Pelvic Support

Another term for pelvic support problems is pelvic organ prolapse. It means that the muscles in your pelvic floor (saddle region) are not effectively holding your abdominal contents in place, and one or more of your organs are beginning to “fall”. There are several causes of pelvic support problems. They include such things as vaginally delivering a baby, chronic cough, chronic constipation, having a job that requires physical labor and lifting, being overweight, and heredity.

There are varying degrees of pelvic organ prolapse. Many women with mild cases of prolapse are completely asymptomatic and are thus unaware of it. Some women have a moderate amount of prolapse, and may experience symptoms like heaviness in the saddle area or lower abdomen, fullness or bulging in the vagina, achy pain in the saddle region that gets worse as the day goes on, difficulty keeping a tampon in place, low backache, incontinence of urine or feces, and pain with intercourse. Finally, women with severe prolapse may even notice the cervix of her uterus, or the very top of the vagina in the case of having a previous hysterectomy, bulging out of the vaginal opening.

There are different types of prolapse. They include:

Cystocele. The bladder drops into the vagina.
Enterocele. The small intestine bulges into the vagina.
Rectocele. The rectum bulges into the vagina.
Uterine Prolapse. The uterus drops into the vagina.
Vaginal Vault Prolapse. The top of the vagina loses its support and drops.
Urethrocele. Bulging of the bladder into the vagina.

Treatment of pelvic organ prolapse depends on the type and severity of the problem. Treatment also depends on some other factors including how old you are, whether or not you plan on having children, whether or not you are sexually active, how severe the prolapse is, how bad your symptoms are, and any other medical issues you may have. Treatments range from having corrective surgery, possibly a pessary fitting, or a weight loss and exercise program including a dietary modification.

Pelvic floor exercises, also called Kegel exercises, are used to strengthen the muscles that surround the openings of the urethra, vagina, and rectum. Doing these exercises regularly may improve incontinence and may slow the progression of pelvic organ prolapse. Our physical therapists can help you be sure you are doing these exercises correctly.

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