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Ask Hina :: What’s a PROLAPSE and how do I know if I have it?

 

Prolapse is very common when you’ve had children, especially multiple children. Carrying and delivering the baby puts a lot of pressure on the organs, specifically the uterus, bladder and rectum.

That pressure can push down on those organs and push them out of the vaginal or rectal canal and cause pressure or discomfort in the low back or it sometimes causes a dull type pain in the vaginal area or rectal area (not common put some people come in with that). You can have constipation, because the rectum, if that’s fallen enough, blocks the opening so you might feel like you have to move something out of the way in order to have a bowel movement.

There are four types of prolapses you can have: 

  • *Uterine prolapse, uterus has fallen into vaginal canal
  • *Vaginal prolapse, vagina falls into the vaginal canal
  • *Bladder prolapse, Bladder falls into the vaginal canal
  • *Rectal prolapse, rectal falls into the Rectal canal

What do I do?!

It’s nothing to be scared about, it’s not a medical emergency. But you don’t want to walk around with a prolapse.

The first thing I would recommend is to see your gynecologist and see if they think it’s significant enough and what to do about it.

We’re fortunate in the Philadelphia/Main Line area to have wonderful hospital systems and many gynecologists are conservative and they will recommend pelvic floor physical therapy as a more conservative treatment. However, if you were told to go straight to surgery, especially if it’s mild to moderate, I highly recommend getting evaluated by an integrative holistic pelvic floor physical therapist.

What I mean is that someone who’s not just going to give you Kegel exercises to do for strengthening your pelvic floor. That was the old model for how to treat prolapses conservatively way back. We’ve come to the understanding that it’s not just doing Kegel exercises to strengthen the pelvic floor that’s going to keep these organs up.

How can my alignment affect a prolapse?

One of the big things you also have to address when treating a prolapse is the alignment of the body.

Your organs sit in your pelvis. Depending on the posturing of the body, if you tilt in one direction more, the organs will sit in a position based on the alignment of your body and push down in a different direction. When you’re in good alignment, the normal pressure in the body will push them forward toward the pubic bone versus down through the opening of the vagina and the rectum. When your alignment is off, you’re going to have an imbalance of pressure and that pressure can push things down outside of the canal.

There’s a lot of things such as stretching, strengthening, soft tissue and hands on work to improve this that will help to balance the pressure so it’s pointing more forward instead of down. And then if we need to go in to teach you exercises to strengthen the pelvic floor we may add that in addition to a lot of other things.

Kegels might make pelvic pain WORSE

For some of you experiencing pain, as well as having a prolapse, vaginal pain in general, rectal pain in general, pain with intercourse, IBS, the pelvic floor could actually be TOO tight. There are many people who have tightness of their pelvic floor AND they have a prolapse. You don’t want to strengthen your pelvic floor if it’s already too tight because that will just create more imbalance and more pain.

Your body works as a whole, it doesn’t work in different pieces. We need to look at everything in an integrative fashion – everything in your body works together.

For those of you experiencing a pelvic organ prolapse, I highly recommend getting evaluated by an integrative pelvic floor therapist prior to getting surgery.

Think you might have a prolapse? You can schedule a complimentary phone consultation to discuss your symptoms here.

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