Fitting and Management of Pessaries for Pelvic Organ Prolapse

A Pelvic Organ Prolapse is the descent of one or more of the anterior vaginal wall, posterior vaginal wall, the uterus/cervix or the apex of the vagina (after a hysterectomy).  It is estimated that 1 in 3 women are affected to the degree that the vaginal bulge extends either equal to or beyond the vaginal opening.

The 6 most common symptoms are:

  1. Vaginal Bulge
  2. Pelvic Pressure
  3. Splinting/digitation
  4. Low back ache
  5. In severe cases bleeding, discharge and infection
  6. Bladder and/or bowel diction

 Conservative management can include the use of a structural pessary. There many different types of pessaries and the based on a vaginal assessment a type will be chosen that is best likely to provide the support needed for each individual situation. If fitted correctly you should not be aware of the pessary and your prolapse symptoms should be relieved.

Many pessaries can be self-managed and removed regularly however some remain in situ and are removed by your provider at a time period determined by how the pessary is being tolerated ie. 4-6 months. On removal it is recommend a speculum check is performed by your GP.

If you are postmenopausal it is recommended that you are using vaginal oestrogen supplementation prior to fitting a pessary. Your GP can prescribe this but will only do so after reviewing your medical history for any contraindications.

The process of fitting a pessary, and if indicated teaching self-management, typically requires 2-3 visits. Other conservative management strategies that are usually used in conjunction with the use of a pessary include: pelvic floor strengthening exercises if indicated and managing lifestyle factors which can contribute to pelvic organ prolapse i.e. heavy lifting, constipation, respiratory conditions.

It is important to note that many women are very distressed when first experiencing pelvic organ prolapse symptoms. This is quite understandable. An important role of a pelvic floor physiotherapist is to educate and reassure you that your symptoms are in no way life threatening and for many women can be managed well conservatively.

Llama Blue

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Assessment and treatment of chronic, complex musculoskeletal conditions

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Conditions may include chronic spinal and pelvic girdle pain, recurring overuse injuries i.e. tendonitis, bursitis, fibromyalgia, myofascial pain syndromes, pain related to joint dysfunction, pain related to nerve injury or dysfunction, complex regional pain syndromes.

Treatment may include but not be limited to:

  • Manual Therapy i.e. myofascial release, soft tissue massage, joint mobilisation, mobilization of the nervous system.
  • Movement Reeducation i.e. movement lessons based on Feldenkrais principles, core integration with an emphasis on pelvic floor muscle awareness and the connection to the foot/ankle.
  • Stress and pain management/reduction techniques (i.e. breath work) , education about the neuroscience of chronic pain, brain retraining methods.

Llama Blue

Llamablue specialises in Squarespace and provides web design, web hosting, online stores and SEO strategies for businesses in and around Australia, USA, UK, Europe and internationally. Llamablue hosts customer websites in Australia - Adelaide, Melbourne, Sydney, Canberra, Brisbane, Sunshine Coast, Gold Coast and now in the USA. We are expanding rapidly and can help you wherever you are based. So let's talk.

Pre and post-natal care and education

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Taking care of women throughout pregnancy and post delivery. 

Common conditions treated include:

  • Musculoskeletal pain particularly of the pelvic girdle and spine.
  • Pelvic floor education and training
  • Assessment and retraining of abdominal wall and pelvic floor post-delivery
  • Ultrasound therapy for mastitis
  • Ergonomics training related to caring for a baby
  • Hire and training in use of Obstetric TENS Machine for pain relief during labour

Llama Blue

Llamablue specialises in Squarespace and provides web design, web hosting, online stores and SEO strategies for businesses in and around Australia, USA, UK, Europe and internationally. Llamablue hosts customer websites in Australia - Adelaide, Melbourne, Sydney, Canberra, Brisbane, Sunshine Coast, Gold Coast and now in the USA. We are expanding rapidly and can help you wherever you are based. So let's talk.

Pelvic floor muscle assessment and training

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Assessing and treating issues related to pelvic floor dysfunction including: 

  • Pelvic organ prolapse
  • Urinary and/or faecal incontinence
  • Birth trauma
  • Pelvic pain conditions

Accurate assessment of the pelvic floor muscles requires an internal examination to be performed. The procedure is explained in detail prior to commencement and can be stopped at any time.

A private and relaxed environment is assured and a chaperone is welcome for this portion of the evaluation if this assists a woman to feel completely comfortable.

Llama Blue

Llamablue specialises in Squarespace and provides web design, web hosting, online stores and SEO strategies for businesses in and around Australia, USA, UK, Europe and internationally. Llamablue hosts customer websites in Australia - Adelaide, Melbourne, Sydney, Canberra, Brisbane, Sunshine Coast, Gold Coast and now in the USA. We are expanding rapidly and can help you wherever you are based. So let's talk.