Pessaries & Prolapse 101
Dr. Jenn Gelfand, PT, DPT, E-RYT explains pelvic organ prolapse to patient at Root to Rise in Scarborough
During a recent staff meeting, Nina Pham, SPT our student clinical intern gave our crew an inservice on pelvic organ prolapse and pessary use. She included some exciting tidbits from the latest research on the use of pessaries.This is perfect timing as we prepare for Dr. Daisy and Dr. Jenn’s participation in a training on pessary fittings! Let’s dive into some highlights from Nina’s talk.
First let’s all get on the same page about what we mean by prolapse. According to the American College of Obstetrics and Gynecology prolapse (or pelvic organ prolapse) is a “disorder that causes one or more of the pelvic organs to drop from their normal position.” The pelvic organs, which include the vagina, uterus, bladder, urethra, and rectum, can shift down when they aren’t well supported by the pelvic floor muscles, fascia and ligaments.
What might cause the pelvic floor the inability to offer this support? Mainly an injury or chronic condition leading to too much laxity in the tissues, tendons or muscles. The most common cause of pelvic organ prolapse is pregnancy and childbirth. While the prevalence is hard to nail down, one source Nina found indicated that up to 50% of women could be impacted.
Common symptoms of prolapse include vaginal heaviness and pressure, a sensation of a ball sitting inside the vagina, or the feeling of something falling out of the vagina, like a tampon becoming dislodged.
The conservative treatment is to use pelvic floor therapy to address prolapse, which we highly recommend. But more and more we are learning about pessary use in conjunction with pelvic floor therapy. Surgery is also an option for prolapse if symptoms remain unmanageable.
So what is a pessary? A pessary is a device inserted into the vaginal canal to offer additional support. There are many different types including a Gellhorn, often for uterine prolapse; a ring with support, often for bladder prolapse; and a ring with a knob to address both bladder prolapse and urinary incontinence, among others.
What type and the right fit for a pessary really matters. The goal being that you can perform all of your daily activities without being aware of it. They can be worn continuously, sometimes for months at a time, or used temporarily for high impact activities like running.
We are really looking forward to learning even more about the options and how to find the right fit at Dr. Daisy and Dr. Jenn’s upcoming pessary fitting training so we can offer this service at Root to Rise to better support our patients. Stay tuned for more to come next month!
Also, to learn more about our approach to integrating pessaries with pelvic floor therapy check out our blog posts Pelvic Organ Prolapse & Pessaries, How Pessaries Help Many With Prolapse Reach Their Goals Faster and All About Pessary Fittings.
At Root to Rise Physical Therapy & Pelvic Health, we believe in a holistic approach to physical therapy. Our Doctors of Physical Therapists are specialized in treating both orthopedic and pelvic health conditions. Our practice also integrates acupuncture and yoga and we are always excited to be a resource for the community we practice in. We are located in Scarborough, Saco, and Bath, and are here to support you!
~Dr. Jenn & The Root To Rise Team
