Restoring stability: Understanding pelvic organ prolapse

Pelvic organ prolapse (POP), also known as pelvic prolapse or pelvic floor prolapse, is a common condition that affects many women, especially after childbirth or as they age. At Essential Alchemy’s medispa in Perth, we understand the impact this condition can have on your quality of life and are dedicated to offering treatments that can help you regain your confidence and well-being.

What is pelvic organ prolapse?

Pelvic organ prolapse occurs when the muscles and fascia supporting the pelvic organs (such as the bladder, uterus, and rectum) become weak or damaged. This weakening can cause one or more of the pelvic organs to lower (prolapse) from their normal position and either press against the walls of the vagina, or when severe, emerge from the body. (1)

Exploring pelvic organ prolapse: Causes and symptoms

Causes of pelvic organ prolapse

Pelvic organ prolapse can result from a variety of causes, each contributing to the weakening of the pelvic floor muscles and connective tissues, including:

• Childbirth: Vaginal delivery, particularly when the use of instruments is required, can weaken or damage the pelvic floor muscles.
• Ageing: As women age, the risk of pelvic organ prolapse increases due to the natural weakening of muscles and tissues coupled with the effect of gravity exerting a downward pressure on the pelvic floor.
• Menopause: A decrease in oestrogen levels during menopause may contribute to a loss of pelvic floor muscle or fascia tone.
• Chronic coughing: Conditions like chronic bronchitis or persistent coughing can place extra pressure on the pelvic floor, especially if its myofascial integrity has already been weakened.
• Heavy lifting: Lifting heavy objects increases intra-abdominal pressure with each effort, the cumulative strain places excessive downward force on the pelvic floor muscles.
• Genetics: Some women may be more predisposed to pelvic prolapse due to genetic factors.

Symptoms of pelvic organ prolapse

The symptoms of pelvic organ prolapse can vary depending on the severity of the condition and the specific organs involved. Common symptoms include: (2)

• A feeling of heaviness or pressure in the pelvic area.
• A noticeable bulge in the vagina.
• Difficulty emptying the bladder or bowel completely.
• Incontinence or frequent urination.
• Pain during intercourse.
• Lower back pain.

Experiencing bladder incontinence? Speak to us about how Emsella may be able to help.

Types of pelvic organ prolapse and their impact

There are several types of pelvic organ prolapse, each affecting different organs and having unique impacts:

• Cystocele: Prolapse of the bladder into the vagina, which can lead to urinary issues or incontinence.
• Rectocele: Prolapse of the rectum into the vagina, which may cause bowel dysfunction.
• Uterine Prolapse: Prolapse of the uterus into the vaginal canal, often resulting in pelvic discomfort including painful intercourse.
• Enterocele: Prolapse of the small intestine into the vaginal space, contributing to pelvic pressure.

Each type of prolapse can significantly affect daily life, underscoring the importance of understanding and addressing these conditions.

Importance of early detection and diagnosis

Early detection and diagnosis of pelvic floor prolapse are vital for effective management. A pelvic health exam with a women’s health physiotherapist and prompt reporting of symptoms to healthcare providers enable early intervention.

Diagnostic tools such as pelvic floor ultrasound, MRI, and physical exams help to accurately identify the type and extent of prolapse, and facilitate tailored treatment plans.

Treatment options for pelvic floor prolapse

Treatment for pelvic organ prolapse varies based on the severity of the condition and patient preferences. Non-surgical options include:

• Pelvic floor muscle training (PFMT) with a women’s health physiotherapist: Also known as Kegel exercises can strengthen the pelvic floor muscles and provide relief from symptoms. The NICE Guidelines recommend a 16-week course of supervised PFMT for women with symptomatic POP (3)
• Pessary devices: A pessary is a removable device inserted into the vagina to support the prolapsed organs.
• Hormone therapy: Oestrogen therapy can help improve the strength and elasticity of the pelvic tissues, particularly in postmenopausal women.

For more severe cases, surgical interventions might be necessary to restore normal anatomy and function.

Lifestyle changes to support pelvic floor health

Adopting lifestyle changes can support pelvic floor health and prevent the progression of prolapse. Maintaining a healthy weight (3), avoiding heavy lifting, managing constipation, and quitting smoking can all contribute to reducing the load on the pelvic floor.

Additionally, incorporating a balanced diet rich in fibre and staying hydrated supports bowel health, and reduces constipation and the need to strain.

Incontinence issues related to pelvic organ prolapse

Incontinence is a common issue that often accompanies pelvic organ prolapse. The weakened pelvic floor muscles may lead to stress urinary incontinence, where activities such as coughing, sneezing, or exercising cause urine leakage. This can be distressing and significantly affect one’s confidence and quality of life.

The International Consultation on Incontinence advises that “supervised pelvic floor muscle training (PFMT) should be offered as a first-line conservative therapy for women of all ages with urinary incontinence”. (4)

How Emsella can help

At Essential Alchemy, we offer the Emsella treatment to address incontinence issues related to pelvic floor prolapse. Emsella is a non-invasive treatment that uses high-intensity focused electromagnetic (HIFEM) and radio frequency (RF) energy to stimulate the pelvic floor muscles.

Benefits of Emsella

• Improved muscle strength: Emsella induces thousands of supramaximal pelvic floor muscle contractions in a single session, strengthening the muscles more effectively than traditional exercises.
• Non-invasive and comfortable: The treatment is completely non-invasive, allowing you to remain fully clothed and comfortable during the sessions.
• Quick sessions: Each session lasts about 28 minutes, making it easy to fit into your schedule.
• No downtime: You can return to your daily activities immediately after treatment.

Want to enquire about Emsella? Book a free consultation today.

Tips for preventing recurrence of pelvic prolapse

Preventing the recurrence of pelvic prolapse involves ongoing attention to pelvic health. Continuing pelvic floor exercises, maintaining a healthy weight, and avoiding activities that put excessive strain on the pelvic muscles are crucial. Regular follow-up appointments with healthcare providers help monitor pelvic health and promptly address any early signs of recurrence.

Understanding pelvic organ prolapse and implementing these strategies can lead to significant improvements in pelvic health and overall well-being. By taking proactive steps, individuals can restore stability and enjoy a higher quality of life.

References

1. HandaVL,RoemJ,BlomquistJL,DietzHP,MuñozA.Pelvic organ prolapse as a function of levatorani avulsion, hiatus size, and strength. American journal of obstetrics and gynecology. 2019 Jul 1;221(1):41-e1.
2. Haylen BT, Maher CF, Barber MD, Camargo S, Dandolu V, Digesu A, Goldman HB, Huser M, Milani AL, Moran PA, Schaer GN. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP). International Urogynecology Journal. 2016 Feb 1;27(2):165-94
3. NICE National Institute for Health and Care Excellence. NICEGuideline123:Urinary Incontinence and Pelvic Organ Prolapse in Women: Management. NICE National Institute for Health and Care Excellence.https://www.nice.org.uk/guidance/ng123. Published 02 April 2019, Updated 24th June 2019.
4. Incontinence 6th edition 2017 vol 1 & 2 – Abrams P, Cardozo L, Wagg A, et.al. Incontinence 6th edition ICI-ICS Bristol: International Continence Society edn. 2017.