IS THIS DIAGNOSIS HELPFUL???
June is Pelvic Organ Prolapse Awareness Month!
As the month draws to an end I wanted to highlight a few thoughts on the subject…
Pelvic organ prolapse is common – with up to 50% of women who have had a vaginal delivery having some form of prolapse.
Of most diagnoses that I have come across in my career, one of "pelvic organ prolapse" aka POP is perhaps the most unhelpful, frightening and vastly vague diagnosis a woman can be given.
Let me clarify …frequently, women are given the "diagnosis" of bladder prolapse or uterine prolapse without much guidance into what it means for their present and their future. Most women go home and google "organ prolapse" and are met with scary pictures of complete organ prolapses – spiralling many women into a world of uncertainty, exercise avoidance, fear (if you become paralysed by the fear of moving because of the state of your pelvic floor, it may have worse impact on your mental health, as well as your over-all physical health), and little to no advice on how to manage or prevent their symptoms from worsening.
This diagnosis can be traumatic experience for so many women who either restrict their activities in hopes of avoiding their "organs from falling out" or opt in for ‘last resort’ surgery to rectify the situation – (often earlier interventions can avoid the need for surgery)
If you hear pelvic organ prolapse , here is what I want you to think about AND ask your GP/ pelvic health physiotherapist or specialist:
1️⃣ GRADE - Prolapse can range FROM grade 1 where you DO NOT see ( or often not feel) anything coming out of your vagina TO grade 4 where an entire organ can protrude outside the vagina. What grade is your prolapse? Ask and make sure you understand what that means.
2️⃣ PROGRESSION - One thing that makes women jump to surgeries is the assumption that time will make their prolapse worse. THERE IS NO STRONG EVIDENCE TO SUGGEST THAT LOW GRADE PELVIC ORGAN PROLAPSE WILL PROGRESS WITH TIME. Watchful waiting and physiotherapy may be a clinically sound options and should be discussed with your practitioner, (some health professionals may fail to relay to the women that if you aren’t bothered by the prolapse, then you don’t necessarily have to rush into surgery to just correct the anatomy)
3️⃣ SYMPTOMS - Do you feel any symptoms from POP? Heaviness, fullness, bulging, pain? VERY OFTEN, women have low grade prolapse without any symptoms. If you don't have any symptoms, can you manage conservatively? Pelvic Health Physiotherapy is an EXCELLENT option for improving low grade prolapse symptoms so too are pessary devices – which can be hugely beneficial for many women – Has a PESSARY been offered as an option??
4️⃣ TYPE - What is the specific organ that is prolapsing? Bladder is the most common one, followed by rectum and uterus. Knowing this in addition to the grade can be helpful in making sense of your symptoms (Check out an older blog I did-http://www.hawkesbaypelvicphysio.co.nz/blog/pelvic-organ-prolapse-confused-about-what-it-is-how-it-occurs)
In summary - If you become aware that you have prolapse there is so much you can do to increase your chances that the prolapse won’t progress to the point that you may be bothered by it and ultimately need surgery. Early intervention can be helpful and allow you to continue to lead an active life with the types of exercise you want to do.
👉🏻 Calm your anxiety / fears. They hurt you more than you know 🤗
👉🏻Try more than one physiotherapist if the first one does not help. There is a HUGE difference between practitioner's education and their own experience/belief system
👉🏻It is almost always a good idea to attempt conservative treatment (aka physiotherapy or pessary) first before surgery
Having a prolapse need not be considered a devastating diagnosis.
Our Vagina is dynamic not static and rigid - it moves and responds to increased intra-abdominal pressure – and is also hugely influenced by the movement or rigidity of the abdominal organs and diaphragm muscle. It is also likely to change through the day depending on your activity levels (increased intra-abdominal pressure) and the degree of upright vs sitting/lying you undertake and it changes and adapts through pregnancy and birth.
Therefore, in any one woman can vary from day to day and from hour to hour within any given day depending on what they are doing.
As a Holistic Pelvic Health Physiotherapist I care for my clients as a WHOLE. A woman is more than her prolapse and every woman is an individual and her individual needs have to be respected, her story has to be heard, and if it’s a traumatic birth – just because 20, 30 or 50 years ago women knew no better and seemed to ‘suck it up’ – doesn’t mean this denial of what the woman has gone through has to be continued.
Contact me today for an holistic consultation:
Phone 021 02554238
Bernadette is a pelvic health & women’s physiotherapist, a mother & female advocate. She specialises in treating ALL conditions affecting women, especially new mums and mums-to-be. She runs Hawkes Bay Pelvic Health & Women’s Physiotherapy, empowering & helping women through all stages of life