At Healthy Core, many women are referred for treatment either before or after post surgical sling or suspension surgeries, used for the correction of Pelvic Organ Prolapse (POP). Prolapse occurs when there is a dysfunction in the network of muscles, ligaments and connective tissue within the pelvis that holds the pelvic organs in place. The bladder, urethra, uterus and/or bowel can slip out of place and descend, or prolapse. This is on a continuum with a first degree prolapse being mild and a fourth degree being severe, to the extent in which the organs are literally falling outside the vaginal opening. Early symptoms often include urinary stress incontinence, when a few drops of urine are involuntarily expelled during activities such as coughing, sneezing, lifting or laughing. The condition usually worsens over time and may require surgery to correct. Other symptoms of prolapse include pressure in the vagina or pelvis, a lump or bulge in the opening of the vagina and/or urinary, bowel or sexual dysfunction.
Many dysfunctions are often present presurgically and ideally should be evaluated and treated before surgery. If these dysfunctions are not addressed, it might lead to voiding dysfunctions or the inability to tolerate penetration or intercourse. Surgery is always a risk factor for musculoskeletal dysfunctions in the pelvis and increases the risk for adhesions and dysfunction. In addition, AVOID sit-ups or crunches and make it a habit to EXHALE when lifting or getting out of a chair.
Physical therapy is also a viable treatment option for mild to moderate organ prolapse. The pelvic floor muscles attach to the hips and do not get the maximum fascial lift if there is hip tightness or pain. In addition, the abdominal wall provides fascial support to the pelvic floor and organs. It is what holds up, or suspends the pelvic floor and helps to create atmospheric pressure to keep urine in the urethra. The deep abdominals act like the plug at the top of a straw when pulled out of water. If there is lower abdominal weakness and/or hip pain, consider seeking the help of a women's health physical therapist before surgery. The positive results of strengthening the deep core muscles include greater support for the back and a thinner waistline. And if surgery is inevitable, therapy can improve the outcome and minimize dysfunction. Healthy Core therapists are here to evaluate the lumbopelvic region for dysfunction, especially for individuals contemplating surgery.