Things that Droop: Pelvic Organ Prolapse
Do you feel as though something is falling out of your body? You may have problems describing this feeling. But you have been feeling it. And maybe you’ve been feeling it for a long time. Perhaps since you have had your children? Maybe that was a long time ago. Maybe it was more recent. But have you been feeling as if…something is falling out of your body? Literally?
You are not crazy—and you are not alone! You are feeling like something is falling out of your body because something is literally falling out of your body. This condition is called Pelvic Organ Prolapse.
Pelvic Organ Prolapse occurs when a pelvic organ (bladder, uterus, rectum) ‘drops’ or prolapses from its normal place in your lower belly and pushes against the walls of your vagina. This can happen when the muscles that hold your pelvic organs in place get weak or stretched from childbirth or surgery.
There are many layers of muscles and connective tissue in your pelvis. These muscles and connective tissue support your pelvic organs. There has to be a space or ‘hole’ in these muscle layers in order for your pelvic organs to have an outlet. Your bladder needs to eliminate urine through your urethra. Your large intestine needs to eliminate stool through the rectum. Your uterus needs to deliver a baby through your vagina. There needs to be a space in the muscle layers to allow for these organs to perform these functions. The problem is that the organs themselves can slip down through this space. This is called a prolapse.
You may feel as if something is falling out. You may feel like there is a lump slipping down. You may feel heaviness in your abdomen. Or you may find it difficult to insert a tampon—it may feel as if something is in the way. Sex may feel awkward if your partner feels that there is something in the way.
You may feel as though you need to push on your low abdomen in order to fully empty your bladder when you go to the bathroom. Or maybe you need to stand up or sit forward or squat in order to fully empty your bladder. This is because your bladder has dropped and is not positioned where it usually is positioned.
The weakness is in the wall of your vagina as well. The weak walls of your vagina are allowing the bladder or rectum to drop and push in. You may even be able to see a bulge if you look at your vaginal opening when you go to the bathroom. It may bulge more when you cough or sneeze or bear down.
Also you can have several organs dropping at the same time. Your bladder can drop, your uterus can drop and your rectum can drop. OR they can all drop at the same time (or two at the same time). Sounds awful, doesn’t it?
Don’t fear! There is help! And hope!
What you can do about it:
- Pelvic Physical Therapy
See a women’s health physical therapist to learn of exercises you can perform to strengthen your pelvic floor muscles and support your pelvic organs more efficiently. Prolapses are staged. If you are in the earlier stages, physical therapy can be very effective to control your symptoms and stabilize your pelvis.
A pessary is a device that is placed into the vagina to support the uterus or bladder and rectum. It is a firm ring that presses against the wall of the vagina and urethra to help decrease urine leakage. It can help the severity of your symptoms. Your doctor would show you how to use this device. You may leave it in place or take it out and clean it as necessary. This is sort of a ‘band-aid’. Many women choose this option instead of surgery.
This should be your last option! This option is also offered to women who are closer to a Stage 4 prolapse. Stage 4 prolapse means that the woman’s pelvic organs may be slipping past the surface of her body. Her uterus may be outside her body. In this case, surgery would be appropriate. There are many different types of surgeries, materials, and approaches used. The surgeon may ‘secure’ the organ to the pelvic wall using different materials. Seeing a pelvic physical therapist before and after surgery will help facilitate the rehabilitation process.
Speak to your doctor to find out which option is best for you. Don’t worry, there is hope and help out there. You don’t have to live with this discomfort. Make sure you address the problem as it is a progressive condition.