Pelvic Organ Prolapse
What is Pelvic Organ Prolapse?
“a departure from normal sensation, structure, or function, experienced by the woman in reference to the position of her pelvic organs”
-The International Urogynecology Association (IUGA) and the International Continence Society (ICS)
Descent or herniation of pelvic organs from normal attachment sites or normal position in the pelvis into the vagina or beyond.
Isolated or global
Muscular, ligament and fascia weaknesses
Stages:
“Prolapse stage ≥2 has been demonstrated among 37% of women presenting for annual gynecologic examinations. It seems to make little sense to define something as stage 1 or 2 of a disease process that is very common, benign, and not predictive of symptoms or progression.”
-Dietz & Mann 2014
Etiology:
POP can be acquired by Trauma, abdominal pressures, pregnancy. It can also be congenital secondary to connective tissue defect, or neurologic defect. It may also be a part of the aging process due to loss of hormones.
It is estimated that POP is associated with Stress Urinary Incontinence (leakage of urine) in 40% of the cases.
Risk Factors:
Obesity BMI > 25
Hysterectomy
Previous prolapse surgery
Defective connective tissue
Denervation
Myopathy leading to wide levator ani hiatus
Increasing age
Chronic cough (allergies/asthma/smoking)
Constipation and straining § Family history of POP
Signs of a connective tissue disorder (hemorrhoids, hernias)
Heavy occupational
Vaginal delivery (especially forceps delivery)
Treatment:
Pessaries- Prosthetic devices to help assist internal structure
Behavioral: Weight Loss, Smoking Cessation, Decrease straining with activity modification
Pelvic Floor Rehabilitation uses exercises and evidence based methods
Surgeries to restoration normal anatomy
To get treated by a professional that has advanced training in this field, ask if your healthcare professional (nurse, PA, MD, OT, PT, or NP) is BCIA Board Certified.
To ask us more questions, email us at smplytherapy@gmail.com
