Post-Prostatectomy Incontinence: Causes, Symptoms & A Wholistic Approach to Recovery

Prostate surgery is often necessary for treating prostate cancer or other prostate conditions, but for many men, it comes with an unexpected challenge—post-prostatectomy incontinence (PPI). This condition affects up to 95% of men following prostate removal, causing bladder leakage and impacting daily life.

The good news? Most men regain full bladder control within 3 to 12 months after surgery. However, for some, incontinence persists beyond a year, requiring further intervention. Understanding why PPI occurs, how to manage it, and what treatments are available is key to regaining confidence and quality of life.

What Causes Post-Prostatectomy Incontinence?

The prostate plays an essential role in urinary control, acting as a structural and functional component of the continence mechanism. When the prostate is surgically removed, several changes occur that can lead to incontinence, including:

• A shortened urethra, reducing its ability to maintain closure

• Decreased urethral pressure, making it harder to control urine flow

• Disruption of nerves and muscles responsible for bladder control

• Changes in bladder capacity and function

While incontinence is common after prostate surgery, certain factors can make symptoms more severe or prolonged. These include:

• Obesity (BMI >30)

• Pre-existing bladder conditions

• Previous radiation or pelvic surgeries

• Lack of physical activity

• Surgical complications

• Increasing age

By addressing these risk factors before and after surgery, men can significantly improve their chances of a faster and smoother recovery.

Recognizing the Symptoms of PPI

The type and severity of urinary leakage can vary, but common symptoms include:

• Stress incontinence – Leaking urine during activities like coughing, sneezing, lifting, or straining

• Urge incontinence – A sudden, intense urge to urinate that may lead to leakage

• Post-micturition dribble – Leakage that occurs after urination

• Increased urinary frequency – Needing to urinate more often, both day and night

These symptoms can affect daily activities, confidence, and even mental well-being. However, with the right treatment and rehabilitation plan, men can regain control over their bladder.

Treatment for Post-Prostatectomy Incontinence

At Eastern Osteopathy - The Pelvic Place Melbourne, we take a holistic, osteopathic approach to PPI treatment, focusing on restoring function and addressing the body as a whole. Our osteo-led pelvic health treatment plans are tailored to each individual and may include:

1. Pelvic Floor Muscle Training

The pelvic floor muscles play a crucial role in bladder control. Strengthening these muscles through individualized pelvic floor exercises can significantly reduce incontinence and improve continence function.

2. Small Group Exercise Rehabilitation

A structured exercise program focused on core stability and pelvic floor coordination can help retrain muscles and improve function. These programs are designed to be safe and effective for men recovering from prostate surgery.

3. Lifestyle & Activity Guidance

Returning to physical activity is essential, but doing so safely is key. We provide individualized advice on gradual exercise progression, movement strategies, and bladder retraining techniques to support long-term recovery.

The Osteopathic and Wholistic Approach

At Eastern Osteopathy - The Pelvic Place Melbourne, we believe true recovery goes beyond just treating symptoms. Our osteopathic and holistic approach ensures that posture, breathing patterns, muscle balance, and nervous system function are all addressed as part of bladder rehabilitation.

A key focus of our treatment is reducing extra load on the bladder and pelvic floor, which can significantly improve continence. This includes:

✔ Optimizing posture and alignment to reduce pressure on the bladder
✔ Improving breathing mechanics to minimize unnecessary pelvic floor tension
✔ Addressing core and hip stability to support pelvic function
✔ Reducing strain on the pelvic floor by promoting efficient movement patterns

By assessing the whole body, we aim to:

✔ Improve core and pelvic floor strength
✔ Enhance nervous system communication
✔ Optimize bladder function
✔ Reduce overall tension and dysfunction

This comprehensive approach leads to better long-term outcomes and helps men regain confidence, control, and quality of life after prostate surgery.

Put Post-Prostatectomy Incontinence Behind You

We understand that dealing with incontinence after prostate surgery can be frustrating and emotionally challenging. But you don’t have to navigate this journey alone.

At Eastern Osteopathy - The Pelvic Place Melbourne, we are committed to providing expert care, evidence-based treatments, and compassionate support to help you regain bladder control and restore confidence.

If you or a loved one is experiencing post-prostatectomy incontinence, reach out to our team today. Book an appointment online or contact us to learn how we can support your recovery.

Let’s work together to put post-prostatectomy incontinence behind you—so you can move forward with confidence.

Understanding Peyronie’s Disease: Causes, Symptoms, and an Integrative Treatment Approach

Peyronie’s Disease is a condition that many men find difficult to talk about, yet it can have a significant impact on both physical and emotional well-being. Characterized by the development of scar tissue in the penis, Peyronie’s can lead to painful erections, a noticeable curve, and even difficulties with intimacy. While the exact cause is not always clear, an integrative approach to treatment—including therapeutic ultrasound, osteopathy, and lifestyle adjustments—can help manage symptoms effectively.

What is Peyronie’s Disease?

Peyronie’s Disease is considered a wound-healing disorder that occurs when calcification forms in the tunica albuginea, a fibrous sheath surrounding the erectile tissue. This leads to scar tissue formation, which can cause the penis to bend or curve abnormally. Many men also experience pain during arousal or intercourse.

While studies suggest that Peyronie’s affects around 9% of men, the actual prevalence could be much higher—up to 22%—due to underreporting. Many men feel embarrassed discussing their symptoms, leading to delays in diagnosis and treatment.

Symptoms of Peyronie’s Disease

Peyronie’s Disease presents with a range of physical symptoms, often worsening over time. The most common signs include:

• Noticeable penile curvature

• Painful erections

• Soft or incomplete erections

• Narrowing or shortening of the penis

• Difficulty during intercourse

Beyond the physical symptoms, the emotional impact can be significant. Over 75% of men with Peyronie’s report experiencing high stress, anxiety, or depression, often due to concerns about their sexual health.

What Causes Peyronie’s Disease?

Peyronie’s Disease is most common in men between the ages of 45 and 60, though it can occur at any age. While the exact cause remains unclear, several factors may contribute to its development, including:

• Sexual trauma or injury (e.g., sudden bending or “buckling” of the penis)

• Family history (2% of cases show a genetic link)

• Connective tissue disorders

• Repeated minor injuries over time

• Autoimmune conditions

• Hypertension (high blood pressure)

• Smoking and obesity, both of which can impact circulation and tissue health

How is Peyronie’s Disease Diagnosed?

A penile Duplex Doppler ultrasound is the preferred diagnostic method. This imaging technique helps identify scar tissue, calcifications, and blood flow abnormalities, providing a clearer understanding of the condition’s severity.

An Integrative Approach to Treating Peyronie’s Disease

While some mild cases of Peyronie’s Disease (13 out of 100 cases) resolve on their own without treatment, many men require medical intervention to reduce pain, improve curvature, and prevent further complications like penile shortening.

At Eastern Osteopathy - The Pelvic Place Melbourne, we take a comprehensive approach to treatment, focusing on both physical and emotional well-being. Our integrative treatment plan includes:

1. Therapeutic Continuous Ultrasound

A non-invasive and highly effective treatment, therapeutic ultrasound works by breaking down calcifications into smaller particles (<0.5mm). The warming effect of the ultrasound improves blood flow, softens scar tissue, and enhances erectile function. Patients typically undergo three sessions per week for four weeks for optimal results.

2. Osteopathy and Manual Therapy

Osteopathy plays a crucial role in Peyronie’s Disease treatment by addressing underlying musculoskeletal imbalances. Through gentle manual therapy, osteopaths can:

• Improve circulation and tissue flexibility

• Reduce pain and tension in the pelvic region this may include internal rectal techniques to reduce pelvic floor tension, or external techniques to improve the tension in the region

• Enhance overall structural alignment, which may relieve secondary symptoms

By working on the body’s connective tissues, osteopathy supports natural healing and complements other Peyronie’s treatments.

3. A Holistic, Integrative Approach

Beyond direct treatment, we emphasize lifestyle adjustments to improve overall health and manage Peyronie’s symptoms effectively. This includes:

• Dietary improvements to support circulation and reduce inflammation

• Exercise and movement therapy to enhance pelvic health

• Stress management techniques, such as mindfulness and breathing exercises

• Treating underlying conditions like hypertension or obesity that may contribute to worsening symptoms

Final Thoughts

Peyronie’s Disease can be distressing, but you don’t have to suffer in silence. With the right combination of therapeutic ultrasound, osteopathy, and lifestyle modifications, it’s possible to manage symptoms, improve function, and regain confidence.

If you or someone you know is experiencing symptoms of Peyronie’s Disease, we encourage you to reach out for professional support. At Eastern Osteopathy - The Pelvic Place Melbourne, we provide personalized treatment plans designed to address both physical and emotional aspects of this condition.

Book a Consultation Today

Take the first step towards relief—contact Eastern Osteopathy today to learn more about our integrative approach to Peyronie’s Disease treatment and book an appointment with either Kathryn, Meg or Rose.

Understanding Hard Flaccid Syndrome: A Holistic Approach to Healing

Hard Flaccid Syndrome is a relatively new term, coined by patients rather than clinicians, to describe a distressing set of symptoms related to penile dysfunction. While the condition is not widely recognized in mainstream medicine, many men experience its effects, which can significantly impact their physical and mental well-being.

At Eastern Osteopathy - The Pelvic Place Melbourne, we believe in a holistic approach to treatment, considering not just the symptoms but the underlying causes that contribute to Hard Flaccid Syndrome. By addressing lifestyle, musculoskeletal health, and pelvic function, we help patients find lasting relief.

What is Hard Flaccid Syndrome?

Hard Flaccid Syndrome is characterized by one or more of the following symptoms:

• Shortening or retraction of the penis in the flaccid state

• Sensation or temperature changes, such as numbness or coolness

• Texture changes, described as “rubbery” rather than “spongey”

• Pain in the penis or perineum

• Painful ejaculation

The causes of Hard Flaccid Syndrome vary but are often linked to factors such as penile injury, stress, anxiety, and pelvic floor muscle tension. High levels of tension in the pelvic region can restrict blood flow, create nerve hypersensitivity, and result in persistent discomfort.

A holistic Approach to Diagnosing Hard Flaccid Syndrome 

Understanding the root cause of Hard Flaccid Syndrome requires a comprehensive assessment. At Eastern Osteopathy - the Pelvic Place Melbourne, we take a holistic view of your health, looking beyond the symptoms to identify contributing factors.

Our Treatment process includes:

• Medical History Review: We assess any history of pelvic trauma, UTIs, high stress levels, or previous medical conditions that may be linked to symptoms.

• Pelvic Floor Assessment: This may include perineal palpation, ultrasound, or a digital rectal examination to evaluate muscle tone and dysfunction.

• Whole body assessment, looking at muscles, fascia and joints that may be influencing your pelvic health

We ensure that every step of the assessment is clearly explained so that you feel empowered to make informed decisions about your care.

Holistic Treatment for Hard Flaccid Syndrome

At Eastern Osteopathy - the pelvic place Melbourne, we take a holistic and integrative approach to treating Hard Flaccid Syndrome, focusing on both physical rehabilitation and lifestyle adjustments to promote long-term healing. Our treatment plan may include:

1. Pelvic Floor Muscle Downregulation

For many individuals, excessive pelvic floor tension contributes to Hard Flaccid Syndrome. Learning how to release and relax these muscles through guided exercises can be crucial for recovery.

2. Pelvic Yoga and Gentle Movement

Yoga and mindful movement play a key role in restoring balance to the pelvic region. These exercises focus on deep breathing, muscle relaxation, and gentle stretching to improve circulation and reduce tension.

3. Osteopathic Treatment

Osteopathy is a hands-on therapy that helps to realign the body, reduce muscular restrictions, and improve overall nervous system function. By addressing musculoskeletal imbalances, osteopathic treatment can relieve pressure on the pelvic floor and surrounding structures.

Looking Beyond Symptoms: Addressing the Whole Person

At Eastern Osteopathy - The Pelvic Place Melbourne, we understand that Hard Flaccid Syndrome is more than just a physical issue—it often has a significant emotional and psychological impact. Our approach integrates stress management techniques, lifestyle adjustments, and patient education to empower individuals on their healing journey.

If you are struggling with symptoms of Hard Flaccid Syndrome, know that you are not alone. Kathryn, Meg and Rose are here to help you navigate this condition with a holistic, compassionate, and patient-centered approach to recovery.

Understanding Erectile Dysfunction: An Integrative Approach to Pelvic Health

Erectile dysfunction (ED) is a topic that many men hesitate to talk about, but it’s more common than you might think. If you’re experiencing difficulties with erections, you’re not alone. Research shows that approximately 1 in 5 men over 35 face this condition, and around 1 in 10 men are unable to achieve erections at all. While it’s more common as men age, younger men can also be affected. The good news? ED is often treatable, and understanding the condition is the first step toward finding a solution.

At Eastern Osteopathy - The Pelvic Place Melbourne, we believe in a holistic approach to treatment, considering not just the symptoms but the underlying causes that contribute to erectile dysfunction. By addressing lifestyle, musculoskeletal health, and pelvic function, we help patients find lasting relief.

What is Erectile Dysfunction?

Erectile dysfunction is the persistent inability to achieve or maintain an erection firm enough for sexual activity. It can present in different ways—some men struggle to get an erection at all, while others lose their erection midway through intercourse. ED can be mild, moderate, or severe, and experiencing occasional difficulties doesn’t necessarily mean you have a chronic issue. However, if it’s happening frequently, it may be time to explore the underlying causes and seek professional guidance. 

Common Symptoms of Erectile Dysfunction

If you have ED, you may notice one or more of the following symptoms:

• Difficulty achieving an erection firm enough for penetration

• Trouble maintaining an erection throughout intercourse

• Losing your erection prematurely during sexual activity

• A decline in confidence or increased anxiety about sexual performance
  

What Causes Erectile Dysfunction?

ED can stem from various factors, including:

• Physical health conditions: Heart disease, high blood pressure, diabetes, and obesity can all contribute to ED.

• Hormonal imbalances: Low testosterone levels or thyroid disorders may affect sexual function.

• Pelvic health issues: Dysfunction in the pelvic floor muscles, often overlooked, can play a significant role in ED.

• Psychological factors: Stress, anxiety, depression, and relationship issues can impact sexual function.

• Lifestyle choices: Smoking, excessive alcohol consumption, drug use, and lack of physical activity can impair erectile function.

• Medications: Some prescription drugs for high blood pressure, depression, or prostate conditions may lead to ED as a side effect.

Osteopathy and Pelvic Health in Erectile Dysfunction Treatment

An integrative approach to ED looks beyond conventional treatments and explores the role of pelvic health. Osteopathy, a holistic therapy that focuses on restoring balance within the body, and from our clinical experience can be highly beneficial for men experiencing ED. Osteopathic treatments can:

• Improve blood flow and circulation to the pelvic region, which is crucial for strong erections.

• Address musculoskeletal imbalances that may be restricting proper nerve function and circulation.

• Enhance pelvic floor function, ensuring the muscles involved in erection and ejaculation are properly engaged.

• Reduce stress and tension, which can contribute to both physical and psychological aspects of ED.

Solutions and Treatment Options

The good news is that erectile dysfunction is often treatable. Some potential solutions include:

1. Chatting to your GP about drug therapy

2. Lifestyle and Pelvic Health Improvements

• Engaging in pelvic floor exercises, can strengthen the muscles involved in erections.

• Maintaining a healthy diet and regular exercise can improve blood circulation and overall sexual health.

• Reducing stress through meditation, therapy, or relaxation techniques may help.

• Avoiding smoking, excessive alcohol, and drug use can positively impact erectile function.

3. Psychological Support

• Counseling or sex therapy can help address performance anxiety and relationship concerns.

• Treating underlying mental health conditions, such as depression or anxiety, can also improve symptoms.
  

When to Seek Help

If you’re experiencing frequent erectile dysfunction, it’s important to talk to a healthcare provider. ED can sometimes be a sign of an underlying medical condition that needs attention. Seeking treatment early can improve not only your sexual health but also your overall well-being.

Final Thoughts

Erectile dysfunction is a common yet treatable condition that affects men of all ages. An integrative approach that includes osteopathy, pelvic health, and lifestyle changes can provide effective and sustainable solutions. While it can feel frustrating or embarrassing, there are many resources available to help restore confidence and improve sexual performance. If you're dealing with ED, know that you are not alone—and there is help available. By addressing the causes and exploring holistic treatment options, you can take control of your sexual health and enhance your quality of life.

If you have concerns about ED, don’t hesitate to reach out to a healthcare professional, including an osteopath specializing in pelvic health. Taking that first step could make all the difference in your well-being and relationships.

If you’re experiencing erectile dysfunction, we’re here to help. Kathryn, Meg and Rose will take the time to understand your symptoms, assess your condition thoroughly, and create a personalized treatment plan that supports you.

Don’t let erectile dysfunction control your life—take the first step today. Book an appointment with one of our osteopaths today and start your journey to feeling better.

Understanding Male Pelvic Pain: An Integrative Approach to Treatment

Pelvic pain is a condition that affects 1 in 12 Australian men, yet it remains widely misunderstood and often misdiagnosed. Pain can occur anywhere between the belly button and the SIT bones (the bony structures at the base of the pelvis) and, if it persists for more than six months, it is classified as chronic or persistent pelvic pain.

Unlike many other pain conditions, male pelvic pain doesn’t always show up on routine scans or medical tests. This often leads to frustration, misdiagnosis, and ineffective treatments. This significantly affects a man’s quality of life. However, with the right approach, pelvic pain can be managed and improved. At Eastern Osteopathy, The Pelvic Place Melbourne we pride ourselves in addressing your pelvic pain using our osteopathic foundations and pelvic health training to holistically address your concerns

What Does Male Pelvic Pain Feel Like?

Pelvic pain can manifest in many ways, and every man’s experience is different. Some of the most common symptoms include:

• Pain when sitting – discomfort in the tailbone (coccyx), perineum, rectum, or genitals.

• Pressure, throbbing, tingling, or burning sensations – felt anywhere in the pelvis, including the penis, testicles, urethra, tailbone, or rectum.

• Bowel issues – such as rectal or anal pain, difficulty emptying the bowels, pain during bowel movements, or trouble passing wind.

• Bladder problems – including bladder pain, frequent urination, reduced urine flow, or a feeling of incomplete emptying.

• Sexual pain – discomfort during or after intercourse or with ejaculation.

• Mental health challenges – anxiety, depression, and high stress levels are common in men experiencing pelvic pain.
  

Why Is Male Pelvic Pain So Hard to Treat?

One of the biggest challenges with pelvic pain is that it often doesn’t have a clear, identifiable cause. Many men undergo multiple medical tests—such as scans, ultrasounds, or blood work—only to be told that everything looks “normal.” This can be incredibly frustrating and disheartening.

However, just because pelvic pain doesn’t appear on a scan doesn’t mean it isn’t real. In many cases, the pain is related to muscle tension, nerve irritation, postural imbalances, or stress-related factors, rather than an obvious structural issue. That’s why an integrative approach—which looks at the whole person, rather than just one part of the body—is often the key to effective treatment.

An Integrative Approach: How Osteopathy Can Help

At Eastern Osteopathy, we assist with male pelvic pain through a holistic and evidence-based approach that combines osteopathy and pelvic health. Rather than focusing only on the site of pain, we assess the entire body, looking for underlying issues that may be contributing to your symptoms.

What Does Treatment Involve?

Each treatment plan is tailored to the individual, but it may include:

✔️ Hands-on manual therapy – to release muscle tension, improve blood flow, and reduce nerve irritation.
✔️ Postural and movement retraining – to correct imbalances that may be putting strain on the pelvic region.
✔️ ️ Breathwork and relaxation techniques – to address stress-related tension in the pelvic floor.
✔️ Bladder and bowel retraining – to improve symptoms related to urination and digestion.
✔️ Lifestyle and ergonomic advice – to help manage pain triggers, whether it's sitting posture, physical activity, or stress levels.
✔️ Collaboration with other healthcare professionals – including GPs, psychologists, or pain specialists when needed.

The Mind-Body Connection in Pelvic Pain

Many men are surprised to learn that stress, anxiety, and past trauma can play a significant role in pelvic pain. The pelvic floor muscles respond to emotional stress just like any other muscle in the body—by tightening up. If this tension becomes chronic, it can lead to persistent pain, urinary problems, and sexual dysfunction.

That’s why our treatment approach focuses not just on the physical symptoms but also on nervous system regulation, relaxation techniques, and stress management to help break the pain cycle.

Regain Your Quality of Life

Living with pelvic pain can be isolating and frustrating, but you don’t have to go through it alone. With the right treatment and support, it’s possible to reduce pain, improve function, and reclaim your quality of life.

If you’re experiencing pelvic pain, we’re here to help. Kathryn, Meg and Rose will take the time to understand your symptoms, assess your condition thoroughly, and create a personalized treatment plan that supports your recovery.

Don’t let pelvic pain control your life—take the first step toward relief today. Book an appointment with one of our Osteopaths today and start your journey to feeling better.

Six Week Postpartum Checkup

1. Birth History

   Taking a detailed birth history is an integral first step when seeing patients for their six-week postpartum check. It is important to gain an understanding of the pregnancy and birth experience; be it vaginal, planned or unplanned cesarean. Knowing if labour was induced or came on spontaneously, the length of each stage of labour, whether there was any tearing or an episiotomy, how these scars are healing, pain relief that may have been used during labour and if any is still required, what forms of intervention may have been needed and if the patient felt they experienced any trauma, their general recovery and if they have the appropriate support inside and outside of the home. This information is essential to ascertain the individuals physical, emotional and social well-being, allowing you to treat the whole person.

2. General History Taking

   Along with the patients' birth history it is important to be aware of the patients general health status. Some individuals have experienced other hospitalisations, surgeries, medical conditions, musculoskeletal complaints, previous pregnancies and births or take ongoing medication. Knowing and understanding this information allows us to gage how much load their body is currently under, if there are any red flags that contraindicate safely proceeding with treatment and how to appropriately treat and manage their complaint.

3. Assessment

   Assessment begins as soon as we take our patient into the treatment room. A lot of information can be gathered by observing them walk into the room and the position they assume once seated.Once the birth history and medical history has been taken the "official" assessment begins. Starting with the patient standing, we observe their posture, breathing and functional movement. The patient then lies on the bed and we assess their abdominal muscles for any diastasis recti, if applicable we will feel for any tension that may be present around the cesarian scar. We also perform functional tests in this position before going on to assess the pelvic floor. The all important pelvic floor assessment! This involves observing the healing of any tears and episiotomy scars, checking for any signs of prolapse, assessing how the pelvic floor muscles respond to commands such as contracting and coughing, assessing the strength of the pelvic floor muscles and checking if any tension is present.

4. Treatment

   Treatment objectives are based on the patients' history, examination findings and treatment goals. Treatment can incorporate both internal pelvic floor techniques and external treatment techniques integrating all findings to treat the patient as a whole.When treating the pelvic floor we focus on decreasing the load applied to the pelvic floor muscles and any strain patterns that may be present and impacting function. Techniques include internal and external myofascial release to the pelvic floor, other muscles in the body, any scars that are present and joint restrictions.

5. Exercise Prescription

   Exercise prescription is a helpful tool to support patients in reaching their postpartum goals. This often begins with ensuring the patient is able to connect their breath with their pelvic floor. Many people are unaware that our pelvic floor actually rises and falls with concentric and eccentric contractions, as does the diaphragm, on exhalation and inhalation respectively. Occasionally, this movement is not synchronised or may not be present at all so it imperative that this is established first. From here we start including exercises aimed at easing tension or building strength of the pelvic floor in a functional manor and in combination with movement based exercise for the whole body.

6. Lifestyle Advice

   Lifestyle advice is another tool that we use in conjunction with treatment and functional exercise to support patient's working towards their goals. We incorporate lifestyle advice as part of the 6-week postpartum check and future appointments. This may include tips for lifting and carrying their newborn (and other children), pushing the pram, pain management as well as tips around creating healthy bowel habits and strategies to aid in managing other symptoms that may be present like urinary urgency or light bladder leakage. We find that this thorough and holistic approach is most beneficial in achieving positive patient outcomes and helping patients feel supported and empowered during their postpartum journey.

@bump.to.babe.osteo

What is Pelvic Organ Prolapse?

The most simple way to think about a pelvic organ prolapse is that there has been an anatomical shift in the position of one (or multiple) pelvic organs downwards.

The pelvic organs are supported in their position by the muscles of the pelvic floor and an intricate network of fascia and connective tissue. When these supporting structures lose integrity from weakness, stretching and or as new research suggests tension; the ability of this network to support the pelvic organs is impacted. When this happens the organs can bulge into the vagina (or rectum with a rectal prolapse) and towards the vaginal opening.

Common symptoms associated with prolapse include;

• Heaviness or dragging in the vagina.

• Fullness or bulging sensation in or out of the vagina.

• Urinary retention, post void dribble, urinary incontinence and urgency.

• Difficulty having a bowel movement.

• Constipation.

• Pain during intercourse

The most common presentations of pelvic organ prolapse are uterine prolapse, cystocele and rectocele. Although not as common, rectal prolapse, vaginal vault prolapse and intestinal prolapse as a herniation can also occur.

Can I have sex with a prolapse?

Sex with a prolapse; please know there are no studies or research to suggest sex makes a prolapse worse. The wall of the vagina is made to stretch and move, in most cases the penis, finger, dildo will move your prolapse out of the way, especially with the assistance of gravity.

If you have a prolapse and are wanting to be, or are active in the bedroom here are our top six tips:

• Grab a mirror, get comfortable and get to know your anatomy. If you’re up for it, masturbate. Yep, We just suggested that! Homework: learn what feels good.

• Use a good quality water based lubricant where the pH is in the range of the vagina.

• Experiment with pillows and positions that use gravity. Lifting your pelvis uses gravity to help move your organs away from the vaginal opening.

• Communicate with your intimate partner. Let them know what feels good, what makes you uncomfortable and if any pain is experienced. If sex is painful please seek out a health provider who can help.

• Take your time, have fun, and be kind to yourself.

• Listen to your body; stress, fatigue and long days on your feet can all impact your prolapse. What may have felt good that morning or last week may be uncomfortable later.

If you have a prolapse, help is available. Sex is possible. We are here to help

What should I do if I have a Prolapse?

You have a pelvic organ prolapse (POP), maybe it’s been officially diagnosed by a health professional, maybe you can see and feel it or maybe you know things ‘just ain’t right’ since you gave birth. The reality is up to 50% of people who have given birth, have a POP. Whether you have given birth or not, we have compiled our top five tips for those who have a prolapse.

1. Drop everything and see a pelvic floor physical therapist who is skilled in the assessment of POP. It is essential you have a thorough assessment of the pelvic floor, your breath, abdominal wall, core and whole body posture. You will need a plan for treatment and rehab along with lifestyle advice specific for you and your goals. Kathryn Johns is a leader in the fields of osteopathy, pregnancy and pelvic health in Australia and is experienced working with patients experiencing prolapse.

2. Breathe. You need to spend time reconnecting with your breath, this is a great way to connect with your pelvic region and core. Correct breathing strategies allow full range of motion of your pelvic floor and optimal strength. Poor breathing mechanics can increase the load down onto the pelvic floor and pelvic organs. 

3. Fix constipation. Constipation and straining on the toilet is a major risk factor for POP. If you are concerned about prolapse and you are constipated you need to see a naturopath/nutritionist and pelvic floor therapist ASAP. A great way to start impacting constipation right now is by looking at your pooping posture.

4. Listen to your body. Exercise, sexual positions and movement practices that felt great yesterday or even that morning may not feel good at another time. If this is the case, come back to your breath and rest. Reconnect with your pelvic floor, take things slow and be kind to your self.

5. Reduce stress. Studies have shown that when you are stressed and your central nervous system is in a heightened state your POP will bother you more. What does this mean? When you are stressed your POP symptoms will appear worse, they will bother you more than two days ago when you were feeling fancy free. This is not a reflection of how your anatomy is positioned, in fact you may have improved. If you are feeling stressed, come back to your breath, if this is not working it might be time to see a health professional to help with stress management strategies.

Everything you need to know about Pilates and Osteopathy for the Pre and Postnatal Period

Why should I participate in specific pre and postnatal pilates?

Prenatal Pilates at Eastern Osteopathy

Your body is doing amazing things to prepare for birth. As you progress through pregnancy, your body undergoes many changes. As osteopaths, we understands the physiological changes your body is going through throughout this period. Mia’s additional pilates training has deepened her understanding of what exercises are safe and relevant during the different trimesters of pregnancy. Exercises can be tailored to you and your individual needs throughout your pregnancy, with the focus of helping to prepare you for your birth and the postnatal period.

Postnatal Pilates at Eastern Osteopathy

Congratulations, you have had your baby and now you are ready to get back to your everyday activities and exercise!

Your body is recovering from the changes it has undergone throughout your pregnancy. Once you have your baby, the goal is to assist in restoring your body’s structure and function. At Eastern Osteo we work with a postpartum exercise guideline, which we tailored to you and your goals. Pilates is great for the postnatal period as we can begin to ease your body back into exercise with low impact activity. Regardless of your goal, if you want to exercise or not, there are many benefits to some postnatal pilates inspired workouts. You are now caring for someone else, this requires strength and function as your baby gets bigger and bigger! 

Mia is currently doing 1:1 consultations, focused on getting back into movement in the postpartum period. This entails a 45 minute consultation where a combination of manual therapy, assessment and implementation of exercises are utilised. This allows for individual time, advice and technique review so that you have the tools to correctly implement these practices at home. 

How does Eastern Osteopathy use Pilates inspired exercises in conjunction with manual therapy?

The beauty of having the combination of osteopathy and pilates is that Mia is able to assist and treat your pain with manual therapy and then prescribe pilates inspired exercises to maintain and improve function. 

Mia and Kathryn work together to formulate the most suitable program for your individual needs. Kathryn treats pelvic floor dysfunction with manual therapy; as we utilise a holistic approach, we know that other structures in the body can contribute to your pelvic floor dysfunction, and Mia works on these through manual therapy. In addition to manual therapy, Mia and Kathryn work together to design movement programs specific to you and your presenting complaint.

What is Constipation?

Constipation is a bowel condition that is estimated to affect approximately 20% of people. Typical symptoms include less than three bowel movements a week, where the consistency of the stool is dry and hard making it difficult to pass. The sensation of incomplete emptying can be a common complaint for those with constipation.

What causes constipation?

Constipation occurs when our waste moves through our digestive tract too slowly or the stool cannot be eliminated effectively from the rectum. When this happens stool becomes more solid, dryer and even harder to pass. 

The pelvic floor and constipation. 

Today let's talk about the pelvic floor and the important role it plays in helping you to eliminate a stool. For many this happens naturally and there is no need to think about it. But if you have dyssynergy of your PFMs (puborectalis - PR)  they become uncoordinated making it difficult to have a bowel movement.  

Why is coordination of the Pelvic Floor Muscles so important for a bowel movement?

It is increasingly recognized that pelvic floor dysfunction can cause difficulty with bowel movement and constipation. 

The puborectalis (PR) muscle originates from the pubic bone and wraps around the bowel, by doing so it creates a kink in the bowl. This kink works as part of our continence system. When the timing is right and you're getting ready to expel a bowel movement the PR muscles should relax in a coordinated manner, this straightens the back passage and with a strong propulsion through the rectum should allow for easy expulsion of the stool. 

Up to 50% of those who are chronically constipated have dyssergy of their PR. This means that either the PR is unable to relax or it reflexly contracts rather than relaxes with a bowel movement. This results in constipation. 

How do I treat constipation?

Our Osteopaths will work alongside your current health care providers to produce an individualized treatment plan, they use a variety of techniques to help your pelvic floor muscles relax and with biofeedback techniques teach you how to effectively bear down. 

Osteopaths work with your breath and facial system to help relieve any tension within the abdominal region restricting movement of your bowel. Then, through education, work with you to create a healthy bowel routine, defecation training, ensure good toilet habits using correct posture/stool and breathing strategies while having a bowel movement.

Tips to Improve Constipation at Home

1. Stop and chew your food. No rushing. 

2. Drink adequate water

3. Eat a variety of fibrous foods.

4. Exercise regularly

5. Abdominal massage

6. Spend time outside each day

7. Use a stool when sitting down for a bowel movement.

8. Relax the rectum when sitting on the toilet, allow your perineum to bulge. 

9. Keep your mouth and jaw relaxed.

10. Use low toned sounds - oooooo cha.

11. Never delay a bowel movement.

12. Relaxed breathing 

13. Don’t strain - use correct breathing strategies. 

14. Avoid negative self talk when toileting. 

What is Pudendal Neuralgia?

Before I start, let me introduce you to the pudendal nerve. The pudendal nerve originates at the sacrum levels S2-4, it then travels through the Alcocks canal and up along the pubic bone. It has three branches which supply the rectum, clitoris and the perineum. The nerve is made up of sensory, motor and autonomic fibers. When this nerve is irritated, which can occur anywhere along its entire length, Pudendal Neuralgia (PN) is the result.

What are the symptoms of Pudendal Neuralgia?

The Pudendal nerve is a complex nerve with numerous functions and branches, when it is compromised the symptoms can vary greatly depending on the branch or fibers affected.

• Increased pain when sitting

• Sharp and/or altered sensation in the area between the genitals and anus. 

• Can be described as a prickling, itching swollen sensation in the vulva, rectum or perineum. 

• Clitoral pain/sensitivity

• The feeling of recurrent bladder infections

How did I get Pudendal Neuralgia?

The nerve compression/irritation can occur due to of a number of reasons, including;

• Vaginal birth and stretching of the nerve.

• Excessive sitting where the inner parts of the sit bones are compressed, like when riding a bike. 

• Mechanical force/trauma to the area.

• Hypertonic pelvic floor muscles that compress the nerve. 

What is the treatment for Pudendal Neuralgia?

We recommend seeing Kathryn Johns, our osteopath who has extensive training in pelvic health and chronic pain conditions. Her approach is individualized to your specific needs and presentation and may include,

• Internal pelvic floor myofascial release work to help decompress the pudendal nerve. 

• Whole body treatment focusing on the fascial and biomechanical regions impacting the pelvis

• Breathing education

• Specific movement practices to help release tension in the pelvis and spine

• Mindfulness and meditation

• Lifestyle advice

Will I recover from Pudendal Neuralgia?

Yes. With the right treatment and management you can expect to make a full recovery. Our bodies are amazing and have enormous capacity to heal, allowing you to get back to living your full potential.