Organ descent (pelvic organ prolapse)
Pelvic prolapse, commonly known as organ descent, is the descent of one or more pelvic organs (e.g. bladder, urethra, uterus, rectum and colon) into the vaginal canal. Approximately 40% of women aged 50 and over will experience organ descent, but younger women can also suffer. Bladder descent is the most common.
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What is pelvic organ prolapse?
Pelvic prolapse, commonly known as organ descent, is the descent of one or more pelvic organs (e.g. bladder, urethra, uterus, rectum and colon) into the vaginal canal.
Approximately 40% of women aged 50 and over will experience organ descent, but younger women can also be affected. Bladder descent is the most common.
What causes pelvic organ prolapse?
Organ descent occurs when the tissues supporting the organs (e.g. muscles, ligaments) weaken or become damaged.
Certain factors can increase the risk of organ descent:
- Aging;
- Lifestyle habits (e.g. smoking);
- Pregnancy and childbirth;
- Chronic constipation and/or poor defecation technique;
- Chronic cough or chronic lung disease;
- Pelvic surgery (e.g. hysterectomy);
- Repetitive lifting (e.g. at home, at work, in sports);
- Medical conditions that weaken connective tissue (e.g. Ehlers-Danhlos syndrome, Marfan syndrome).
What are the symptoms of pelvic organ prolapse?
Organ descent may be asymptomatic or accompanied by numerous symptoms such as :
- A sensation of vaginal heaviness;
- The sensation of a foreign body inside the vagina;
- The sensation that something is coming out of the vagina (e.g. when using the toilet or shower);
- Pressure or pain in the lower back;
- Difficulty urinating or having a bowel movement;
- Difficulty emptying the bladder (urine) or rectum (stool) completely;
- Pain during sexual relations (e.g. dyspareunia);
- Urinary or fecal leakage (e.g. incontinence).
How is pelvic organ prolapse diagnosed?
Diagnosis is made through a subjective and physical examination in the clinic. There are also medical tests that can be prescribed by a doctor.
How can physiotherapy help pelvic organ prolapse?
Your perineal rehabilitation physiotherapist will first carry out a complete assessment (e.g. lifestyle habits, posture, breathing, pelvic floor muscle contraction/relaxation, etc.) to determine the cause(s) of the organ descent.
Based on the assessment results, your physiotherapist will:
- Mobilize the muscles and soft tissues in the abdomen and pelvic floor;
- Give you specific exercises to do at home to address the cause of the problem (e.g. strengthening, etc.);
- Teach you how to properly manage your daily activities and hobbies to optimize healing;
- Give you advice on lifestyle, postural habits and movement.
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If that's not enough, your physiotherapist may recommend the use of a pessary, a silicone orthosis that provides additional support for the descended organ.
Finally, if physiotherapy treatment is not sufficient, your physiotherapist will refer you to your doctor to assess your other options (e.g. surgery).
When should I seek physiotherapy for pelvic organ prolapse?
You should consult a physiotherapist if you have one or more of the symptoms described above or if your doctor has ruled out any other causes that may be responsible for your symptoms.
You can also consult a physiotherapist for prevention. If you have no symptoms but have one or more of the above-mentioned risk factors, you may benefit from a consultation to prevent the onset of organ descent.
You do not need to see a doctor before consulting a physiotherapist. If your condition requires you to see a doctor, your physiotherapist will be able to tell you.
What can I do at home for pelvic organ prolapse?
If you feel a heaviness or presence in the vagina:
- lie on your back with your pelvis supported on one or more cushions, so that your hips are slightly higher than your shoulders
- If you have difficulty urinating or having a bowel movement: place your feet on a small bench at the toilet, press your knees together and lean forward slightly.
To learn more...
You can view the podcast "Talk to me about health" produced by one of our physiotherapists, Alexis Gougeon.
Episode #23 discusses perineal and pelvic rehabilitation:
Find the episode on YouTube :
Click below to listen to episodes on podcast platforms:
https://open.spotify.com/episode/4K8MhluZYTYDzmFNn2dDAt?si=a7a8e4a1a64f4cbd
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