Is my vagina broken?  What is pelvic organ prolapse and stress incontinence?

In our last blog, we talked about the anatomy and function of the pelvic floor or Kegel muscles.  We discovered that both male and female bodies have three LAYERS of muscle with multiple muscles in each layer. And that these muscles provide the following functions in our bodies:

  1. Supportive: of the pelvic organs (bladder, rectum, uterus, prostate)
  2. Sphincteric:  opening and closing of the urethra, vagina and anus
  3. Sexual:  contributing to arousal and orgasm
  4. Stabilizing:  with a host of other muscles pelvic floor contributes to stability of trunk, pelvis and hips
  5. Posture:  maintains good posture along with back and abdominal muscles
  6. Breathing:  the pelvic floor and your main breathing muscle, the diaphragm, coordinate together
  7. Pumps fluids: contraction and relaxation of pelvic floor muscles supports the flow of fluids in the body

Today we are going to learn about how pelvic floor function relates to pelvic organ prolapse (POP) and stress urinary incontinence (SUI). 

Pelvic Organ Prolapse is a condition where your internal pelvic organs (bladder, uterus, rectum) have shifted position and lean toward the vagina.  This usually happens because the ligaments and support tissue that hold the organs in place have been stretched.  People with prolapse often have a sense of a bulge in the vagina or difficulty emptying their bladder or bowel.  The pelvic floor muscles can also play a role. Strong muscles might help support the displaced organ, while weak muscles might lead to more symptoms. You can read more about pelvic organ prolapse here.

  Normal Female Pelvic Anatomy vs. Cystocele (bladder prolapse). A dropped or prolapsed bladder (cystocele) occurs when the bladder bulges into the vaginal space. It results when the muscles and tissues that support the bladder give way.

Stress Urinary Incontinence (SUI) happens when you accidentally leak urine when you cough, sneeze, laugh, lift, jump, run or otherwise experience an increase in intraabdominal pressure.  The urethra (tube from your bladder to the outside of you) doesn’t stay closed and some urine escapes.  This condition is often referred to as light bladder leakage and some women refer to SUI as their “mommy bladder,” reflecting the fact that childbirth often contributes or causes SUI to develop. 

  A diagram of a normal bladder & urethra (on the right) vs. a bladder & urethra that has stress urinary incontinence

A good analogy for SUI is a leaky faucet. It would be that the valve is just not closed all the way (weak muscles) or perhaps it is broken and unable to close (structural changes).  In the same way, there are various reasons why the urethra does not fully close and contributes to urine leakage. 

What causes bladder leakage related to stress urinary incontinence? There can be many factors that contribute to bladder leakage such as:

  1. Being overweight
  2. Straining with constipation
  3. Vaginal childbirth where you pushed for more than 2 hours or less than 30 minutes
  4. Vaginal childbirth with forceps
  5. Having multiple pregnancies and deliveries
  6. Having twins, triplets etc.
  7. Giving birth at an older age
  8. Damaged nerves
  9. Pelvic surgery
  10. Certain medications like diuretics or water pills

You can read more about stress incontinence here.

You might think that only nonfunctioning or weak muscles would present with the symptoms of stress incontinence or prolapse, but I can tell you from many years of experience that I have seen a range of muscle presentations with these symptoms. For example, often times women with leakage or prolapse develop a habit of habitually tightening their pelvic floor muscles which can lead to overactivity, pain and muscles that don’t function well.  

We will talk about the difference between and importance of pelvic floor strengthening or kegel exercises, relaxation, and coordination in a future blog! 

Wouldn’t it be helpful to know how YOUR pelvic floor muscles are functioning! 

A specialty trained pelvic health physical therapist can evaluate the state of your muscles and organs and provide a customized treatment program to meet the needs of your body.  Muscles can be trained through physical therapy to improve in function regardless of their current state.  

Now here’s some really good news. Uresta works regardless of pelvic floor muscle function and can provide immediate support to your organs, ligaments, and connective tissue.  Uresta works in theory like an ankle brace. Image you had a bad ankle sprain but really wanted to get back to running.  An ankle brace could support your body while you are working on your recovery.  The ankle brace might be something you use short term, or just as needed.  Or, maybe the injury to your ankle was more severe and using the brace may be an important part of your daily self-care.  

Use of Uresta to support the bladder and urethra works much the same way. Some people may use it just for exercise, while others will find the most benefit using it on a daily basis. Easily inserted vaginally, Uresta helps to keep the urethra closed and the bladder supported with increases in intraabdominal pressure, so that you can do the things in life you love without worrying about prolapse or leakage.  

There is no reason for women to suffer in silence with pelvic floor dysfunction, prolapse, or stress incontinence.  Help is available!  

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