Treatments for pelvic floor problems or prolapse

TREATMENTS FOR PELVIC FLOOR PROBLEMS OR PROLAPSE

  • Prolapse of the vagina or womb is a common problem affecting the quality of life of millions of women
  • Treatment should be tailored to the individual woman with the purpose of alleviating her symptoms
  • Treatment should take into account whether the woman is sexually active and whether she intends to have further children
  • Surgery is not the only solution
  • Prolapse treatment requires lifestyle changes even after surgery to prevent it returning

Conservative treatments

 

These treatments are low risk, and include reducing or stopping activities  that involves straining, and treating constipation or persistent coughing.

It also includes undertaking a pelvic floor muscle strengthening programme under the care of a dedicated Women’s Heath physiotherapist. This is also important for prevention of recurrence of prolapse after surgery or development of a new prolapse in the vagina where there was not prolapse previousl

Vaginal Devices

 

pessariesIf conservative measures have been unsuccessful in alleviating the symptoms of prolapse, a vaginal device may be used.

There are several devices that can be used, the most commonly used is a ring pessary. This is popular because it does not block the vagina and therefore is compatible with sexual intercourse. It needs to be replaced every six months, but otherwise should not be felt or bothersome and does not prevent any activity the women wishes to undertake.

Alternatives to the ring device include the shelf, Gellhorn, and cube pessaries or variations. These devices block the vagina and are not therefore compatible with sexual activity, with the exception of the cube pessary that has a mechanism for insertion and removal by the patient herself and therefore can be taken out and re-inserted before and after sexual intercourse.

The advantage of these devices is that they confer much less risk than surgery and can be inserted and replaced in the outpatient setting without the need for anaesthetic of any kind.

The disadvantage of devices is that they may fail. This means that they are displaced from the vagina by the prolapse despite trying different sizes or different devices. This method is also an ongoing treatment that requires repeated attendance for appointments. For some women this is not desirable. The final drawback of devices is that they can produce a vaginal discharge which some women do not like.

 

Surgery

 

There are a variety of surgical options for women with vaginal prolapse symptoms. These include vaginal repair, vaginal hysterectomy, uterus preserving prolapse surgery, vaginal and perineal reconstruction.

We carry out almost all our procedures for prolapse through minimally invasive means through the vagina. This means that there are no cuts or stitches on a woman’s abdomen and quicker recovery and shorter hospital stay. We also offer a range of laparoscopic procedures alongside our advanced laparoscopic surgeon. Due to the collaborative nature of our service, we are offer a comprehensive gynaecological service because our consultants frequently operate together to manage women with other gynaecological conditions in association with prolapse or pelvic floor problems, such as period problems or endometriosis .

Click here to download information sheets regarding procedures for prolapse