Women experiencing pelvic organ prolapse have had one or more of their pelvic organs drop from their normal position, usually into the vagina. Organs that may drop include the bladder, the intestine, uterus, the pouch between the uterus’ back wall and the rectum, the top of the vagina, or the front or back wall of the vagina. In mild cases, you may experience no symptoms. In more serious cases, you may experience symptoms such as painful or impaired bowel and bladder functions, pain during sexual activity, ability to see or feel a bulge of tissue outside the vaginal opening, a heavy or full feeling in the pelvic region, and/or aches or pulling in the lower abdomen or pelvis. A variety of treatments exist, including lifestyle changes and weight loss, exercise and physical therapy, insertion of a pessary, or surgery. Your doctor may prescribe a combination of these treatments.
Top 4 Prolapse Treatment Options
- Lifestyle changes & weight loss
- Exercise & Physical therapy
- Pessary
- Surgery
Lifestyle changes & weight loss
Your doctor may recommend lifestyles changes such as a healthier diet, weight loss and to have you stop smoking. The recommended diet features at least 20 grams of fiber per day. The increase in high-fiber foods helps prevent constipation. If you are not already at a medically healthy weight, your doctor will provide a diet to help you reach and maintain it. Other lifestyle changes include a cessation of smoking tobacco and avoiding activities that cause pelvic muscle stress like heavy lifting.
Highlights:
- Healthier, high-fiber diet
- Weight loss
- Stop smoking
Exercise & Physical therapy
Another option includes physical therapy and a daily exercise regime to strengthen your core and pelvic muscles. In physical therapy you’ll learn pelvic floor exercises to strengthen your pelvic floor muscles. The physical therapist attaches monitoring devices with sensors to your skin, vagina or rectum that provide biofeedback. As they teach you the exercises, a computer screen shows the muscles you’re using and the strength of each squeeze/contraction. This helps you learn to perform each exercise properly by letting your physical therapist see that you’re using the right muscles. You’ll continue to perform the exercise regime daily at home over the long-term.
Highlights:
- Physical therapy with biofeedback
- Core strengthening exercises
- Pelvic muscle strengthening exercises
Pessary
Some cases of prolapse require insertion of a pessary into the vagina to support the dropped organs. Made of silicone, pessaries vary in shape and size. Although it is inserted into the vagina, it does not require surgery. The pessary used for you depends on the affected organs and your measurements.
Highlights:
- Made of silicone
- Variety of shapes and sizes
- Inserted in vagina
Surgery
In cases where non-surgical treatments fails, your doctor may recommend surgery. In some severe cases, surgery does not correct the problem or prolapse re-occurs after surgery. The surgery needed depends on which organs the prolapse affects. Depending on the organs affected, you may need an obliterative surgery or a reconstructive surgery. Obliterative surgery narrows or closes off the vagina to support the organs. You may no longer engage in sexual intercourse after this surgery. Reconstructive surgery may remove an organ, such as the uterus (hysterectomy) or may support it by reconfiguration of the ligaments or by inserting vaginal mesh or other means. Some women may need estrogen treatment before surgery. Your doctor will consider factors such as your age, childbearing plans, health conditions, weight, and whether you smoke. Surgery can cause new problems including pain in the pelvic area, painful sex, or urinary incontinence.
Highlights:
- May require estrogen treatment before
- May end sexual activity
- May cause new problems
Conclusion
Most doctors recommend non-surgical treatments for pelvic organ prolapse and save surgery as a last resort. Treatment options include lifestyle changes such as diet, ceasing smoking, and weight loss; core and pelvic strengthening exercise regimes combined with physical therapy using biofeedback; insertion of a silicone pessary in the vagina to provide organ support; obliterative or reconstructive surgery. Talk with your doctor to determine the best treatment option for you.