How Safe Is Pelvic Floor Splinting With Prolapse and Bowel Emptying?

Bowel emptyingMany women support (splint) their pelvic floor during bowel emptying.

If you’re one of the many women who use this technique, take comfort in the knowledge that you’re definitely not alone!

Read on now to learn:

  • What is pelvic floor splinting?
  • When is pelvic floor splinting used?
  • Benefits versus risks?

What is Pelvic Floor Splinting?

Pelvic floor splinting is manually supporting the pelvic openings during bowel movementsPelvic floor splinting

Splinting usually involves the pads of the fingers holding up or physically supporting the perineum and/or vagina during bowel emptying.

The perineum is the skin/tissue located between the anus and the vagina (shown below).

When Is Splinting Used?

Women use manual pelvic floor support to support bowel emptying with a range of different pelvic floor problems.

  1. Prolapse

perineumSome women with prolapse problems apply gentle counterpressure
to the perineum and/or vagina to improve the ease of bowel emptying.

Women with rectocoele (posterior vaginal wall prolapse) sometimes use 2 fingers pressed against the internal back vaginal wall to reduce straining with emptying.

  1. After Prolapse Surgery

The prospect of bowel emptying after prolapse surgery can be terrifying, especially for women who have had perineal repair accompanying their repair.

Gently applying award of roll toilet paper or a soft pad to support the vagina and perineum can improve the ease of bowel movements during the early days of recovery.

  1. After Recent Childbirth

New mums often benefit from manual perineal support in the early days following vaginal delivery.

Supporting episiotomy stitches in the perineum can provide relief and reduce the fear associated with bowel movements after childbirth.

  1. Descending Perineum

Descending perineum is a condition where the pelvic floor tissues are stretched and lax. This condition causes the perineum to move downwards with the pressure of bowel emptying.

Some women with descending perineum apply gentle upwards counterpressure to the perineum for additional support during bowel emptying. Counterpressure may be applied using a wad of toilet paper or a pad.

Benefits Of Pelvic Floor Splinting?

For some women there are a number of potential benefits provided by splinting the pelvic floor during bowel movements including:

  • Decreasing prolapse bulging during emptying (e.g. with prolapse or after prolapse surgery)
  • Reducing discomfort (e.g. after vaginal delivery)
  • Decreasing perineal stretch (e.g. descending perineum)
  • Reducing straining to empty

Potential Risks?

There are no major risks from pelvic floor splinting!

During bowel emptying it’s important to remember to:

  • Maintain the correct seated posture with the inward curve in the lower back
  • Using the brace and bulge bowel emptying technique (shown in the video right)
  • Adhering to good hygiene with thorough hand washing


Key Points For Pelvic Floor Splinting With Bowel Emptying

  • Many women manually support their pelvic floor during bowel movements
  • Manual pelvic floor support need not be a source of embarrassment
  • Pelvic floor splinting with bowel emptying can be helpful for a range of pelvic floor problems
  • Always remember importance of correct posture and technique for optimal bowel emptying


prolapse exercises

with Pelvic Floor Physiotherapist Michelle Kenway

Learn how to exercise safely, strengthen your prolapse and reduce your risk of repeat prolapse.

Prolapse Exercises is a complete exercise guide for women after prolapse surgery seeking to exercise safely and protect their pelvic floor.



We Welcome Your Comments



  1. Your description of splinting is NOT clear. Illustrate or describe in detail. Are we talking ressing from the outside, or pressing inside the vagina.

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Linda some ladies support the outside of the vaginal and press up against the perineum (tissue between the vagina and anus). Others splint by supporting the inner back wall of the vagina internally by pressing against the stool via the vagina. I hope this clarifies things for you, cheers

  2. Vivienne says

    I had prolapse surgery 2 years ago on 1 st July.
    After waking up I was in such severe pain I was not sure what was happening to me . Without putting me straight back into surgery to have a look the surgeon diagnosed a punched sciatic nerve . Said it would get better went away on holidays for 5 weeks . The severe pain continued over the coming weeks with no sign of letting up . My GP put me onto Lyrica to give me some relief until the surgeon got back . Once he did get back I saw him immediately he then put me back into surgery and diagnosed Pudendal neuralgia which he injected nerve blocks into the nerve points . The nerve never settled consequently it attacked my bowel causing 2 bowel operations 7 more nerve blocks in theatre
    Now u gave sacral Neuromodulation machine implanted to work vowel and help with nerve oain . My daughter finally got me over to the United States where a friend of hers and her hubbys is head of Gyno at A major New York hospital after lots of testing by Gyno , nerve and bowel doctors here in Bew Tork they were all horrified at what this surgeon had done to me . He had wrapped barbed mesh around the nerve and ligaments to secure instead of stitching and lined my total pelvic floor with this mesh which they said was outlawed her in U.S because of probs it caused . They also all agreed that had this surgeon put me straight back in and released the ligaments and nerves straight away I would not have had to endure bowel surgery as I had no bowel problems before the original surgery .
    They all agreed I needed to go back into surgery and release what had been done 2 years ago .
    Now 3 weeks down the track the nerve pain is so much better . Although nerve still very sore nothing like what I was going through .
    I am back to square one though needing prolapse operation again after nerve settles and because of continual nerve shocks the vowel ops I had have been undone too so I need to address that again as well . It’s a warning to every woman needing this kind of surgery . I thought I had the best doctor in Australa and even so this happened to me 2 years out of my life 2 years in excruciating pain . 13 trips to theatre in Au. Now having machine implanted to help with bowel and nerve oain .
    Not to mention my married life my husband is so supportive and we had a living intimate relationship that has been taken away from me too. I have no feeling ir sensation around vagina or anal area and hoping when nerve settles it will come back but Pudendal Nerve is a back nerve to mess with it controls a lot of things too many to list . So even though I feel I have been butchered and looking at more operation down the track after this latest surgery I feel u gave turned a corner . Hoping to try and get my life back and these exercises and tips are very helpful .
    Thank u Michelie

    • Michelle Kenway Physiotherapist says

      Hi Vivienne

      Thanks so much for sharing your experience, I am sure that reading this will help other women in many ways so thank you for your generosity.
      I wish you all the best on your road to recovery from this major hurdle in your life. It must be very reassuring for you indeed that despite being early days your nerve pain is easing.

      Best wishes to you

  3. Is there any harm pressing outside the body just below the coccxis bone to help with bowel movements. This is after 3 rectoceal surgeries

  4. Mrs Davis says

    Hi Michelle, Pleased always to read your letters. Since you told me about foods not to eat I have had no trouble and no accidents. What I would like to know is some more vegetables I may eat.At the moment I only eat carrots,cauli ,pumpkin,peas,potatoes. could you tell me any others that are suitable? I also have a spoonful of Metamucil on my cereal and one panamax with one codeine tab in the morning. I am the lady who went for the trip overseas last year and had no trouble,thanks to your advice. Iam 83years old and have a worry free life because of you and your books. Thanks once again and you may pass this on if it helps anyone else. T Davis.

    • Michelle Kenway Physiotherapist says

      Hi Mrs Davis

      It’s always lovely to hear from you. Unfortunately I’m not a dietician and can only give general information on those foods likely to soften or firm the stool. According to the Looking After Your Bowel Brochure (Australian Government) the vegetable that soften the stool to limit include “red capsicum, cabbage, onions, spinach, dried and fresh beans, peas, corn, Brussels sprouts and broccoli” and that “potatoes, pumpkin and white rice (grain) help firm the stool. Have you tried other root vegetables like turnips, taro, parsnip or swede? These along with different varieties of potatoes might be worth testing too. It would probably help to see an accredited practicing dietician for specific advice for your situation. You might like to read the brochure referred to above as well for more information, I hope this gives you some ideas.

      All the best

  5. As always your information is both helpful and interesting, thanks Michelle. Cheers Marg.

    • Michelle Kenway Physiotherapist says

      As always it’s so lovely to hear from you Marg, thanks so much for always being there to support!

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