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Prolapse Treatment Options
Prolapse treatment options can be split into two broad categories: nonsurgical treatments and surgery. Considering the advantages and disadvantages of each can help you to understand which prolapse treatment is ideal for you based on your symptoms and needs.
Important Note: Please consult with your doctor or medical institution before beginning any prolapse treatment.
Nonsurgical Prolapse Treatments
If you have early stage prolapse or a chronic illness that prevents you from choosing surgery, there are still a variety of treatments that you can actively perform at home to lessen or control symptoms.
Nonsurgical Treatment Options:
- Changes to lifestyle and habits
- Pelvic floor exercises (Kegel exercises)
- Pessaries
- External prolapse braces
Lifestyle Changes and Habits
- Maintain a healthy body weight
- Diet (drink more water and consume fibrous foods to avoid constipation)
- Quit smoking
- Avoid heavy lifting
- Clothing choices (avoid clothes that cause unwanted pressure on the abdomen which puts stress on the pelvic floor)
Pelvic Floor Exercises (Kegel Exercises)
Pelvic floor exercises help strengthen the muscles that hold up the pelvic organs like the uterus, bladder, small intestine, and the rectum. Strengthening these muscles can prevent pelvic organs from descending or prevent existing POP from worsening. Prolapse exercises are also commonly known was Kegel exercises. Kegel exercises were invented by Arnold Kegel, an American gynecologist. These exercises are recommended by The American College of Obstetricians and Gynecologists as one way to “slow the progression of pelvic organ prolapse."
Before starting on any type of exercises, it is important to consult a professional like a physiotherapist that has in-depth knowledge of what exercises are beneficial or harmful. You do not want to worsen the prolapse by exercising the wrong way.
Pros of Pelvic Floor Exercise:
- Reduces progression of symptoms, prevention
- Easy to do at home
Cons of Pelvic Floor Exercise:
- It is said that Kegels takes 3-8 months to begin seeing results
- Exercises must be done consistently every day
- Since muscles weaken with age, any gained results may go away if you stop
- You can expect maintaining results until the onset of symptoms
Pessaries
A pessary is a prosthetic medical device that is inserted into the vagina in order to prevent prolapsed organs from sinking down further. The ring pessary is commonly prescribed by doctors. Vaginal washing and ring replacement are usually required at the hospital every 2 or 3 months. Pessaries are a relatively simple solution compared to surgical treatments, but since the device is placed inside the body, it can lead to infections, an increase of discharge, and cause an unpleasant odor. The vaginal membrane can also be scratched, which leads to bleeding. Since the pessary is inserted into the body, it impedes sexual intercourse. Although a simple solution, not every woman is able to find a pessary suitable for their body. Pessaries must be fitted by a doctor with a trial and error method which can cause a lot of burden to the body.
Pros of Pessaries:
- Simple treatment option
- Can be used as a treatment when surgery is not an option
Cons of Pessaries:
- Periodic replacement is required
- Risk of infections
- Vaginal bleeding can occur
- Excessive discharge
- Bad odor
- Insertions and removal can be painful
While pessaries are a common non-surgical treatment, it's important that you weigh the benefits and risks as other nonsurgical treatment options are available, such as a prolapse brace that can be worn outside the body. FemiCushion was designed for this purpose and has been effectively used by many women who could no longer accept the side effects of using a pessary. Read more about why women around the world continue to make the switch from pessaries to FemiCushion.
FemiCushion: Prolapse Treatment Without Surgery or Pessary
Unlike pessaries, FemiCushion is a non-invasive prolapse treatment designed to be used outside the body. It offers a gentler solution for prolapse by combining three main components - cushion, holder, and supporter. All components work together to keep the prolapse inside the body which relieves symptoms like pain and discomfort. FemiCushion is discreetly worn underneath clothing making it undetectable by others. The user has complete control over this treatment method and it is easy to take off and put on making it suitable for women of all ages.
Pros of FemiCushion:
- Customization options to fit your prolapse condition and body type
- Relief from pain, bleeding, discomfort, and incontinence
- No risk of infections since nothing is inserted inside the body
- Can be worn all day or when you feel discomfort
- Easy to clean and wash
- Discreet design ensures that no one else will know you're wearing it
- FDA Class 1 (1st grade) Medical Device
- CE-approved (European Standard)
Case Study: FemiCushion's Effective Results
A recent independent study on FemiCushion conducted by the Urology Department at the University of Campinas in São Paulo, Brazil, and published in the Pelviperineology journal showed effective results in women aged 60 to 79 who used the prolapse support device three months in a row. Improvements were found in lessening or decreasing:
- Pain or discomfort in the lower abdomen
- Feeling a lump or bulge in the pelvic area
- A visual lump or bulge outside the vagina
The study found that FemiCushion is an effective option for improving quality of life and managing symptoms caused by pelvic organ prolapse. For more information about this study, read the full article.
Pelvic Organ Prolapse Surgery
There are several pelvic organ prolapse surgery options currently available and your doctor can help you decide whether one of these options is appropriate based on your age, physical strength, and degree of symptoms. The table below outlines common pelvic organ prolapse surgeries.
| Method | Overview | Pros | Cons |
|---|---|---|---|
| Hysterectomy | Removal of the uterus | Eliminates the risk of uterine cancer and uterine fibroids | Unable to get pregnant |
| Vaginal Repair | Stitching of weakened vaginal wall tissue | Simple procedure | Risk of recurrence because it is formed of damaged tissue |
| Conventional Method (combination of the two methods above) | Stitching of vaginal wall after the removal of the uterus | Most common POP surgery and minimally invasive | Risk of recurrence and unable to get pregnant |
| Transvaginal Mesh Surgery (TVM)* | Reinforcing the weakened vaginal wall with a sheet-like mesh | Surgery is performed transvaginally (eliminates abdomen incision) and recurrence rate is low | Surgical mesh for transvaginal repair POP surgery is banned due to safety and effectiveness issues in the United States |
| Obliterative Surgery | Narrowing/closing the vagina to support prolapsed organs by sewing together front and back vaginal walls | Surgery can be completed in a short amount of time | Unable to have sexual intercourse and pap smears (test for cervical cancer) |
| Laparoscopic Sacrocolpopexy (LSC) | Attaching surgical mesh from the vaginal walls to the sacrum to strengthen the pelvic floor and return the vagina to it's anatomical position. This is done by using a laparoscope that is inserted into the abdomen through small incisions | Surgery with the lowest recurrence rate, short hospital stay, and quicker recovery | This is considered a major surgery, therefore it comes with risks like infections, damage to kidney/bladder, mesh eroding, difficulty passing urine, etc. Costs of surgery are high |
*In April 2019, the Food and Drug Administration (FDA) ordered that all makers of vaginal mesh for transvaginal repair of pelvic organ prolapse to stop producing and distributing this product immediately. The FDA has judged that makers of these devices "have not demonstrated reasonable assurance of safety and effectiveness." Therefore, the FDA is taking action to protect the health of these women across the United States. Learn more here.
Pros of Surgery:
- Pelvic organ prolapse surgery offers the potential of greatly improving your medical condition.
Cons of Surgery:
- Possibility of serious complications.
- Hospitalization is required.
- Recurrence can happen
The Best Prolapse Treatment Depends on Your Symptoms and Your Preferences
Finding the right prolapse treatment option for you can be very hard. There are many options available. It is important to research about the pros and cons of each treatment option then weight it out based on your preferences and the severity of your prolapse.
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