How is pelvic organ prolapse treated?
There are non-surgical and surgical options for the treatment of prolapse.
A prolapse can happen during pregnancy, just after childbirth or many years later and even to people who do not have pregnancies or give birth.
The majority of women (40%) have minor prolapses which have minimal or no symptoms. Many people experience different symptoms with the same size of prolapse. For some, it may affect their every move and for others, they may not notice it for the majority of time.
How ‘bothersome’ your prolapse symptoms are, normally defines your treatment.
Here are your options:
DO NOTHING – if your prolapse is not affecting your day-to-day quality of life and is not bothering you – leave it alone. You can make lifestyle adjustments to maintain this. You should follow a graded exercise programme that allows you to lift heavy gradually and under the supervision of a pelvic health fitness trainer. Manage your bowels and avoid being constipated as repetitive straining/bearing down through your pelvic floor muscles are likely to cause you to feel symptoms.
Try HYPOPRESSIVE exercises – This is where you learn to decrease your intra-abdominal pressure which can help with prolapse management. Many ladies I have met in Europe swear by this exercises to help reduce those bothersome symptoms of heaviness in the vagina or a bulge felt down there.
Use a PESSARY – A pessary is a ring/cube that inserts into your vagina that allows mechanical support to the inside of the vaginal walls. There are many different shapes and sizes so it can be trial and error to get a good fit. Pessaries will help reduce symptoms if they fit correctly and they can allow you to continue with normal activities of daily living and exercise. A pelvic health physiotherapist may be able to fit you one or a gynaecologist or GP. Ask for a referral and do some research. These are NOT for old ladies!
PELVIC FLOOR EXERCISES – Evidence from the NICE guidelines now confirms that regular strengthening programmes of our pelvic floor muscles will help improve or prevent prolapse symptoms from getting worse. It’s all about timing, motivation and technique as like any muscle they can take 6 – 12 weeks to strengthen.
If you struggle to remember to fit them in then be sure to download my free e-booklet: 10 Super quick ways to fit pelvic floor exercise into your day
A 16-week programme of pelvic floor strengthening is recommended as the first line of treatment for prolapse management under supervision of a pelvic health physiotherapist.
SURGERY – Based on your age, severity of prolapse and your general health your gynae surgeon will discuss appropriate surgical options for you. Generally, there are two types of surgery: reconstruction or vaginal closure which depend on the severity of your prolapse and if you are sexually active or not. Recently there have been lots of headlines about the MESH scandal. As always, discuss all your treatment options benefits, side effects and choices with your chosen health care provider.
Finally, don’t ignore your body’s symptoms.
Your body is AMAZING at keeping you HEALTHY and it is telling you something you need to address.
For more pelvic organ prolapse information, visit my prolapse educational website page.