Prolapse...is there anything that you can do?

What is pelvic organ prolapse?

A pelvic organ prolapse is a bothersome descent of a pelvic organ into your vaginal cavity. Despite there being no natural cures for this condition this does not mean it has to affect your livelihood and limit your activity forever. YOU HAVE OPTIONS!

Below are just some of the conservative and medical treatment options available to help reduce your prolapse symptoms and aid in correcting the pelvic organ position.

Treatment options for prolapse

DO NOTHING

Please know that not everyone with this condition requires regular intervention. For many just being educated and aware about the changes in their body and how to maintain a healthy bladder and bowel function is enough to reduce their concerns and therefore there is no need to proceed any further. Many may choose to seek treatment at a later date if their prolapse becomes symptomatic.  

NON-SURGICAL OPTIONS

Lifestyle changes

  • Avoiding/ reducing heavy lifting  & avoid coughing and sneezing: Both of these lifestyle factors increase one’s intra-abdominal pressure which increases the downward pressures through your pelvic floor and pelvic organs, therefore increasing one’s sensation of heaviness.

  • Weight loss: Reducing one’s body weight can help to reduce some of the additional daily pressures being placed on the pelvic floor.

  • Cease smoking: Reduces coughing and improves vaginal tissue health

  • Maintaining healthy bowel habits and avoid straining: Straining with bowel motions places pressure and further stretch on the pelvic fascia which can increase its laxity. Healthy bowel health is passing a motion 1x every 3days or 3x in one day. Bowel motions should be soft server ice-cream consistency and should be able to be passed without effort.

Pelvic floor exercises   

The role of your pelvic floor is to aid the pelvic fascia structures in supporting your pelvic organs and help to maintain continence. Strengthening one’s pelvic floor can help to reduce the dragging sensation often felt with exercises or tasks of daily living.

Vaginal support pessaries

A pessary is a device that is inserted into your vaginal cavity (in the same way as a tampon is) to support the vaginal walls and prolapsed pelvic organs. Pessaries come in several different shapes, sizes and materials to ensure they support the correct organs, are comfortable and are durable in a number of different environments such as playing sport. Some pessaries can be inserted and only removed every 3 months while others can simply be used for the activity that is causing you the most bother.

Topical oestrogen

Vaginal oestrogen works to improve tissue quality and reducing dryness in the area, aiding in reducing the sensation of drag.

SURGICAL OPTIONS

If you are not receiving your desired result with non-surgical options, you may consider a surgical procedure. Surgeries to repair a prolapse include but are not limited to anterior vaginal repair, posterior vaginal repair and a vaginal colpopexy.

These surgeries may involve the use of your own tissues (native tissues) or a biological graft (human or animal) or polypropylene mesh. The type of surgery and the materials used are dependent on which structures have prolapsed, the severity of the prolapse and the surgeon performing the procedure. All surgical options should be discussed with your surgeon prior to the procedure.

 

Further Information and resources

1.     https://www.safetyandquality.gov.au/sites/default/files/migrated/Treatment-Options-POP-Consumer-Info.pdf

2.     https://www.continence.org.au/information-incontinence-english/prolapse

 

Rachel Morgan-Varlow