Pelvic Organ Prolapse (POP)

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Pelvic organ prolapse is the medical term for what happens when the tissue between your bladder, vagina, uterus, and/or rectum become less supportive and these organs push in on one another.

Because the vagina has more of an opening than the other sealed organs, pressure from the bladder, rectum, or uterus are most likely to push in on the vagina. This is called a “cystocele” (when the bladder pushes in on the vagina), a “rectocele” (when the rectum pushes in on the vagina), or a “uterine prolapse” (when the uterus pushes in on the vagina). Prolapse occurs sometimes after a hysterectomy; when the uterus is removed, because it leaves an empty space in the pelvis. Tissues move due to this space and prolapse may occur as a result. Prolapse occurs in 50% of women who have given birth vaginally. The amount of prolapse that occurs is graded by how much of the bladder/rectum/uterus pushes in on or out of the vagina.

Symptoms from prolapse are different for each women. Changes in how often you have to use the bathroom, or how strong the urge is to go; discomfort during sex; and feeling heaviness, fullness, or that things are falling out in your pelvic region are some symptoms that may be experienced. Not everyone that has prolapse has symptoms. The symptoms that are experienced are different for each women.

At Alkaline Wellness, we take a conservative, long term approach to addressing your issues:

  • Pelvic floor muscles are trained for appropriate activation, strength, and endurance. Exercises will progress so you can make them part of your daily activities.
  • Biofeedback is utilized to ensure the muscles are activating properly and you can complete the contraction the right way on your own.
  • Progression of exercises begins with pelvic muscle strength assessment and activating the pelvic floor with breathing exercises.

In a 2011 study conducted by Braekken et al, in comparison of weekly physiotherapy vs control group for pelvic floor muscle training, the group that received pelvic floor muscle training had less surgery and experienced symptoms less often than the group that had no physiotherapy. In a 2014 study by Weigersma et al, women with a mild degree of prolapse had 50% better recovery in symptoms than those who were put into a “watch-and-wait” group.

  1. Hagen S, Thakar R. Conservative management of pelvic organ prolapse: Review. Obstaetrics, Gynaecology, and Reproductive Medicine. 2015; 25:4:91-96.
  2. Hagen S, Stark D, Glazener S. Individualized pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomized controlled trial. Lancet 2014; 383: 796–806. Published Online November 28, 2013
  3. Braekken IH, Majida M, Engh ME, Bo K. Can pelvic floor muscle training reverse pelvic organ prolapse and reduce prolapse symptoms? An assessor-blinded, randomized, controlled trial. Am J Obstet Gynecol 2010;203:170.e1-7.
  4. Weigersma M, Panman C, Kollen B, et al. Effect of pelvic floor muscle training compared with watchful waiting in older women with symptomatic mild pelvic organ prolapse: a randomized controlled trial in primary care. BMJ 2014;349:g7378 doi: 10.1136/bmj.g7378 (Published 22 December 2014)
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