Pelvic Organ Prolapse

Surgery

If you have pain and discomfort from pelvic organ prolapse that does not respond to non-surgical treatment and lifestyle changes, you may want to consider surgery. The choice of surgery depends upon which organs are involved, how bad your symptoms are, and what other medical conditions are present. In addition, your surgeon may have experience with and preference for a certain procedure. The goals of surgery are to relieve your symptoms and restore the normal functioning of your pelvic organs.

There are several types of surgery to correct stress urinary incontinence. These can be done at the same time as surgery to repair prolapse. These surgeries lift the urethra and/or bladder into their normal position. To learn more about these surgical procedures, see the topic Urinary Incontinence in Women.

Should I have surgery for pelvic organ prolapse?

Surgery Choices

Surgical procedures used to correct different types of pelvic organ prolapse include:

• Repair of the prolapsed bladder (cystocele) or urethra (urethrocele).
• Removal of the uterus (hysterectomy).
• Repair of the rectum (rectocele) and small bowel (enterocele).
• Repair of the vaginal wall (vaginal vault suspension).
• Closure of the vagina (vaginal obliteration).

What To Think About

Surgeries are designed to treat specific symptoms, so you may still have other symptoms after surgery. A pessary test may help the doctor see if urinary incontinence would be a problem after surgery. If the pessary test shows that urinary incontinence will be a problem, another surgery can be done at the same time to fix the problem.

Surgery in one part of your pelvis often makes a prolapse in another part worse, possibly requiring separate treatment in the future.⁶

Pelvic organ prolapse can recur after surgery. Doing Kegel exercises after surgery has been shown to improve symptoms of pelvic organ prolapse more than surgery alone. Other exercises recommended by a physiotherapist, when done after surgery, can have the same result.⁷

Since pelvic organ prolapse is strongly linked to labour and vaginal delivery, you may want to delay surgical repair until child-bearing is complete.

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Author:	Carrie Henley Monica Rhodes	Last Updated: November 29, 2007
Medical Review:	Adam Husney, MD - Family Medicine Joy Melnikow, MD, MPH - Family Medicine R. Hugh Gorwill, MD - Obstetrics and Gynecology
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