse POP.
What is pelvic organ prolapse? The International Uro-gynecological Association defines POP as “the bulging/herniation of one or more of the pelvic organs (uterus, vagina, bowel, and bladder) into or out of the vagina.” POP occurs when the muscles, ligaments, and fascia (a network of supporting tissue) that hold these organs in their correct position become weakened. POP is common because its causes are so common: pregnancy, labour and childbirth, aging and menopause, genetics and family history, obesity, chronic cough, chronic constipation, heavy lifting (work or play), hypermobility (naturally stretchy people) and pelvic surgeries (especially hysterectomies). Often the impact on supportive structures earlier in life (i.e. pregnancy) that create prolapse will not be functionally obvious until menopause. That’s why being assessed for POP at any time in a woman’s life is so helpful…..it is usually preventable!
How would you guess that you have POP? Women describe heaviness or a dragging sensation in the vagina or pelvic floor, a lump or bulge in the vagina, aching discomfort in the pelvic region, urinary or bowel problems, a dull backache or sexual problems. These symptoms often worsen with activity or simply as the day goes on. Bladder and bowel problems involve incomplete emptying, feeling the need to bear down or use manual help to finish the job on the toilet. If the bladder prolapses on its own, it can create chronic bladder infections. This is due to kinking of the bladder neck before you’ve completely emptied leaving just enough urine behind to brew up another infection. POP must be assessed functionally, graded, on repeated testing and with an understanding of the deep core system and breathing patterns. Our bodies are supremely clever at recruiting “help”, but often those patterns of recruitment cause further dysfunction.
What can you do about POP? Reversing POP is a new and exciting world in pelvic physiotherapy. We used to think that surgery was the only option…….a challenging surgery and one that is oft repeated due to structural failure as life’s activities challenge the repaired structures. In a recent study in Vancouver, 79% of prolapse surgeries were cancelled after 8 weeks of pelvic physiotherapy, thereby avoiding the risks inherent in surgical intervention.
Creston has a bounty of options for you:
Pelvic physiotherapy will help you to make the changes necessary including integrated pelvic floor and deep core muscle training, establishing healthy bladder, bowel and lifestyle habits, and learning healthy ergonomics for coughing, toileting, lifting, sport/exercise and sitting/standing/resting your body through the day. Pelvic Physiotherapy is available at Full Circle Health Centre with Joanne Gailius. An assessment and a few follow-up sessions are usually all that you’ll need. Hypopressive training is available locally at Spitfire Fitness with Jenn. Group and individual Pelvic Yoga Therapy is at The Yoga Room with Barb. With your gynecologist, you may be fitted for a pessary, a ring that is inserted into the vagina to hold up the organs. After trying all conservative options, you may need surgery. You’ll be ready and able to employ all the skills that you’ve learned already and you’ll have greater benefit from the surgery!
Pelvic organ prolapse is common but not normal. Learn about your pelvis, your deep core strength and a strong and healthy body through life’s seasons.