Prolapse

“Prolapse” is a condition where the pelvic organs, such as the uterus, bladder and bowel protrude or herniate into the vagina. Prolapse is usually the result of weakening of the pelvic floor muscles and stretching of the ligaments that normally support the cervix, vagina, bladder and rectum. This can be the result of childbirth, chronic cough, increased weight, excessive straining or simply occur with the passage of time. It may be exacerbated by factors such as previous surgery eg. Hysterectomy and reduced oestrogen levels such as seen after menopause. With mild degrees of prolapse most women have no symptoms and treatment is often not necessary.

Where prolapse is more marked symptoms may include:

• presence of a lump or sensation of pressure in the vagina
• low back and pelvic discomfort with prolonged standing
• Urinary incontinence, urgency, incomplete bladder emptying, poor urinary stream and recurrent bladder infections
• Bowel discomfort with incomplete rectal emptying, constipation and need to manually assist emptying
• Sexual problems with lack of sensation, pain or vaginal bleeding.

At your appointment your symptoms will be discussed. It would be helpful if you could complete the available questionnaire (120KB) prior to your appointment. At the time of your consultation the degree and type of your prolapse will be assessed by vaginal examination. Options for management will then be discussed, this may include:

• reducing any exacerbating factors
• pelvic floor rehabilitation
• vaginal pessaries
• surgical management

Surgical correction of prolapse is required where the prolapse is severe, conservative treatments have been insufficient and symptoms are troublesome. Depending on individual circumstances and symptoms, the type of procedures to afford best results may include:

• Vaginal repair procedures
• Suspension procedure performed either vaginally or abdominally
• Hysterectomy
• Laparoscopic pelvic floor repair
• Laparoscopic Burch colposuspension
• Laparoscopic Paravaginal repair
• Sling procedures

Download Questioniare (120kb)

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