Pelvic Organ Prolapse

A Pelvic Organ Prolapse (POP) is when one or multiple pelvic organs, such as the bladder, uterus or small bowel, descend toward the vagina, rectum or both. Throughout pregnancy, the carrying of a baby for 9 months, puts extensive pressure on the pelvic floor muscles - contributing to POP. The condition is further exacerbated during labour when exertion from pushing out the baby, perineal tearing and the use of forceps increase the likelihood of POP occurring. It is estimated that close to 50% of postnatal women have some degree of POP.


Some causes of prolapse:

  • Pregnancy and childbirth

  • Repetitive lifting of children and heavy objects

  • Being overweight

  • A constant cough

  • Straining on the toilet.

There are several types of prolapse but the three most common are:


• Cystocele. The bladder bulges through the front wall of the vagina.

• Rectocele. The rectum descends through the back vaginal wall

• Uterine. The uterus drops down into the vagina.


How do I know if I have POP?

  • A bulge felt in the vagina

  • A feeling of heaviness and or downward pressure on the vagina

  • Pain, discomfort or less sensation during intercourse

  • Regular urinary tract infections

  • Feeling like the bladder or rectum doesn’t empty completely when going to the toilet.

There are also different grades of the severity!


Management


There is a lot you can do to improve symptoms such as:

  • Keeping good bowel habits to avoid straining, eat plenty of fibre and drink plenty of water to prevent hard stools.

  • Core and pelvic floor training – throughout your pregnancy and postnatally

  • Paying attention to your alignment, the pelvic floor/core can’t do its job correctly when your alignment is out. Many women have postural changes following pregnancy which results in a tucked under bum and hips jutted out and the rib cage flared and the pelvis is in an anterior pelvic tilt.

  • Exhale on exertion and engage the pelvic floor when exerting yourself eg: lifting children, going from sitting to standing, exercising.

  • Avoid exercise that increases intra-abdominal pressure such as crunches, sit-ups and planking and double leg raises, pilates 100’s.

  • Avoid high impact plyometric exercises such as running, skipping, jumping and burpees and lifting a heavy weight that increases pressure such as an overhead press and barbell squats.

  • And avoid lateral lunging and movement that is getting the legs wide eg; sumo squats.

  • Take precaution when loading the body with weight and be mindful to how it feels, do you feel heaviness and pressure?

  • Play it safe! Visit a women’s physiotherapist following having your baby for an internal examination and before you commence an exercise program.

You may definitely exercise, if you have a prolapse and you can strength train, also but the exercise has to be prolapse safe. Use of the pelvic floor and the breath will help to manage the symptoms of a prolapse.


Kylee


Kylee Todd

Postnatal & Beyond

Personal Training & Group Fitness - Canberra

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