Treatment for Prolapse
This depends on the type and degree of prolapse, the general fitness or health of the woman and her choice:
Pelvic Floor Exercises are very useful in minor degrees of prolapse and should be tried first. A physiotherapist will instruct on how to carry out these exercises effectively. Ring Pessary: This is a plastic ring (PVC) that is inserted into the vagina by a doctor. It comes in different sizes and the doctor will choose the correct size. It stays in place on its own and if in the correct place, you should not even know it is there. The doctor will change this at the clinic every 4-6 months. An oestrogen cream may be used once or twice a week, in addition. Shelf Pessaries: Sometimes the prolapse is so much that the ring pessary falls out. In this case the doctor may try a shelf or other types pessary.
Surgical: There are many different operations available to treat prolapse and the one chosen by the specialist will depend on the type and degree of prolapse and whether there are any waterworks (urinary) complaints. Whether your family has been completed or if you are still having sexual intercourse is important. Some of the usual operations include: Anterior Repair – sometimes called a bladder repair it is performed when the prolapse is affecting the front wall of the vagina. At operation the excess vaginal skin is removed and the tissues brought back together. If there is a problem of urine leakage with coughing or sneezing, extra stitches will be placed around the ‘bladder neck’. This is sometimes called a ‘bladder buttress’.
Vaginal hysterectomy & Repair – performed if the womb is coming down. Posterior Repair – performed if the back wall of the vagina is bulging. At operation the excess skin is removed and the tissues brought back together again. There are other more complex operations for pelvic floor restoration.