Pelvic Organ Prolapse and Incontinence

Pelvic organ prolapse and urinary incontinence are two common issues that we treat at PHRC.

Pelvic Organ Prolapse

Pelvic organ prolapse (POP) occurs when the vagina and/or uterus have dropped from their normal position in the pelvis. Prolapse can be caused by injuries sustained during childbirth, aging, chronic coughing and/or heavy lifting.

Research shows that 50% of women that have had children develop POP, and while 30% to 50% of these women never seek treatment, the reality is that 80% to 90% can be successfully treated. Physical therapy is the first-line treatment for women with POP. Your pelvic floor muscles, in addition to connective tissue, provide support for your pelvic organs. Physical therapy can help you identify which muscles are tight, which muscles are weak, and help you maximize your pelvic floor function to eliminate or minimize your symptoms.

Symptoms of Pelvic Organ Prolapse include:

  • pelvic pressure
  • lower backache
  • organ protrusion from the vaginal opening
  • discomfort during intercourse

Stress and Urge Urinary Incontinence

According to research, 25 million adult Americans suffer with incontinence. Of these Americans, 75% to 80% are women; and 9 million to 13 million of them suffer with severe symptoms.

In the case of women, statistics show that 10% to 60% of women suffer from urinary incontinence, and that 30% to 50% do not seek treatment. That’s because women often view urinary incontinence as either an unavoidable consequence of childbirth or a normal part of the aging process. Society actually validates these misconceptions in a number of ways. For instance, depicting new moms making light of how they “leak” every time they laugh or sneeze in the media or by normalizing the condition with advertisements for “incontinence products.”

Frustratingly, when a women initially talks to her doctor about any problems she might be having with incontinence, she is simply told to “do Kegels.” The logic behind this is that incontinence is caused by weak pelvic floor muscles and Kegel exercises are meant to strengthen the pelvic floor. The problem with this advice is that, according to recent research, 51% of women could not perform a Kegel properly with verbal cueing alone. And 25% of the women in the study were actually performing the attempted-Kegel in a manner that could promote incontinence. Another issue with universally telling people with incontinence to “just do Kegels” is that if that person also has a tight pelvic floor, doing kegels can cause pelvic pain. Plus, pelvic muscle weakness is not the only issue that causes incontinence, so muscle strengthening exercises may be completely inappropriate.

As for male urinary incontinence, it is a common problem following prostate surgery. In fact, as many as 50% of men report leakage due to stress urinary incontinence in the first few weeks following prostate surgery after removal of the catheter. In approximately 20% of men, some degree of stress urinary incontinence will continue to be a significant problem one year post-surgery.

The good news is that the physical therapists at PHRC can help both women and men with incontinence issues.

I am very happy with your entire staff and had GREAT success with my treatment.

Related Conditions:

Cystocele

A cystocele is caused by a defect in the anterior vaginal wall that allows the bladder to protrude into the vagina.

Symptoms of a cystocele may include:

  • pelvic pressure
  • lower backache
  • protrusion of the bladder from the vaginal opening
  • discomfort during intercourse
  • involuntary urine loss or retention
Rectocele

A rectocele is caused by a defect in the posterior vaginal wall, allowing the rectum to protrude into the vagina.

Symptoms of a rectocele may include:

  • pelvic pressure
  • lower backache
  • protrusion of the rectum from the vaginal opening
  • discomfort during intercourse
  • constipation

Evaluation and Treatment

During a  patient’s first appointment at PHRC a.k.a. the “evaluation appointment,” a physical therapist will take an extensive medical history. Following the history, the physical therapist will perform a thorough external and internal musculoskeletal examination. You are always welcome to have another individual in the room during evaluation and/or treatment.

Your initial evaluation may include:ID-10097744

  • Postural and structural assessment
  • Evaluation of connective tissue in the abdomen, back, pelvis and lower extremities
  • Myofascial evaluation of the pelvic girdle muscles
  • Examination to identify myofascial trigger points in the pelvic girdle and pelvic floor muscles
  • Pelvic floor examination (done by gently inserting a gloved, lubricated, finger into the anus) to assess muscle tone, motor control, strength, nerve and coccyx tenderness
  • Evaluation of muscle strength
  • Skin inspection
  • Peripheral altered neurodynamics testing/palpation

Following the physical examination, your physical therapist will discuss your physical findings, their assessment, and your prescribed treatment plan. This will include the suggested frequency and duration of physical therapy. For local patients,  physical therapy treatments are weekly and typically thirty minutes to one-hour in length. Usually a patient will undergo eight sessions, at which time we will perform a re-evaluation and set new goals based on progress. The sessions are about two weeks apart initially and then one month apart once an exercise program is established. Patients with pelvic organ prolapse are typically seen six to eight times over a three to six month period.

I never knew something like pelvic health rehab existed and I am so glad to have found you. Every time I walk into the office, I am greeted with friendly smiles. The experience at PHRC is all around fun and friendly, but very professional. I have and will continue to recommend PHRC. Thanks again!

The treatment you will receive at PHRC will be 100% one-on-one physical therapy. You will never be left alone in a room hooked to a machine, or left in the care of a PT’s assistant.

In addition, at PHRC we embrace a multidisciplinary treatment approach, meaning that our therapists draw from all appropriate medical disciplines to develop a comprehensive treatment plan for our patients. Toward that end, we have established a wide network of pelvic floor specialists throughout the country that we regularly draw from to round out our patients’ healing. Once your team of providers is in place, we embrace the role of team leader. In that role, we communicate and coordinate with all other providers as well as recommend any adjunct treatments that we believe can play a role in your healing.

Another important tenet of our care is patient communication. Prior to your first appointment and throughout the treatment process, you will have access to your PT to ask questions or discuss concerns. It is our commitment that in every area of treatment, we will take that extra step (or leap!) to ensure that you receive the best treatment possible to meet your goals.