Treatments for pelvic organ prolapse include:
- Conservative treatments, such as lifestyle changes
- Pelvic Floor exercises
- Vaginal pessaries
- Surgical procedures
Non-Surgical Treatment
Lifestyle Changes
Other causes of prolapse include an unhealthy lifestyle, such as being overweight or long-term coughing, which heavy smokers frequently experience. Reducing heavy lifting and high impact exercise as well as modification to working practices may also help reduce the strain on the pelvic floor.
Pelvic Floor Exercise
Maintaining a healthy weight, as well as performing pelvic floor exercises such as kegel exercises, are also recommended by health professionals.
Vaginal Pessary
Many women question if developing pelvic organ prolapse may be fixed without receiving surgery. If conventional approaches do not alleviate uterine prolapse symptoms, or you are experiencing a severe prolapse, a vaginal device may be the next best solution.
Several devices can be utilised, but our gynaecologists usually recommend a ring pessary in the first instance but other pessaries are also available such as gellhorn or cube pessary, and we would discuss this with you and choose a device suitable for your needs.
The advantage of the ring pessary devices is that they do not block the vagina and are compatible with sexual intercouse. The cube pessary can be removed and reinserted before and after sexual activity.
Advantages of Vaginal Pessary Devices
- Less risky than vaginal surgery
- May be inserted and replaced in the outpatient setting without the need for anaesthetic
Disadvantages of Vaginal Pessary Devices
- May fail or be displaced (the ring moves from the vagina by the prolapse despite trying different sizes/devices)
- Ongoing treatment (continual checkups)
- May produce vaginal discharge
Surgical Treatments
A surgical procedure may be the next necessary step if pain and discomfort cannot be eased even after attempting lifestyle changes or using pessaries.
Uterus prolapse surgery is quite common and normal. 1 in 10 women undergoes vaginal prolapse surgery by the time they reach 80 years old. Various surgical options are available for women with pelvic prolapse symptoms that depend on the following:
- The organs involved
- The severity of the vaginal prolapse
- Any other medical conditions existing
- Severe cases/ Prolapse occurs again.
Surgery treatment options include:
- Vaginal repair
- Vaginal hysterectomy
- Uterus-preserving prolapse surgery
- Vaginal and perineal reconstructive surgery
About London Women’s Centre – Prolapse Treatment Expert
We also offer a range of laparoscopic procedures alongside our advanced laparoscopic surgeon.
You can expect a team that specialises in pelvic floor disorders, performs further tests, and manages them to a tertiary level, including highly complex cases and those with previous surgery.
Our dedicated team is highly skilled in various women’s health issues, sexual difficulties and issues with fertility. We deliver patient-centred care supported by our values of collaboration, clinical excellence and availability when you need us.
Mr Demetri Panayi – Pelvic Organ Prolapse Expert ✓
Diagnosis
At London Women’s Centre, we analyse detailed history and perform an abdomen and pelvic examination to identify the extent of the problem to repair uterine prolapse.
Our urogynaecologist examine the patient lying on her back or in a standing position to best demonstrate the prolapse.
If a pelvic mass (a rare cause of uterine prolapse) is suspected, further additional tests may include urodynamics to assess bladder function or an ultrasound to assess the pelvic floor and rule out pelvic mass.
Depending on the effect it will have on the quality of your life, the type of treatment options you need for the prolapse should be personalized to alleviate the symptoms.
Several therapeutic options are available for women with vaginal or uterine prolapse; not all require surgery. The treatments range from basic lifestyle changes include avoiding activities that put strain on the pelvic floor, pelvic floor muscle strengthening exercises and intravaginal devices (vaginal pessaries).
Surgery may be the best option for some women, but a more cautious approach is preferable for others. A London Women’s Centre consultant urogynaecologist will assess your symptoms and examine you, and develop a treatment plan that is individualised to you.
Pelvic organ prolapse and pelvic floor disorders frequently affect millions of women and their quality of life. Pelvic prolapse can be related to childbirth and menopause, which can cause discomfort and self-esteem issues.
Uterus prolapse may affect urine, bowel, and sexual function, especially after childbirth, when the pelvic floor muscles are weakened and have an increased risk of prolapse.
As a result, the muscles may fail to maintain the pelvic organ effectively, causing them to descend into the vagina. This is also commonly referred to as pelvic floor prolapse.
Prolapse can affect the vagina’s front wall, roof (anterior), back wall, floor (posterior), and the uterus, or womb.
These conditions are not mutually exclusive. As a result, a patient may have pelvic organ prolapse of one or both vaginal walls, with or without a uterus/womb prolapse.
Pelvic organ prolapse is caused by the weakening of the pelvic floor that support the organs and can be caused by various factors. Childbirth injury and menopause are the commonest risk factors for pelvic organ prolapse, especially if the labour is prolonged and difficult or if the baby is large.
Other risk factors include lifestyle causes such as occupations that involve prolonged standing or lifting, or straining conditions such as constipation. The pelvic organs lose their support as a result of these factors, and descend into the vagina, causing symptoms of prolapse such as bulging, dragging, or the feeling of sitting on a lump.
Sometimes, women with pelvic organ prolapse have no signs or symptoms and are unaware they have it. Fortunately, it has little impact on their lives and normally goes away on its own. For example, uterine or vaginal prolapse can be diagnosed by chance during a smear test appointment.
For women who sense they have symptoms, here are several of them associated with pelvic organ prolapse:
- Feeling of a lump in the vagina
- Dragging sensation
- Inability to retain tampons
- Slow urinary flow/incomplete emptying of the bladder
- Feeling the need to pass urine frequently or urgently (overactive bladder)
- Difficulty in bowel movement with associated straining
- Using a finger in the vagina or on the perineum to help empty the bladder or bowels
- The feeling of an obstruction when having sexual intercourse
- Difficulty achieving penetration when having intercourse
- A sense of vaginal laxity during sexual activities
- Pelvic muscles or lower back pain/discomfort
Our consultants frequently operate together to manage women with other gynaecological conditions closely related to vaginal prolapse or pelvic floor problems, such as period problems or endometriosis. Due to this collaborative nature of our service, we offer a comprehensive gynaecological service.
See the below links for some of the London prolapse procedures available:
Posterior Vaginal Wall & Perineal Body Repair
Vaginal Hysterectomy for Prolapse
Our London Clinics
The Medical Chambers
10 Knaresborough Pl,
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Kensington, London,SW5 0TGThe Lister Hospital
Chelsea Bridge Road
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London, SW1W 8RHSpire St. Anthony's Hospital
801 London Road, North Cheam
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Sutton, Surrey, SM3 9DWParkside Hospital
53 Parkside, London
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SW19 5NXNew Victoria Hospital
184 Coombe Lane West
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Kingston upon Thames, KT2 7EG
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