In deciding what treatment is most suitable, there are a few factors to consider:
Lifestyle
Depends on your level of physical activity, mobility, quality of life etc.
Preservation of sexual function
Although prolapse tends to occur in the older age group, it does not mean sexual function is unimportant. Many couples are still sexually active in their seventies.
The severity of the prolapse
This will determine the approach and options most suitable for treatment. "Uterine" prolapse is usually not just the uterus "drooping" but also the front compartment (bladder) and the back compartment (rectum and perineum). Usually, prolapse occurs as a result of:
- ageing,
- loss of pelvic support,
- ligament laxity and
- also, damage sustained during childbirth (which may be many years ago).
Generally, prolapse can be treated in several ways:
1. Conservative management: through pelvic floor exercises to strengthen the pelvic floor. A pessary may also be inserted to "push up" the prolapsing organs.
2. Vagina surgery to repair and strengthen the tissues. The womb may or may not be removed to achieve the desired result.
3. Abdominal or laparoscopic approach. This addresses the various compartment defects and serves to use stronger tissues in the body to "pull up" or anchor the organs to prevent it from drooping.
