Prolapse refers to tissue falling down. Many women develop a feeling of tissue falling down vaginally which very slowly gets worse over time. This can either be tissue of the front vaginal wall, back vaginal wall or the uterus. It is not possible for patients to know the difference between these but it can be determined on an examination.
Pelvic floor exercises, Pilates, losing weight, vaginal estrogen cream, avoiding heavy lifting and straining bowels can all improve prolapse but it is unlikely to disappear completely.
Often a visit with a Physiotherapist is required to ensure you are doing your pelvic floor exercises correctly - they can be hard to learn by yourself at home, and if done incorrectly they could make your prolapse worse. If Physiotherapy is the right choice for you, a supervised pelvic floor exercise program, along with tailored lifestyle advice, can reduce prolapse symptoms and prevent progression.
However, if your prolapse continues to be problematic there are 2 different types of treatment.
- Vaginal Pessaries
Vaginal pessaries are made of soft silicone. They come in many different shapes and sizes. They can be inserted vaginally to hold up the prolapsing tissue. These are replaced every 6 months but can provide a very good long term treatment option.
Prolapse surgery needs to be individualised to the type of prolapse but almost always it can be performed vaginally or with key-hole (laparoscopic) surgery.