Pelvic Organ Prolapse
Treatment Overview
Many women who have pelvic organ prolapse do not have symptoms and do not require treatment. If your symptoms are bothersome, you may want to consider treatment. Treatment decisions should take into account which organs are affected, the severity of symptoms, and whether other medical conditions are present. Other important factors are your age and sexual activity.
Many women are able to reduce pain and pressure from a pelvic organ prolapse with non-surgical treatment, which may include making lifestyle changes, doing exercises, and/or using a removable device called a pessary that is placed into the vagina to support areas of prolapse.
If your pelvic organ prolapse is causing pain or problems with bowel and bladder functions or is interfering with your sexual activity, you may want to consider surgery. Surgical procedures used to correct different types of pelvic organ prolapse include repair of the supporting tissue of the prolapsed organ or vagina wall. Another option is the removal of the uterus (hysterectomy) when it is the prolapsed organ or if it is causing the prolapse of other organs (such as the vagina).
Sometimes surgery cannot repair all the prolapsed organs. And sometimes pelvic organ prolapse comes back after surgery.
Initial treatment
Pelvic organ prolapse can be a long-lasting condition, but it does not have to be a cause of symptoms that disrupt your life. Many women with pelvic organ prolapse are able to relieve their symptoms without treatment by adjusting their activities and lifestyle habits. These changes might include:
- Doing pelvic floor (Kegel) exercises every day to tighten and strengthen pelvic muscles.
- Eating high-fibre foods to prevent constipation. Get at least 20 g of fibre per day.
- Cutting down on caffeine (found in coffee, tea, and soft drinks), which acts as a diuretic, causing you to urinate more often. Drink about 6 to 8 glasses of water a day.
- Achieving and maintaining a healthy weight.
- Avoiding activities, such as heavy lifting, that stress your pelvic muscles.
If your symptoms are not relieved by these lifestyle changes, you may want to consider treatment for pelvic organ prolapse. Treatment will be different depending on which organs are involved, how bad your symptoms are, and what other medical conditions are present. Treatment may include using a vaginal pessary, a removable device that is placed into the vagina to support areas of prolapse.
Ongoing treatment
Pelvic organ prolapse can be a long-lasting condition, but it often responds to adjustments in activities and lifestyle habits. If you have tried self-care, such as eating high-fibre foods, maintaining a healthy weight, and doing pelvic floor (Kegel) exercises, but your symptoms are increasingly bothersome, you may want to consider non-surgical treatment. Treatment will be different depending on which organs are involved, how bad your symptoms are, and what other medical conditions are present. Treatment may include using a vaginal pessary, a removable device that is placed into the vagina to support areas of pelvic organ prolapse.
Treatment if the condition gets worse
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. Types of surgery for pelvic organ prolapse include:
- Repair of the bladder (cystocele) or urethra (urethrocele).
- Removal of the uterus (hysterectomy).
- Repair of the rectum (rectocele) or small bowel (enterocele).
- Repair of the vaginal wall (vaginal vault suspension).
- Closure of the vagina (vaginal obliteration).
Often the doctor performs more than one of these surgeries at the same time. These surgeries are designed to treat specific symptoms, so other symptoms may remain after surgery.
For more information about surgery, see:
What To Think About
If you are considering having children, you may want to delay pelvic organ surgery. If you have surgery and then deliver a child vaginally, the strain on your pelvic organs may cause them to prolapse again.
Sometimes surgery cannot repair all the prolapsed organs. And sometimes pelvic organ prolapse comes back after surgery. If you have surgery to repair pelvic organ prolapse, whatever caused the pelvic organ prolapse the first time may cause it to happen again. Certain exercises and changes in lifestyle and diet can sometimes prevent this.
Pelvic organ prolapse may be a progressive condition, gradually getting worse and causing more severe symptoms. However, in many cases it does not progress and may improve over time.3
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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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