Treatments for pelvic organ prolapse include:

  • Conservative treatments, such as lifestyle changes
  • Pelvic Floor exercises
  • Vaginal pessaries
  • Surgical procedures

Non-Surgical Treatments

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.

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Pelvic floor exercises

Health professionals recommend maintaining a healthy weight as an important factor in supporting pelvic health, as excess weight can put added pressure on the pelvic organs and muscles. In addition, pelvic floor exercises, such as Kegel exercises, are highly beneficial for strengthening the muscles that support the bladder, uterus, and rectum. Regularly practising these exercises can help improve muscle tone, reduce the risk of pelvic organ prolapse, and support overall pelvic health. These exercises are best undertaken under the supervision of a specialised Womens Health Physiotherapist.

Vaginal pessary

Many women question if developing pelvic organ prolapse may be fixed without receiving surgery. If conventional methods do not relieve uterine prolapse symptoms, or you are experiencing a severe prolapse, a vaginal device may be the next best solution.

There are several types of devices available, 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. Similarly, the cube pessary is compatible with sexual activitiy but must 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 if not changed in a timely manner

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.

Uterine prolapse surgery is a common and routine procedure, 1 in 10 women undergoes vaginal prolapse surgery by the time they reach 80 years old.  There are several surgical options available for women with pelvic prolapse symptoms, and the most suitable approach depends on factors such as:

  • 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

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About London Women’s Centre – Prolapse Treatment Expert

We also offer a range of procedures carried out by our specialist urogynaecologist. You can expect a team that specialises in pelvic floor disorders, and manages them to a tertiary level, including highly complex cases and patiens who have had previous surgery.

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 ✓

Mr Panayi is a highly accomplished gynaecologist and subspecialist urogynaecologist with vast experience in the NHS and private sectors. Holding various senior positions and being a respected leader in his field, he is a sought-after speaker at national and international meetings and a dedicated mentor, researcher, and trainer for the next generation of consultants.

He has been a consultant for thirteen years and specialises in treating women with pelvic organ prolapse, as well as chronic pelvic pain and urinary incontinence. (link to appropriate pages)

Start your journey to better pelvic health by booking a consultation today.

Pelvic organ prolapse

Pelvic organ prolapse and pelvic floor disorders affect millions of women and their quality of life. Pelvic prolapse can be related to childbirth and menopause, as well as lifestyle and occupational factors and can cause discomfort and self-esteem issues.

Uterine prolapse can interfere with urinary, bowel, and sexual functions, particularly after childbirth when the pelvic floor muscles are weakened, increasing the risk of prolapse. This occurs when the pelvic floor muscles and attachments fail to support the pelvic organs effectively, causing them to descend into the vagina, a condition commonly known as vaginal prolapse.

Prolapse can affect the front wall or roof of the vagina (anterior), back wall or floor of the vagina (posterior), and the uterus, or womb. These conditions are not mutually exclusive, a patient may have pelvic organ prolapse of one or both vaginal walls, with or without a uterus/womb prolapse.

Causes & symptoms of pelvic organ 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 life, for example, uterine or vaginal prolapse can be diagnosed by chance during a smear test appointment.

For women who have symptoms, here are several of them associated with pelvic organ prolapse:

  • Feeling of a lump in the vagina
  • Dragging sensation, or feeling of the vagina dropping out
  • Sensation of something at the entrance to the vagina, ‘sitting on a ball’
  • 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

Diagnosis of prolapse

At London Women’s Centre, we take a detailed history and perform an abdomen and pelvic examination to identify and determine the severity of the prolapse. Our urogynaecologist will examine you lying on her back or in a standing position to best demonstrate the prolapse and your symptoms.

If a pelvic mass (a rare cause of uterine prolapse) is suspected, further additional tests may be required such as an ultrasound to assess the pelvic floor and rule out pelvic mass.

When should you seek treatment for prolapse?

You should seek treatment when you are affected by your prolapse or are concerned that you might have a prolapse. Prolapse can affect day to day activities or affect quality of life and have both physical or emotional effects. If you are experiencing any of these then you should seek medical advice.

What is the treatment for prolapse?

The treatment options for pelvic organ prolapse should address the specific impact it has on your quality of life, aiming to alleviate symptoms effectively.

There are several therapeutic approaches available for women with vaginal or uterine prolapse, and not all of them require surgery. These treatments can include lifestyle modifications, such as avoiding activities that strain the pelvic floor, pelvic floor muscle strengthening exercises, and the use of intravaginal devices like vaginal pessaries.

For some women, surgery may be the most appropriate option, while a more conservative approach may be better for others. Our consultant urogynaecologist at London Women’s Centre will assess your symptoms, conduct an examination, and discuss with you a tailored treatment plan that suits your individual needs.

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