If you have been diagnosed with or think you may have a prolapse, you can find out about the different types of treatments that may be offered to you here, as well as ways of helping yourself. This information should be used in conjunction with support from your GP or health professional to help you find the right course of treatment best suited to your individual needs; enabling you to manage your condition and improve your quality of life.
Please use this information carefully and always speak to your GP or health professional, they can explain what is causing your problem and how the different treatments may help you. They will also talk to you about any side effects, these are extra problems that can be caused by the treatment. Together, you can decide which treatment is the most suitable.
There are four options to consider:
- Do nothing – if the prolapse is not causing any interference with daily life. However, avoiding heavy lifting or prolonged standing will reduce the symptoms.
- Physiotherapy may help with the use of the pelvic floor exercises and equipment aimed at stimulating and strengthening the pelvic floor muscles. The aim would be to relieve any discomfort and in mild cases, possibly cure the prolapse. Further information about pelvic floor exercises can be found via the conservative treatments link box below.
- The use of a mechanical device called a pessary. This is used to ‘hold up’ the prolapse and reduce the symptoms. The pessaries do not cure prolapse but just control the prolapse whilst the pessary is in place. There are a variety of pessaries available, but the most commonly used one is the ring pessary.
- Finally, surgery – The most common surgery for prolapse is a pelvic floor repair. This is a term used to describe basic repairs to the pelvic floor. More specifically, the term anterior repair refers to correction of the front wall of the vagina; and posterior repair, to correction of the back wall of the vagina. If the uterus is prolapsing, then it can be removed with a hysterectomy. If you have already had a hysterectomy, then the top of the vagina can be re-suspended.
Surgery for Prolapse – things to consider
Sometimes the operation you have for prolapse will change from the original plan, either because of what the assessment the doctor does at the beginning of surgery to consider what is prolapsing and how much or difficulties experienced during the operation. In this case, your doctor will do what he or she thinks is best for you at that time. If a mesh or extra tissue is used in a prolapse operation, there is a risk that the mesh can get infected, though antibiotics are given in theatre and for a period of time after surgery to prevent this, or the mesh can cut through (erode) the surrounding tissue. This may require a further operation to remove part of the mesh or repair any damage.
About a third of women who have prolapse surgery need more than one operation because there is a 25-30% chance the prolapse can return or a different type of prolapse develops. For example, a prolapse of the womb can occur after an operation for prolapse of the vagina and vice versa.
Prolapse surgery usually improves or cures the symptom of ‘something coming down below’ or the lump in the vagina. Symptoms that relate to bladder and bowel problems, including constipation or incontinence, are not always improved. Similarly, problems with your sex life may not be improved with surgery.
In some cases, some new bowel or bladder symptoms develop after prolapse surgery, which may require further treatment in the future, including further surgery. Some women develop incontinence after prolapse surgery and some have problems emptying their bladder and need to use a catheter afterwards. This problem usually gets better with time. There is a small risk of venous thrombosis (clots forming in your legs and lungs) with any pelvic surgery. To reduce this risk you will be given an injection every day and some anti-embolic stockings to wear.
How long will it take to recover?
Many women have a vaginal pack (ribbon gauze material) inserted at the end of a prolapse operation, to prevent bleeding. A urinary catheter is also used to rest the bladder immediately following the operation. Both of these are usually removed the day after surgery. It is likely that you will be in the hospital for 2-3 days depending on the type of prolapse operation and any medical conditions you have. Following this the recuperation period is 2 -3 months and you must avoid heavy lifting and stretching for three months.