Treatment Options for Pelvic Organ Prolapse

“Best decision I ever made when I opted to have the surgery!”
– Laurie, 55

Don’t be discouraged by your condition. Half of all women between the ages of 50 and 79 say they have prolapse symptoms.36 There are different options you can consider to treat pelvic organ prolapse. It is best to consult a physician that specializes in pelvic floor treatments as they will be the one to guide you through your treatment options and help you decide what the best treatment option is for you. Your treatment will depend on the type of prolapse you have as well as your future plans, which may include pregnancy.

Your Diagnosis

Prolapse is a very common problem affecting millions of women.35 However, many women believe that their condition is a normal part of aging. Others are unaware of this condition and its treatment options. With the treatment options available today, women no longer have to live with this uncomfortable condition.

  • After discussing your medical history and symptoms with your physician, they should perform a pelvic exam, using a speculum, to confirm a diagnosis.37 You may need additional tests to determine the type of prolapse, the cause and the best treatment options for your condition.37

Additional exams that might be necessary to assess the symptoms or severity of prolapse include:37

  • Pelvic ultrasound is a diagnostic exam that allows your physician to view the organs and structures within your pelvis.38
  • A pelvic MRI provides images of the pelvic area to allow closer examination of your pelvic organs and structures.37
  • Urodynamic study or testing focuses on how the bladder, sphincters and urethra work together to store and release urine. (39)
  • Cystoscopy involves your physician using a cystoscope (rigid or flexible) to visually examine your bladder and urethra.37
  • Defecography is a radiologic study to look at bowel function and any prolapse symptoms that may be present.37

 

Treatment Options

Non-surgical Management Options Prolapse may be managed with vaginal pessaries, Kegel exercises, biofeedback and lifestyle changes. These options may involve long-term treatment, on-going maintenance and continued expenses, and they may not address your underlying condition.36

Vaginal Pessary is a device that’s placed in the vagina to support the pelvic floor and support the prolapsed organ. Your physician will fit and insert the pessary, which must be cleaned frequently and may have to be removed before intercourse.40

Kegels are exercises that you can do on your own to help strengthen your pelvic floor muscles.9

Biofeedback Therapy involves learning how to notice and working to control your body’s functions. While a monitoring device is placed by your physician, you will be asked to use your pubococcygeus muscle to see how much strength you need to contract your pelvic floor muscles correctly. 41

It is important to understand your body and learn about all of your treatment options, both non-surgical and surgical, to help find a solution that is right for you. Seek out a specialist who specializes in pelvic floor treatments and discuss your options to find the best solution for you.

Surgical Options

Surgical repair can be done through the vagina or through the abdomen.

  • Anterior or posterior colporrhaphy in which the wall of the vagina is strengthened with sutures so that it once again supports the pelvic organs.
  • Surgery using vaginally placed mesh is done through an incision in the vagina. Surgical grafts include synthetic mesh or biologic tissue.
  • Sacrocolpopexy and sacrohysteropexy are done through the abdomen to repair vaginal vault prolapse and uterine prolapse with surgical mesh.

The idea of any surgery can be scary, but rest assured there are 300,000 pelvic organ prolapse surgeries performed in the U.S. each year.35

Reconstructive surgery of the pelvic floor is performed with the goal of restoring the organs to their original position.

If you are considering surgery with the use of surgical mesh to repair your POP, ask your surgeon these questions before you agree to the procedure:

  • Are you planning to use mesh in my surgery?
  • Why do you think I am a good candidate for a prolapse repair procedure with mesh?
  • Why is surgical mesh being chosen for my prolapse repair procedure?
  • What are the alternatives to transvaginal surgical mesh repair for prolapse, including non-surgical options?
  • What are the pros and cons of using mesh in my particular case?
  • Will my partner be able to feel the mesh during intercourse?
  • Could my prolapse be repaired successfully without using surgical mesh?