Pelvic Organ Prolapse
Pelvic organ prolapse is defined as one or more pelvic organs drop from their normal position. Usually, the organs will drop into the vagina. Often times, there may be more than one prolapses present.
- Uterine prolapse: the uterus drops down into the vaginal canal
- Vaginal vault prolapses: after a hysterectomy, the end of the vagina begins to drop down towards the vaginal opening
- Bladder prolapse: may be seen as a cystocele or anterior prolapse; the bladder drops and bulges into the vaginal wall
- Prolapse of the rectum: May be referred to a rectocele or posterior prolapse; the rectum drops and bulges into the vaginal canal; typically, a rectal prolapse refers to the rectum dropping and protruding from the anus. If the rectum is bulging into the vagina, it will be called a rectocele or posterior prolapse to distinguish it from protruding from the anus
- Small bowel prolapses: May be referred to as an enterocele; a portion of the small intestine will drop and start to bulge into the vagina. This will usually occur in the space between the uterus and the rectum. In situations where the uterus has been removed, it drops down into the space previously occupied by the uterus
It is not unusual for a woman to experience one or more of these prolapses. A prolapse is graded based on how far the organ has dropped. The lowest grade is a minimal descent of the organ and the highest grade is when the organ has dropped low enough to protrude beyond the vaginal opening. Speak to your gynecologist if you have concerns about a prolapse and they will be able grade it accordingly.
There are several causes for pelvic organ prolapse. The most common cause is often childbirth via vaginal delivery. Other causes can include menopause, prior surgeries, repetitive heavy lifting, chronic constipation and straining, and also aging.
Treatment options can be invasive (surgery) or non-invasive. Some of the non-invasive treatments can be pessaries or therapy. Therapy could include pelvic floor muscle strengthening, abdominal strengthening/core stabilization, and behavioral modifications to try to decrease the intra-abdominal pressure that can increase the prolapse. Such behavioral modifications could include: exercise modification, work modification, toileting modifications, etc.
The Kehel can be part of an exercise program to improve or help prevent prolapse. The grip exercises on the Kehel app where you contract to lift the weight from the floor is an excellent exercise for improving muscle strength. To perform this exercise, you must be able to contract your pelvic floor muscles and keep the dumbbell in the air by holding the contraction for six seconds without using your stomach, buttocks, or leg muscles. If you can do this, then continue the exercises progressing from 10 to 30 to 60 to 100 repetitions.
If you can’t keep the weight in the air without using your stomach, buttocks or leg muscles then you will need to see our article, “Kehel Games: What if you can’t catch any fish or lift the weights without straining?”