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  • Jodi Forster-Molstad

June is Pelvic Organ Prolapse Awareness Month

Did you know that 33-50% of women will have some form of pelvic organ prolapse in their lifetime, and most have never even heard of it?⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀

Pelvic organ prolapse can be defined as the descent of the pelvic organs (the bladder, urethra, uterus, vagina, rectum, or small intestine) toward or through the vaginal or anal opening. Some women with pelvic organ prolapse have no symptoms at all, and some will experience:⠀⠀⠀⠀

  • A bulge at the vaginal or rectal opening that can be seen or felt and that may change depending on position, physical activity or bowel movements.

  • Heaviness or pressure felt in the perineal region (between the vagina and anus).

  • Incomplete emptying of or difficulty evacuating the bladder or bowels.

  • Difficulty initiating urination.

  • Pain is not typically a defining characteristic of prolapse.

There are different degrees of severity of pelvic organ prolapse, that can be identified by a grading system such as the one below.

Baden–Walker half way system [6]. It consists of four grades: grade 0 – no prolapse, grade 1–halfway to hymen, grade 2 – to hymen, grade 3 – halfway past hymen, grade 4 –maximum descent.

While a woman with minimal prolapse may experience no or relatively minimal symptoms, the severity of a woman's symptoms increase along with the grade of organ descent. When a woman presents with a relatively minor grade of prolapse, they will tend to respond quite well by making lifestyle modifications that ensure good bowel health, activity modifications and a progressive pelvic floor exercise strength program. As the pelvic organ prolapse goes up in grade of severity, so does the need for intervention required to help manage the symptoms. Other options include the use of a vaginal pessary that is inserted vaginally to support the organs, or by surgical intervention. Vaginal pessaries offer a less invasive option than surgery, and it is advised that a woman complete 3 months of pelvic floor exercises before deciding on either option.

For more information about pessaries, see my next blog: A Pessary: what is it good for?

Pelvic health therapists can examine a woman and identify the type and grade of pelvic organ prolapse that she has, and help her determine the best plan of care to eradicate, minimize, or manage pelvic organ prolapse. Some pelvic health therapists who have the training and special equipment needed are able to offer a pessary service. They can determine the right type and size of vaginal pessary for a woman, provide them with a pessary, and teach them how to properly care for and mange a pessary to ensure good vaginal health is maintained.

If you are experiencing any of these symptoms and want to learn conservative options, ask your pelvic health physiotherapist to determine what the best treatment plan is for you.


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