Pelvic Organ Prolapse (POP)- 03

1- What Is Pelvic Organ Prolapse?
2- Pelvic Organ Prolapse Symptoms
3- How Do I Know If I Have Pelvic Organ Prolapse?

4- Types of Pelvic Organ Prolapse
5- How Is Pelvic Organ Prolapse Treated?
6- Treating Pelvic Organ Prolapse at Home

7- Physical Therapy for Pelvic Organ Prolapse
8- Kegel Exercises (Pelvic Floor Exercises)

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7- Physical Therapy for Pelvic Organ Prolapse

Do I Need Physical Therapy for Pelvic Organ Prolapse?

Physical therapy can offer long-term relief from your pelvic organ prolapse symptoms by strengthening core muscles. These exercises are used in addition to Kegels to strengthen muscles on your pelvic floor. Together, they can help improve the symptoms of mild to moderate prolapse.

You may need physical therapy (PT) for pelvic organ prolapse if you:

• Can see or feel a bulge coming through your vagina
• Have urine leaking from your bladder or have a hard time peeing or pooping
• Feel different during sex
• Don’t feel quite right as you go through your daily routines

Your OB-GYN will examine you. She’ll ask about your symptoms and how much they bother you. If she recommends PT, she can also help you find a physical therapist who specializes in exercises for pelvic organ prolapse.

How Does It Work?

Physical therapy for pelvic organ prolapse involves special exercises for the abdominal muscles (“abs”) and lower back. These make up what doctors call your “core.” Your physical therapist will teach you the exercises and breathing techniques. You’ll also learn about proper posture.

Exercises to work the core include things like side planks. To do them, lie on your right side so that your head and feet are in a straight line. Your elbow should be directly under your shoulder. Using your ab muscles, gently lift your hips off the floor, keeping your hips and spine straight. Repeat two to three times, then shift sides.

Typical ab workouts such as crunches or sit-ups may make your symptoms worse by putting more pressure on the pelvic floor.

In addition to the exercises, your physical therapist may teach you how to move through your typical day without making your prolapse worse.

Physical therapy is most effective for minor pelvic organ prolapse. Your doctor will likely recommend surgery if your prolapse is more severe.

Do I Still Need Medical Treatment?

You can also do PT if you use a pessary. That’s a plastic device that’s inserted into your vagina like a diaphragm. It provides support for vaginal or uterine prolapse.

In addition to exercises, your PT may use pelvic floor electrical stimulation.

Percutaneous tibial nerve stimulation (PTNS) delivers an electrical impulse to your ankle. The impulse travels up a nerve in your leg to the nerves that control your bladder. If you get PTNS, you’ll probably start with a 30-minute treatment at the physical therapist’s office during 12 weekly visits.

Your therapist may also recommend you lose weight or seek treatment for things like ongoing (chronic) constipation or a cough that won’t go away. Both of these things strain your pelvic floor muscles.

How Will I Know if It’s Working?

The goal of PT is to reduce your symptoms and stop your prolapse from getting worse. You’ll know it’s working if your symptoms improve.

Even with physical therapy, your doctor will probably tell you to stay away from high-impact activities like running, jumping, or jumping jacks.

You’ll see a physical therapist until you’ve mastered the exercises and can do them the right way on your own. This generally takes about 6 weeks.

Afterward, you’ll need to keep doing the exercises to keep up the benefits. If you stop, the muscles will weaken and your symptoms could get worse.

8- Kegel Exercises (Pelvic Floor Exercises)

What Are Kegels and Why Should I Do Them?

Kegel exercises (also called “pelvic floor exercises”) strengthen your pelvic floor muscles. These muscles support your uterus, bladder, small intestine, and rectum. Kegels don’t just help keep them “fit” -- they can help you avoid embarrassing accidents, like bladder leakage and passing gasand -- or even stool -- by accident. They can even improve your orgasms.

The Case for Kegels

When they’re working like they should, your pelvic floor muscles may never cross your mind. But over time -- as we age -- these muscles can start to weaken. This puts us at risk for a condition doctors call “pelvic organ prolapse” (POP). Basically, your pelvic organs start to droop. They can start to fall into or out of your vagina. Sometimes, if you’ve had a hysterectomy, your vaginal tissues can start to come out of your body, too.

Other things that put you at risk for POP include:

• Pregnancy
• Giving birth through the vagina
• Surgery in the pelvic area (C-section or hysterectomy)
• Genetics
• Frequent coughing, laughing, or sneezing (it pushes on the pelvic organs)

How Do I Do Them?

Sit on the toilet and try to pee. Once urine starts to flow, squeeze your muscles to hold it in. You should feel the muscles inside your vagina “lift.” You just did one Kegel. Relax the muscle and do it again.

Start slowly. Try squeezing your pelvic floor muscles for 3 seconds, then release for 3 seconds. Do this 10 times in a row. That’s one set. If you can’t do 10, do as many as you can and build up over time. Try to work up to one set of 10 Kegels two to three times a day.

Kegels aren’t harmful. In fact, you can make them a part of your daily routine. Do them while you’re brushing your teeth, driving to work, eating dinner, or watching TV. But don’t get into the habit of doing them while you pee. You can actually cause other problems, like urinary tract infections.

How Long Before I See Results?

Most women who do Kegels regularly see results (such as reduced urine leakage) within a few weeks or months. If you’re still concerned about your prolapse or don’t feel your symptoms are getting better, talk to your doctor about other treatments.