Pelvic Organ Prolapse: Strategies for Management
Support of the pelvic organs depends on the integrity of the pelvic floor muscles, connective tissue and nerves. Loss of this support can lead to a pelvic organ prolapse.
Pelvic organ prolapse symptoms often include a sensation of fullness or pressure in the pelvis, difficulty with urination, incontinence, and pelvic or low back pain.
This is a common condition but there is much you can do to help:
Constipation management: It is important to avoid straining with a bowel movement. If you have constipation be sure to discuss management strategies with your doctor and pelvic floor therapist.
Positioning: When you are having symptoms you can try lying on your back with your feet up on a chair, wall, or exercise ball and your pelvis supported on a pillow or wedge. Practice deep breathing or pelvic floor exercises in this position.
Pelvic floor contractions: Well-functioning pelvic floor muscles support urinary function and lessen prolapse. Pelvic floor exercises (especially with integrated with a strong core) can help with the symptoms of prolapse and provide support during a cough or sneeze. Your pelvic floor therapist can help!
Lifting techniques to decrease pressure: When you lift an object try to have it directly in front of you and as close to you as possible. Exhale as you lift and engage your pelvic floor. Keep your ribs lifted away from your pelvis. Store heavier objects on a shelf, so you are not lifting them from the ground.
Splinting: Place your thumb or fingers directly over the perineum (between the vagina & anus) and apply gentle support to the tissues as you have a bowel movement. If your rectum is causing the pressure you may also place your thumb inside the vaginal canal and gently press toward your rectum for support or assistance during a bowel movement.
Reduce double voiding: For bladder emptying, once you have emptied, if you feel like there is still urine in your bladder try leaning forward, back, side to side. Also try doing pelvic floor squeeze/relax sets. You can also try standing up and sitting back down but our goal is to reduce this need.
SOURCES:
Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women. Wallace et al. 2019 Current Opinions in Obstetrics & Gynecology
Pelvic Guru , LLC 2020. All rights reserved. This document is not reproducible without permission except as a patient handout.
