Pelvic Organ Prolapse and Pessaries

What are they? And who are they for?
 
Pelvic Organ Prolapse (POP) is a very common condition in women, and can result in leaking from the bladder or bowel, a feeling of heaviness or bulging in the vagina, or even lower back pain. POP can vary significantly in its severity, the organ involved and the cause. Mild POP may be completely symptom free, however to stop the POP progressing and worsening women should be seen by a Women’s Health Physiotherapist for lifestyle advice, strengthening exercises where appropriate and possibly the use of a pessary to support the POP. 
 
Pessaries are a silicone or plastic device that can be inserted into the vagina to support the pelvic organs. If there is a lack of support for your pelvic organs – usually due to muscle weakness, fascial (ligament) damage, or a recent vaginal birth, there is a risk of developing or worsening a Pelvic Organ Prolapse – POP. 
 
In the past, pessaries have almost exclusivly been used in the older female population – mainly post menopausally to manage a current POP if surgery was not wanted or appropriate. However, recently pessaries are being used more and more in the younger female population, and in particular early post natal women. We often use pessaries to support a mild POP while the body heals and recovers post pregnancy and birth, or prophylactically for women who want to return to high impact exercise or running before their pelvic floor and fascia are ready. The positive effects from exercise on your physical, mental and emotional wellbeing are vast and very well known, however many women who have a POP are told that they can’t do a particular exercise anymore. The use of a pessary can give many women the required support to allow a safe return to high impact exercise, or even just symptomatic relief so that they don’t notice the POP.

What are they? And who are they for?

Pelvic Organ Prolapse (POP) is a very common condition in women, and can result in leaking from the bladder or bowel, a feeling of heaviness or bulging in the vagina, or even lower back pain. POP can vary significantly in its severity, the organ involved and the cause. Mild POP may be completely symptom free, however to stop the POP progressing and worsening women should be seen by a Women’s Health Physiotherapist for lifestyle advice, strengthening exercises where appropriate and possibly the use of a pessary to support the POP. 
 
Pessaries are a silicone or plastic device that can be inserted into the vagina to support the pelvic organs. If there is a lack of support for your pelvic organs – usually due to muscle weakness, fascial (ligament) damage, or a recent vaginal birth, there is a risk of developing or worsening a Pelvic Organ Prolapse – POP. 
In the past, pessaries have almost exclusivly been used in the older female population – mainly post menopausally to manage a current POP if surgery was not wanted or appropriate. However, recently pessaries are being used more and more in the younger female population, and in particular early post natal women. We often use pessaries to support a mild POP while the body heals and recovers post pregnancy and birth, or prophylactically for women who want to return to high impact exercise or running before their pelvic floor and fascia are ready. The positive effects from exercise on your physical, mental and emotional wellbeing are vast and very well known, however many women who have a POP are told that they can’t do a particular exercise anymore. The use of a pessary can give many women the required support to allow a safe return to high impact exercise, or even just symptomatic relief so that they don’t notice the POP.
 
Pessaries are not for everyone, and like shoes different types give different support and what works perfectly for one women might not work for another. It’s a bit of trial and error to find the best pessary, and sometimes you need to try a few before you find the right one. 
 
If you suffer from incontinence or leaking when for cough, sneeze or run, have difficulty fully emptying your bladder or bowel, have a feeling of heaviness, bulging or dragging in your vagina, then I would strongly advise you to see a Women’s Health Physiotherapist for an assessment. 
 
We recommend that all women who have had any birth – vaginal or caesarean,  have an assessment before they return to high impact exercise. We can help you get stronger if required, guide you with what is safe and not safe to do for now, and if appropriate fit you with a pessary so that you can get back to doing what you love. 
 
Sarah May is qualified to assess, fit and advise on the use of pessaries. To book an appointment please call 9968 3424 or book an Initial WH appointment online.