Uterine Prolapse

Treating Uterine Prolapse

Lifestyle Changes
Lifestyle changes can help alleviate prolapse. For example, weight loss is recommended in women with uterine prolapse who are obese. Also, heavy lifting or straining should be avoided, because they can worsen symptoms.

Pessaries
Most women with mild uterine prolapse do not have bothersome symptoms and don’t need treatment. Vaginal pessaries can be effective for many women with uterine prolapse. Surgery usually provides excellent results, but some women may require treatment again in the future.Uterine prolapse can be treated with a vaginal pessary or surgery. A vaginal pessary is a silicone or plastic ring-shaped device that is inserted into the vagina to hold the uterus and vaginal walls in place. It may be a temporary or permanent form of treatment. Vaginal pessaries are fitted for each individual woman. Some pessaries are similar to a diaphragm device used for birth control, or they may have other shape. Many women can be taught how to insert, clean, and remove the pessary on their own.

Since pessaries may cause an irritating and abnormal smelling discharge, they require periodic cleaning, sometimes done by the doctor or nurse. In some women, the pessary may rub on and irritate the vaginal wall (mucosa), and in some cases may cause blisters in the vagina. The downside of pessaries is that they may interfere with normal sexual intercourse by limiting the depth of penetration. Or in some cases, intercourse is not permissible.

Surgery
Surgery depends on:

  • Degree of prolapse
  • Desire for future pregnancies
  • Other medical conditions
  • Desire to retain vaginal function
  • Age and general health

There are some surgical procedures that can be done without removing the uterus, such as a laparoscopic uterosacral suspension or sacrohysteropexy. Both procedures involve using the natural structure of the pelvis to support the uterus or in some cases, grafts (skin transplants) are used to attach the uterus.

In laparoscopic uterosacral suspension, the ligaments on either side of the uterus are used to help support the bladder. A laparoscope, a thin surgical instrument, is used in the procedure.

In sacrohysteropexy, a synthetic mesh (a special woven fabric) is used to hold the uterus in place. It allows for more normal sexual function and helps preserve childbearing.

A vaginal hysterectomy (when the uterus is removed) may also be used to correct uterine prolapse. Any sagging of the vaginal walls, urethra, bladder, or rectum can be surgically corrected at the same time.