Pelvic Organ Prolapse Treatment Options
There are different treatment options available and your doctor will be able to help you find the best solution to fit your lifestyle and treatment goals. Treatment will depend upon the type and cause of your prolapse as well as your plans for the future such as whether you are planning to become pregnant. Your doctor can diagnose pelvic organ prolapse and its severity during a routine pelvic exam.
There are both non-surgical and surgical treatment options for pelvic organ prolapse. In general, non-surgical treatments work best in mild cases. Surgery can provide long-term symptom relief but is not suitable for everyone. You should discuss all treatment options with your doctor.
Kegel Exercises – Pelvic floor muscle exercises, called Kegel exercises, can help strengthen the pelvic floor muscles. This may be the only treatment needed in mild cases of prolapse. For Kegel exercises to be effective, they need to be done daily.
Vaginal Pessary – A pessary is usually a silicone device placed in the vagina to support the pelvic floor and maintain support for the prolapsed organ. A healthcare provider will fit and insert the pessary, which must be cleaned frequently and removed before sexual intercourse.
Estrogen Replacement Therapy – Taking estrogen may help to limit further weakness of the muscles and other connective tissues that support the uterus, bladder or rectum. Estrogen has some considerable risks for some people. Check with your doctor to see if you are an appropriate candidate for estrogen replacement therapy.
A surgical treatment option for pelvic organ prolapse involves reinforcing the prolapsing pelvic organs with a specially designed graft. Restoring the normal anatomical position of the prolapsing organ may relieve the symptoms of prolapse.
Restorelle® DirectFix by Coloplast was created specifically for female pelvic floor repair. It is composed of a very lightweight mesh to conform to a women’s unique anatomy and leave little to no palpability. This lightweight mesh graft works with your body’s natural collagen promotion and tissue healing to provide extra support. This strengthened support system maintains the organ’s anatomical placement to help correct the prolapse.
Another surgical option which uses natural biological grafts of donated human tissue are called Axis™ Dermis or Suspend® Fascia Lata. These grafts are thoroughly processed, cleaned, and preserved to create a biologically compatible “blank slate” for your body to use in repairing its pelvic floor or stabilizing the urethra. The implanted graft provides strength as a scaffold with a recognized structure, and works in conjunction with your body’s natural regenerative healing process. Your body incorporates its own tissue into the graft to help correct the prolapse, restore continence and improve quality of life.
These options provide an alternative to the use of the patient’s own tissue for pelvic support. In some cases, a physician is able to perform these surgeries without using a graft. These native tissue repairs require healthy enough surrounding tissue or they may involve a second surgical site.
Important Safety Information
Mesh reinforced prolapse repair may not be suitable for every patient, and a thorough discussion between you and your doctor will enable both of you to determine if this treatment is right for you. There are many considerations when deciding to place surgical mesh and these should be discussed before any surgery with your doctor.
Surgical mesh is not appropriate for every patient. Your medical and surgical history will help determine if a procedure with mesh is right for you. Potential complications from mesh surgery may include: pain, slow healing of mesh infection or non-healing, mesh extrusion from the vagina, mesh erosion into adjacent organs, nerve injury, recurrent prolapse inflammation, adhesion formation, fistula formation, narrowing of the vagina, scarring, pain with intercourse and mesh contraction.
As with any surgery, other potential complications can include bleeding, infection, injury to blood vessels, nerves, bladder, urethra or bowel injury during mesh placement and may require additional surgery to repair. Difficulty with urination or defecation can temporarily or permanently occur as well.