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Conservative Treatment Protocol for Prolapsed Bladder A prolapsed bladder can be treated conservatively to include Pelvic Floor Muscle Training (PFMT) and pessary therapy.
Pelvic Floor Muscle Training (PFMT) 10, 13, 16-18.
PFMT are exercises specifically designed to strengthen the muscles of the pelvic floor, which support and control the bladder and other pelvic organs. This is very useful for women with lesser intensity of prolapse. This type of exercise involves voluntary contraction of the pelvic muscles, which in turn increases muscle strength, endurance and overall pelvic stability. Between 75–90% of patients who undergo PFMT become dry or significantly dry12.
Benefits of PFMT
Muscle Building: PFMT done regularly increases muscle volume and helps to lift the pelvic floor resulting in relief of prolapse^.
Reduction in Incontinence: Again, studies have shown that PFMT can lead to a significant reduction in urinary incontinence, and as such it is another good treatment option for women (34).
Convenience: This is one method that you can do alone at your home after some initial guidance from a healthcare professional5.
Limitations
PFMT can be useful for cases of mild POP but is less likely to help with moderate to severe prolapse. Furthermore, consistency to the exercise programme is vital for success; therefore, a portion of people may find it difficult to comply16.
Vaginal Pessary
Vaginal Pessary: A vaginal pessary is a device that is placed into the vagina to help support the bladder and other pelvic organs. This is especially valuable to women who are too busy to do consistent physical exercises or want a non-surgical instant solution.
Advantages of Using a Pessary
A pessary provides immediate support which helps relieve symptoms of prolapse12.
Less Invasive: It provides an non-surgical option that is adjustable and reversible.
For example, pessaries are available in a variety of forms and sizes, allowing for specific fit based on anatomy and comfort45.
Considerations
It works well, but is associated with irritation and (a rare) infection that necessitates regular provider monitoring. Optimal functioning relies on proper fitting and ongoing adjustments67.
These results support the use of PFMT (with no clear benefit in addition by pessaries) as equally successful non-surgical alternatives for treatment of POP. The decision for which to use should be made on a case by case basis combining the type of prolapse, severity and patient’s preference based on treatment methods.
