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Prolapse Treatment

Pelvic organ prolapse is a weakness in the fibrous tissue as well as ligaments that can lead to bulging of pelvic organs.

It's essentially a vaginal hernia, which can contain bladder, rectum or small intestine.

The uterus can also herniate, which is called a uterine prolapse.

For the most part, pelvic organ prolapse is not dangerous, but it can have a significant impact on your quality of life. You can have discomfort and difficulties with evacuation of urine and bowels from vaginal bulging.

Treatment Options

Prolapse can be identified in up to 34% of women during gynecological examinations.

Not all prolapse requires surgical repair; surgery is often reserved for those who develop bothersome symptoms.

We will educate and guide you on all available treatments for prolapse, taking into consideration your general medical health, activity level, sexual activity, age and preference.

What to Expect

If you have symptoms of prolapse, we’ll start with a thorough evaluation to determine the exact nature of your symptoms and what is bothering you the most.

We’ll then perform a physical exam to stage the prolapse.

We’ll also obtain a thorough history and perform a physical exam, because not all of your symptoms may be explained by prolapse.

Once other potential issues such as pelvic masses, bladder lesions, urine infections and high tone pelvic floor issues have been ruled out, we’ll design a treatment plan tailored just for you.

Conservative Treatment

Conservative treatment may include pelvic floor physical therapy or pessary reduction of the prolapse.

A pessary is a round or cuboid shaped object which is fitted to your vagina. With proper placement and sizing, it reduces the prolapse bulge and resolves symptoms without surgery. Some women use this as a temporary measure until they have time to undergo surgery.

Surgical Treatment

In cases where surgical treatment is pursued, our surgeons offer the full spectrum of options. These include:

  • vaginal repairs using either natural tissue or mesh (your choice)
  • open and robotic-assisted laparoscopic surgical techniques
  • repairs that involve uterine sparing or a hysterectomy

After your prolapse treatment, you may need both pre- and postoperative pelvic floor physical therapy to restore bowel and bladder function.

We offer all treatment options, with the choice for prolapse repair tailored to your individual needs.

Surgical Mesh Update

You may have heard that the FDA has ordered the manufacturers of surgical mesh used for transvaginal repair of anterior compartment prolapse (cystocele) to stop selling their products immediately.

It’s important to note this is not because of reported problems with the mesh, but because the manufacturers have not demonstrated reasonable assurance of safety and effectiveness for these devices. For more details on this, visit the FDA information page.

We realize you may have some questions about this.

If you received transvaginal mesh for the surgical repair of prolapse, please continue with your annual and other routine check-ups and follow-up care. There is no need to take additional action if you are satisfied with your surgery and are not having any complications or symptoms.

If you have complications or symptoms, including persistent vaginal bleeding or discharge, pelvic or groin pain or pain with sex, you should notify your health care provider.

You should also let your health care provider know if you have surgical mesh so it can be entered into your medical record, especially if you plan to have another surgery or other medical procedures.

If you were planning to have mesh placed transvaginally for the repair of prolapse, we will discuss other treatment options with you.

If you have had pelvic organ prolapse surgery but don’t recall if mesh was used, please call our office at (425) 899-5800.

Glossary

Colpocleisis

Colpocleisis, or Lefort Procedure, is the closure of vaginal prolapse.

Pelvic Floor Muscle Rehabilitation (PFMR)

The goal of PFMR is to teach you how to contract the pelvic floor muscles to strengthen them and in turn alleviate associated symptoms. This helps reset the nerves and muscles governing bowel and bladder function to give you better control.

Take the first step in navigating your personalized treatment. It's as easy as filling out our secure appointment request form.

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