Pelvic Prolapse Diagnosis & Recovery

Lindsay - the tenacious owner of Tenkara Rod Company, was just four weeks postpartum after the birth of her third child, when she was confronted with a diagnosis of triple pelvic organ prolapse. Her rectum, uterus and bladder were all prolapsing into her vagina, and she was scared.  This post illustrates the profound impact of pelvic floor physical therapy (PT), and in this case, surgical intervention, in allowing a real person to return to her highly active lifestyle, which her physicians initially told her would be impossible.

The Prolapse Diagnosis: 

Lindsay was about 4 weeks postpartum, after the birth of her 3rd child, when she noticed discomfort and swelling "down there", that prompted her to go see her doctor. The diagnosis was staggering—Uterine, Bladder, and Rectal Prolapse. Triple Prolapse!!  

What's worse, was that after giving her that diagnosis, the doctor gave her this disheartening information: Lindsay was told that to eliminate her prolapse symptoms, she would have to significantly overhaul her active lifestyle, including bidding farewell to running, downhill biking, and lifting anything over 25 pounds…essentially forbidding her from participating in all the activities that brought her joy, as well as raising serious questions about how she was supposed to effectively mother her 3 children (two of whom weighed more than 25 pounds).

Exploring Prolapse Solutions: 

The doctor then presented Lindsay with three options—Kegels, Physical Therapy, or Surgery—Lindsay chose the path of PT. However, her initial encounters with local physical therapists over 3 months, left her less-than-satisfied, feeling like her hope for recovery was slipping away. While these PTs said they were "pelvic specialists", they did not do internal muscle assessments, and did not prescribe her any strengthening exercises outside of "laying on her back" position. This felt wrong to Lindsay.

Seeking a lifeline, she pursued a second opinion, leading her to the transformative care of Dr. Kelly.

"I knew from my first phone call with her, that Dr. Kelly was going to be the PT who could help me get my life back." 

Finding Prolapse Hope with Dr. Kelly & Pelvic Floored: 

In their first meeting, Dr. Kelly not only offered hope, but conducted a meticulous pelvic muscle exam, unveiling areas of tightness, weakness, and scar tissue, in the abdominal and pelvic floor region, that were contributing to Lindsay’s troublesome prolapse symptoms. Dr. Kelly guided Lindsay on a personalized exercise regimen crafted to both lengthen and strengthen her pelvic floor.

But they didn't stop with the pelvic floor.  The emphasis extended beyond mere pelvic exercises; it encompassed mastering control over the diaphragm, abdominals, pelvic floor muscles while focusing on whole body, functional strength and lifting tasks, in all positions.

"Kelly did more for me in that first appointment than was done in the two prior months with two other Physical Therapists. Even though I had to travel a long ways to see her, it was worth it."

 

Deciding if Prolapse Surgery is Needed: 

After just two appointments in Pelvic PT with Dr. Kelly, Lindsay exhibited significant improvement in the position of the Uterine and Rectal Prolapse, as well as significantly reduced symptoms, which was amazing.  The position of the bladder prolapse, however, remained unchanged…and unfortunately, this is real life…and there were insurance complications.

"I was going to be losing my insurance coverage in 4 weeks. If I needed surgery, I needed to decide immediately."

At this point, Lindsay and Dr. Kelly were faced with time-sensitive insurance constraints, and had to decide whether to move forward with surgery for the bladder prolapse, after just two visits.  Due to Lindsay’s significant improvement towards rectal and uterine prolapse, but limited gains in bladder prolapse during that time, they decided to move forward with surgery to repair the bladder prolapse. Truthfully, had there not been a time/insurance limitation, Dr. Kelly would have recommended continuing with Pelvic PT an additional 6 weeks.  They were able to visit one additional time (3 total visits) pre-surgery, where Dr. Kelly ensured Lindsay's pelvic floor muscles were in prime condition, augmenting the chances of a successful procedure.

"Even though she is a Pelvic PT, Dr. Kelly helped me determine that, in this case, surgery was the right choice for me and my body."

 

What Post-Prolapse Surgery Looked Like: 

Six weeks after Lindsay's surgery, she came back in for her first post-operative Pelvic PT visit. We did a reevaluation to see exactly where she was at. At this point, she was still having symptoms of pressure, but nothing like before surgery.

Similar to Lindsay's pre-preoperative Pelvic PT exercises, her post-prolapse surgery Pelvic PT and pelvic exercises started out with exercises to lengthen AND strengthen her pelvic floor muscles, based on the findings of the pelvic muscle exam, as well as coordination and strength training of WHOLE BODY muscle groups, to ensure ideal pressure management in all activities.

Lindsay did her own internal work 2-3 days a week at home with either her own hand, the help of her husband, or a pelvic wand from Intimate Rose (pro tip, use this link, or coupon code Kelly21 to get $5 off any product) to help with pelvic floor muscle health after her surgery.

At the eight-week post-surgery milestone, Lindsay celebrated a significant achievement—she was able to use tampons! Due to the feeling of pelvic pressure, she hadn't been able to wear a tampon since the birth of her 3rd child, 8 months prior. Now, at 8 weeks post surgery, she was ready.

"It was an emotional day when I was able to wear a tampon again. I never knew I would take that for granted."

From eight-weeks post surgery, Lindsay’s restorative journey continued, with Pelvic PT once every 2-4 weeks, focusing on global functional strength goals, preparing her for activities like hiking, mountain biking, and surfing that once seemed elusive.

Celebrating Victories After Prolapse Surgery: 

Fast forward to six months post-prolapse surgery, and Lindsay was standing at a symbolic crossroads. Released to downhill mountain biking and encouraged to carry her child, as well as perform regular weight lifting, Lindsay triumphed over challenges once deemed insurmountable by her physician. Lindsay's unwavering commitment to PT showcased the transformative power of personalized pelvic floor therapy.

"Seeing Dr. Kelly every 2-4 weeks for 10 months was the best investment in myself and my health I have ever made. I am now ready to continue on my own."

Concluding

Lindsay's triumphant return to an active and fulfilling lifestyle serves as a powerful testament to the healing power of Pelvic PT, and that surgery, while rarely the first course of action for pelvic prolapse, is not a "bad option", and for the right client, with the right preoperative, and post-operative rehabilitation, surgery truly is life-saving.

Lindsay wanted me to share her story as a beacon of hope to others navigating the complexities of pelvic organ prolapse. She wants you to know that pelvic prolapse isn't a death sentence. That you don't have to give up your life.  That with the right support, restoration is not only conceivable but achievable.

How do we decide between Pelvic PT, Prolapse Surgery, or both?: 

Pelvic PT, without surgery, has an 80% success rate for managing symptom bother from prolapse.  Surgery also has an 80% success rate.  Those are amazing numbers.  Pelvic Floored wanted to share Lindsay’s story, because we want you to know that both Pelvic PT AND Prolapse surgery are great treatment options.

If there had not been the time-constraint due to insurance limitations, and if we were seeing steady functional progress from all three prolapses, we would likely have continued with Pelvic PT for 6-weeks, assessed progress, before deciding on whether to undergo surgery or not. 

Ultimately, I would NEVER recommend prolapse surgery without at least 2-3 visits of preoperative Pelvic PT, as well as NEVER recommend prolapse surgery without postoperative Pelvic PT.  The Pelvic PT improves the tissue health of the pelvic bowl, as well as improves the way the entire body manages pelvic pressure and loads, to improve your confidence and understanding going into the surgery, improve your pain management post operatively, and, by virtue of your improved pelvic pressure management, enhance the success rate of the surgery, thereby reducing the chance of you requiring additional surgeries in the future.  

The decision to have prolapse surgery or not, is an individual one, and depends on many factors.  Another topic, not covered here, but very important to consider in prolapse, is pessary use.  Having a skilled Pelvic PT in your corner can help you make the most informed decision for YOU.  Once you make that decision, that same Pelvic PT can help you move forward in your life, and get the best outcome of whichever route you chose (PT, surgery, or both). 

Ready to take action?

If you can’t find a Pelvic PT near you to have these frank discussions with, please consider a virtual Pelvic Wellness visit, with someone like Dr. Kelly, so that you can feel as empowered as possible, moving forward. 

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For those seeking alternative avenues, perhaps you’re not ready to see a Pelvic PT in person, consider a high-quality online course from a trusted professional (like me!). Pelvic Floored offers world-class streamable online courses and pelvic wellness programs, that you can work through at your own speed, in the comfort and privacy of your own home, for a fraction of the cost of one:one Pelvic PT.

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Thanks for reading!

xoxo, Dr. Kelly :)