Urethrocele
Condition Overview
The bladder and urethra (and other organs including the uterus and rectum) are typically supported in place by a “hammock” of muscles, ligaments, and fascia called the pelvic floor muscles. Throughout the day this “hammock” responds to movement and activity and pressure in order to support the organs in your pelvis. However, if this “hammock” is dysfunctional, a prolapse can occur. There are a variety of prolapses that can occur, but one in particular is called a urethrocele. This is the lowering of the urethra from its position in the pelvis into the anterior (or front) vaginal wall.
The most common causes of a urethrocele are pregnancy and childbirth, prolonged straining, aging/menopause, constipation, chronic coughing, heavy lifting, pushing to urinate, and prior pelvic surgery. These activities contribute to poor pressure management and weakness to the pelvic floor muscles and connective tissues.
How Do I Know if I Have a Urethrocele?
If you have a urethrocele you will likely have urinary incontinence especially when you cough, laugh, sneeze, or jump.
Other symptoms include poor urine flow, difficulty emptying your bladder, and post void urinary dribbling.
What Can Physical Therapy Do For Me?
During a physical therapy evaluation we will assess your bladder/bowel habits, exercise routine, breathing, and pressure system. We will also perform an in-depth muscle examination including an external and internal pelvic floor assessment with your consent. With this, we will determine your abdominal, hip, and pelvic floor muscle strength, endurance, and coordination.
Ironically, despite people thinking that kegels are the solution to a prolapse, they may be helpful at some point but occasionally not right away due to pelvic floor muscle overactivity. In addition, many people lack coordination meaning despite the strength of their pelvic floors they are not performing a pelvic floor contraction at the appropriate times so they do not get the support they need when performing activities. This is why it is so important to have a muscle assessment and not just begin a pelvic floor muscle strengthening program without knowing your baseline.
After your initial assessment, we will set-up a treatment plan depending on your pelvic floor characteristics!
We will educate you about optimal bladder and bowel health, give techniques to improve your pressure management and bladder habits, provide manual treatment as necessary, and outline pelvic floor exercises to begin with.
Manual treatment can include but is not limited to dry needling, myofascial release, cupping, and connective tissue mobilization.
Exercises can include but are not limited to kegels, hip and abdominal strengthening, downtraining/pelvic floor stretches, and functional mobility exercises. With each session we will reassess and progress as appropriate!
Schedule an appointment today if you feel like any of this could pertain to you!