All about vaginal prolapse treatment

There are various treatments for vaginal prolapse available. Find out more in this in-depth article by leading consultant gynaecologist Dr Vladimir Revicky.

What is vaginal prolapse?

Vaginal prolapse happens when the muscles and tissues supporting the organs in a woman's pelvis, such as the bladder, uterus, or rectum, become weak or stretched. This causes one or more of these organs to drop or press into the vagina. It can feel like a bulge or pressure in the pelvic area and might cause discomfort or problems with urination, bowel movements, or sexual activity. It's a common condition, especially after childbirth or as women get older, and there are various treatments available to help manage the symptoms and improve quality of life.

What are the symptoms of vaginal prolapse?

Patients with vaginal prolapse may experience a variety of symptoms, including a sensation of pressure or fullness in the pelvic area, a visible bulge in the vaginal canal, discomfort or pain during intercourse, urinary problems such as incontinence or difficulty emptying the bladder, and bowel issues like constipation.

What are the non-surgical treatments for vaginal prolapse?

Initial treatment for vaginal prolapse often involves non-surgical options. These may include:

Pelvic floor exercises

Pelvic floor exercises, which are also known as Kegel exercises, can help strengthen the muscles that support the pelvic organs. They involve repeatedly contracting and relaxing the pelvic floor muscles.

Pessary

A device inserted into the vagina that supports the pelvic organs. It can be used as a temporary or long-term solution, particularly for women who wish to avoid surgery or are not surgical candidates.

Lifestyle modifications

Certain lifestyle changes can alleviate symptoms of vaginal prolapse. These may include maintaining a healthy weight, avoiding heavy lifting, managing chronic cough and treating constipation to reduce strain on the pelvic floor.

What are the surgical options for vaginal prolapse?

Surgical intervention may be necessary when non-surgical treatments are insufficient. The choice of surgery depends on the type and severity of the prolapse, as well as the patient’s overall health and preferences. Common surgical options include:

Vaginal repair surgery

Vaginal repair surgery involves reinforcing the weakened pelvic floor tissues. This can be done using the patient’s own tissues or synthetic mesh. Procedures vary depending on the specific organs involved and may include anterior repair (for cystocele), posterior repair (for rectocele), and vaginal vault suspension.

Uterine suspension or hysterectomy

For uterine prolapse, surgical options include uterine suspension (repositioning and securing the uterus) or hysterectomy (removal of the uterus). The choice depends on the patient’s desire for future fertility and other factors.

Sacrocolpopexy

Sacrocolpopexy is a procedure typically performed for vaginal vault prolapse. It involves attaching the top of the vagina to the sacrum (a bone at the base of the spine) using a synthetic mesh to provide support.

What can patients expect during recovery?

Recovery time varies based on the type of surgery performed. Generally, patients are advised to avoid heavy lifting and strenuous activities for several weeks post-surgery. Pain and discomfort are common initially but can be managed with prescribed pain relief. Follow-up appointments are essential to monitor healing and ensure the prolapse does not recur.

What are the risks and complications of vaginal prolapse surgery?

As with any surgery, vaginal prolapse repair carries potential risks and complications. These can include infection, bleeding, damage to surrounding organs and adverse reactions to anaesthesia. Additionally, there is a risk of prolapse recurrence or new prolapse in a different part of the pelvic floor. Discussing these risks with a healthcare provider can help patients make informed decisions about their treatment.

How can patients ensure the best outcomes?

To achieve the best outcomes from vaginal prolapse treatment, patients should:

• Follow their healthcare provider’s recommendations for pre- and post-operative care.
• Engage in regular pelvic floor exercises to maintain muscle strength.
• Adopt a healthy lifestyle to minimise strain on the pelvic floor.

By understanding the various treatment options and adhering to medical advice, patients can manage vaginal prolapse effectively and improve their quality of life,

Do you require expert treatment for vaginal prolapse? Arrange a consultation with Dr Revicky via his Top Doctors profile.