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 for pelvic support problems. They include such things as: vaginally delivering a baby, chronic cough, chronic constipation, having a job which 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 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 back ache, 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:
• Uterus (uterine)
• Bladder (cystocele)
• Urethra (urethrocele)
• Rectum ((rectocele)
• Small intestine (enterocele)
• Vagina (vaginal vault)

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

The physical therapy management of pelvic organ prolapse may include the following: biofeedback, postural training, pelvic floor strengthening, patient education, manual therapy, and individualized home exercise program.