Your options for treatment will depend on the type and severity of prolapse.
Treatment options include the following:
Pelvic floor exercises may help to strengthen your pelvic floor muscles
The pessary is a plastic or silicone device that fits into the vagina to help support the pelvic organs and hold up the uterus. The most commonly used types are ring and shelf pessary.
The aim of surgery is to support the pelvic organs and to help ease your symptoms. Surgery for prolapse is usually performed through the vagina. Type of surgery will depend on your type of prolapse and your symptoms, as well as your age, general health, wish to have sexual intercourse and whether or not you have completed your family.
Possible operations include:
- Pelvic floor repair if you have prolapse of the anterior or posterior walls of the vagina (cystocele or rectocele); this is where the walls of your vagina are tightened up to support the pelvic organs. This is usually done through your vagina. In recent years a number of new operations have been developed where mesh (supporting material) is sewn into the vaginal walls. Operations that aim to lift up and attach your uterus or vagina to a bone towards the bottom of your spine or a ligament within your pelvis (sacrocolpopexy or sacrospinous fixation).
- Vaginal hysterectomy (removal of the uterus) is sometimes performed for uterine prolapse. Your gynaecologist might recommend that this be performed at the same time as a pelvic floor repair.
- Colpocleisis (closing off your vagina) may be considered but only if you are in very poor medical health or if you have had several operations previously that have been unsuccessful.
It may be possible to treat urinary incontinence at the same time as surgery for prolapse and your doctor will discuss this with you if relevant.7
How successful is surgery for pelvic organ prolapse?
No operation can be guaranteed to cure your prolapse, but most offer a good chance of improving your symptoms. The benefits of some last longer than others.
About 25–30 out of 100 women having surgery for prolapse will develop another prolapse in the future. There is a higher chance of the prolapse returning if you are overweight, constipated, have a chronic cough or undertake heavy physical activities. Prolapse may occur in another part of the vagina and may need repair at a later date.