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Feeling Different “Down There” Learn About Pelvic Organ Prolapse

Hi. My name is Dr. Allison Feldt, PT, DPT with Body Motion Physical Therapy. I want to go over something that I hear a lot of women talk about. Oftentimes, I’ll hear women say they feel like they have a “heaviness in their vagina,” “something just feels different down there,” “they leak urine or dribble after they’re done peeing” and they get up from the toilet seat and they feel like…and they see that they’ve leaked on the toilet seat or dribbled urine on the toilet seat. Sometimes they’ll feel like something is coming out of their body. Women often report queefing, which is like a vaginal noise that comes out of their vagina when they’re at, yoga or barre or doing Pilates. One can also experience inability to control urine, which is incontinence. And then, they can also say that they feel like their husband’s hitting something when they’re having intercourse. These are a couple of the things I hear a lot, and these are all indicative of pelvic organ prolapse. This is when the certain organs start to lose their support inside the body and gently descend. ​So, there’s different ways that this can happen. Oftentimes, childbirth is one of the mechanisms of injury that facilitate this. Now, I just want to quantify that. When I do pelvic floor postpartum exams, there is usually some descent of the pelvic organs right away. The body has to heal, things have to recoil and go back to where they came from, and postpartum, your uterus is pretty heavy and that can still put some pressure on pelvic floor. Also there’s extra weight, which increases the downward pressure that could be causing organs to be protruding into the vagina.  So you may only notice this. actually having symptoms or problems. But it’s something that every woman should be aware of postpartum, because you can prolapse yourself even in postpartum. So, that’s just something to really look out for. 

So, I want to give you a little demonstration here, and I might have to come a little closer here. But, this is my little picture for you. Now, so you have your pelvic floor here and this is the bladder and this goes down into the urethra, then you have your vagina, then you have your rectum. So, that’s where the poop comes, this is usually used for intercourse, and then this is where the pee comes out of. Okay? And so, here’s your vagina and oftentimes when you have urinary problems and leaking problems, and if you feel a heaviness or pressure, you can have a cystocele. Now, that is where the bladder starts to come down into the vagina, okay? And then, it’s not, like, breaking through any walls, it’s just simply pushing into the vaginal cavity. Now, this is going to change with different activities and different positions that your body is in. It’s not always going to be there, or maybe it is, but there is a ton of techniques to help get it out of that vaginal canal and get it back to where it came from and to decrease your symptoms. And then, you have your rectum. So, this is where you have bowel movements or where your poop comes through. And that can fall into the vagina as well, and that’s called a rectocele. Now, if that happens, there are different techniques to help put that back in place, especially when you’re bowel movements in order to help improve the ability of the stool to completely come out of the anus. And so, those are really important things to keep in mind. And I’m just sharing this because a lot of people are symptomatic, and they’re like, “Oh, that’s my problem. I can’t fully evacuate my stools. I feel like I’m incomplete pooping,” and this can be one of the reasons, okay? And then, same thing with the bladder emptying, like, you can feel like, “I get up and I have to go to the bathroom right away again.” And this could be part of the situation that’s happening. You need a medical professional in order to diagnosis this, but these are some of the things that could be happening for you. And so, then your organs can come all the way outside the body, and same with the rectum, you can actually have a rectal prolapse. That’s where the colon is actually coming out of the body. 

So, these are just some things to keep in mind, and I just wanted to touch base on it. There’s so much that can be done holistically and without surgery or medication in order to help a lot of the symptoms. So, it’s a really good thing to know and pelvic floor rehab, working with a pelvic expert physical therapist is really should be the first line of defense when you find yourself having any of the pelvic floor symptoms, whether it’s incontinence, whether you feel like you have pressure in your vagina or heaviness or something’s in there, or maybe you have an air bubble. These are just really important things to keep in mind. So, if you have any questions, please post your comments, let us know.

*Not mentioned in the video and less common but still possible is the desecent of the uterus into the vaginal canal. This is another type of prolapse. 

Do you think you might have pelvic organ prolapse? 

​Watch the video below.

AUTHOR

Allison Feldt

Body Motion Physical Therapy

"We Help Women Through Fertility, Pregnancy, Birth, Postpartum and Beyond So They Can Live Active, Confident, Healthy Lives Without The Need For Medication Or Surgery"
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