Can Pelvic Floor Exercises help Rectocele (Pelvic Organ Prolapse)

Can Pelvic Floor Exercises help Rectocele (Pelvic Organ Prolapse)

Pelvic floor exercise like Kegels is helpful for prolapse but other types of exercise are too. Don't let prolapse stop you from moving!

Early stage prolapse is very manageable and sometimes even reversible. Once the prolapse progresses to a stage 3 or 4, it may is becomes more difficult to manage and some choose or require surgery.

What is a rectocele?

A Rectocele is a type of pelvic organ prolapse indicated by the rectum bulging into the posterior wall of the vagina. It can contribute to discomfort, difficulty voiding, feeling like ‘something is in there’, difficulty inserting a tampon or keeping it in. It can also be asymptomatic. Many people don’t even know they have a prolapse and symptoms are not always indicative of severity.

Core Confidence Network, Womens Wellness Connection

What is a rectocele repair?

The most common rectocele repair is a repair of the posterior vaginal wall and is called a Posterior Colporrhaphy. An incision is made in the back wall of the vagina. The rectum is re-positioned and the incision is sewn up while also reinforcing the walls of the vagina.

Prevention and early detection are key when it comes to pelvic organ prolapse.

Does everyone need surgery?

Absolutely not. There are many conservative approaches to managing prolapse with diet and pelvic floor exercise being of utmost importance. Surgery is an option but is best considered a last resort. When a decision is made to have surgery, it is essential to consider pre-hab which is essentially working with a pelvic floor physical therapist, doing pelvic floor exercise consistently and choosing the right surgeon.

How can I ensure the best, longest lasting outcome?

  • Work with a pelvic floor physical therapist before, after and for life
  • Keep your diet and elimination optimized - avoiding constipation is ESSENTIAL!
  • Be proactive as you approach menopause and consider local vaginal estrogen and/or DHEA supplementation to support the walls of the vagina
  • Work to reduce inflammation in your body and support your immune system
  • Choose exercise that builds your body up instead of breaks it down
  • There is more to pelvic floor wellness than kegels. Moving in a variety of ways is beneficial
  • Sit less and move more
  • Pay attention to your posture

Here are some possible symptoms to look for:

  • low back pain
  • a feeling of heaviness in the lower abdomen
  • discomfort with sex
  • difficulty starting the flow of urine/difficulty emptying the bladder
  • inability to completely empty the rectum
  • constipation

As the descent of the organs continues, symptoms may progress to:

  • feeling like you are sitting on a golf ball
  • feeling like something is falling out
  • heaviness in the pelvis that gets worse as the day progresses
  • tampons getting pushed out or difficulty inserting a tampon

The Best thing you can do

The best thing a woman can do to prevent prolapse (and any pelvic floor dysfunction) and also manage a prolapse that already exists is to see a pelvic floor physiotherapist at least once a year. They assess the pelvic floor muscles for function and the internal organs to see if they are where they should be.

If a prolapse is found, a number of lifestyle management options would be presented.

Stand, sit, and move with a neutral pelvis most of the time.  Life is varied and doesn't always happen in perfect form but choosing neutral the majority of the time can be beneficial.  If your posture is such that your pelvis is tucked and not aligned with your breathing diaphragm, then you will be given tips on how to stand, move and sit properly which in turn will make the pelvic floor exercises more effective and may also decrease symptoms.

Core Confidence Network, Womens Wellness Connection

Adjust lifting - Lifting causes an increase in intra-abdominal pressure and if your core (pelvic floor) has difficulty managing that pressure, then your organs may continue to shift. It has long been advised to avoid heavy lifting with prolapse or after prolapse surgery but avoidance doesn't build resilient muscles.  That doesn't mean we should throw caution to the wind but rather, find strategies that allow you to continue with your favorite activities. Work with your pelvic floor physiotherapist to develop strategies for proper core activation to make lifting more accessible and beneficial.

Explore a pessary - A pessary is a device inserted high into the vagina that supports the walls of the vagina and the organs. There are many different sizes and shapes, and it may take a few tries to find the right one, but once you do, it can allow the muscles to function better and provide relief from the discomfort of prolapse.

Core Confidence Network, Womens Wellness Connection

Having a prolapse does not mean exercise should be halted.

Some exercise may feel better if modified but avoiding movement may contribute to worsening of the condition and it puts you at risk of other conditions due to inactivity.

One technique that is immensely powerful for prolapse is the Hypopressive Method. The technique involves a series of hypopressive postures (meaning “low pressure”) done with rhythmic breathing and apneas (pauses in breathing) that improve resting tone in the abdomen and pelvic floor and may even reverse early stage prolapse.

Core Confidence Network, Womens Wellness Connection

Let us help you

Fill out the form below/in the sidebar to speak with one of our professionals and get clarity on all the options available to you for prevention and management of your rectocele (or any other prolapse).