Continence & Pelvic Floor

Women’s Health problems affect 1 in 3 women and can occur at any age.
Often women put up with symptoms as they don’t realise that there are simple conservative measures that can help to remedy many problems.

Research has shown that physiotherapy can be effective in the treatment of incontinence and pelvic organ prolapses thereby postponing, or in many cases eliminating the need for drugs or surgery.

Conditions Commonly Treated:

  • stress urinary incontinence
  • urinary urgency and urge incontinence
  • pelvic organ prolapse
  • pelvic pain
  • faecal urgency and incontinence
  • problems controlling wind
  • sexual dysfunction (including pain on sexual intercourse and vulval pain)
  • weak pelvic floor muscles following childbirth
  • rehabilitation after gynaecological surgery, including hysterectomy

What is Incontinence?
Incontinence is classified as an unwanted/involuntary leakage of urine no matter how small.

Stress Incontinence; leakage of urine with activities such as laughing, coughing, sneezing, fast walking, running or jumping.

Urge Incontinence; can’t get there on time to prevent a leak. It may be associated with increased urinary frequency.

Signs of a Weak Pelvic Floor:

  • Leaking urine when you cough, sneeze, walk, run or play sport
  • Inability to control wind
  • Internal heaviness or dragging sensation
  • Difficulty deferring the urge to pass urine or bowel motions

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What is Pelvic Organ Prolapse?
Vaginal prolapse (also called  pelvic organ prolapse, or  vaginal organ prolapse) is what happens when organs inside the pelvis fall, bulge or protrude into the vaginal wall. This condition is due to weakened muscles or ligaments that can occur from a number of  causes, including childbirth, previous surgeries, chronic constipation   and obesity. If you have  signs and symptoms  of vaginal prolapse, learning more about this condition (and discovering you have  options!) can lead to a better way of life.

Prolapse can mean descent of the:

  • Uterus.
  • Front wall of the vagina and the bladder (cystocele).
  • Urethra (urethrocele).
  • Back wall of the vagina and the rectum (rectocele).
  • Upper vaginal support to bowel (enterocele).
  • Rectum (rectal prolapse).

Signs and Symptoms:
While many women do not have pronounced symptoms that accompany vaginal prolapse, weakened supporting muscles can sometimes cause a noticeable bulge or lump in the vagina, as organs sag or protrude into the vaginal wall. This causes a sense of vaginal heaviness. Symptoms to watch for include:

  • A feeling of heaviness in the vaginal area
  • Something protruding from the vagina
  • A pulling or stretching feeling in the pelvic area
  • Pain when standing
  • Painful sexual intercourse
  • Vaginal pain, pressure, irritation, bleeding or spotting
  • Frequent lower back pain
  • Occasional loss of bladder or bowel control
  • Difficulty with bowel movements
  • Difficulty urinating, or delayed or slow urinary stream

How Can Physiotherapy Help?
The aim of physiotherapy treatment for prolapsed is to strengthen the pelvic floor muscles thus allowing them to provide more support to for the pelvic organs.

Physiotherapists can also offer advice regarding lifestyle modification including treatment of cough, smoking cessation, constipation and overweight and obesity. By making simple lifestyle changes like losing weight, eating high fibre foods, stopping smoking, and avoiding heavy lifting or straining some women are able to minimize the frequency and severity of their vaginal prolapse symptoms.

Posture and general muscle tone can play an important role in the management of prolapse. We at Wicklow Physiotherapy Clinic are highly skilled in helping to improve overall muscle tone and adopting a healthy posture.   We can also advise on how to exercise safely with a prolapse and also how to resume exercise safely following surgery for prolapse.

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