Surgery for Prolapse

What Are the Treatments for Pelvic Organ Prolapse?

Pelvic Organ Prolapse It is a condition in which the bladder, uterus or the rectum start dropping down and exerting pressure against the vagina. This might sound very disheartening but there are ways to treat the condition. The condition can be treated both with and without surgery. POP treatment consists of both surgical and nonsurgical treatments.

Nonsurgical Treatments

Pessary-It is mostly recommended as a primary treatment for POP. It helps in supporting the pelvic organs.It is a ring-like device which is inserted into your vagina.

Kegel exercises –These exercises are recommended for strengthening the pelvic muscles.

It is akin to holding your bladder when you have urinary pressure .Squeezing your bladder to hold it does the trick. In one cycle, do it for 5 seconds, relax and then do it again. Repeat the cycle for up to 15 times each day and gradually increase the number of cycles. The prolapse might get better or disappear.

Biofeedback therapy –This therapy teaches you how to contract your pelvic muscles through abdominal control and breathing techniques.

WHAT ARE THE TREATMENTS FOR PELVIC ORGAN PROLAPSE?

If the condition is severe and the noninvasive methods haven’t shown any results, it is best to opt for surgical treatments of prolapse. The surgery is of two types-

  1.  Obliterative-it involves the narrowing or closing off part or all of the vaginal opening. It is aimed at providing more support to the organs that have moved from their locations. It is best in cases where surgery has not yielded any benefit and the person is not in a state to tolerate another surgical procedure. As the vaginal opening will be partially or completely closed, you will be unable to have sexual intercourse after this surgery.
  2. Reconstructive surgery-It is used to repair the pelvic floor and restore the organs to their original position. It usually involves cuts in the vaginal or the abdominal area. The surgery may be done using the traditional open surgery process or through laparoscopy.

     

Types of reconstructive surgeries

  • Sacrospinous ligament fixation and uterosacral ligament suspension

It improves the support to the vaginal vault or the uterus using your own tissue or a vaginal mesh. The surgery involves cutting the vagina and attaching the vaginal vault to a ligament in the pelvis.

  •   Anterior and posterior colporrhaphy

It is aimed at making the tissue in the pelvic organs tighter and stronger. Anterior repair is used in a case where the bladder exerts a pressure on the vagina. Posterior repair is used when rectum pushes into the back of the vagina. Your own tissues or the vaginal mesh may be used.

  • Sacrocolpopexy and sacrohysteropexy.

This procedure uses surgical mesh for fixing and anchoring the organs which have dropped down. Sacrocolpopexy is used for rectifying the prolapse of the vaginal vault. Sacrohysteropexy is used for rectifying the prolapse of the uterus. These operations can be done either through open surgery or through laparoscopy.Vaginal mesh is used for helping in the lifting of the sagging organs and putting them into place.

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THE SUCCESS RATE OF SURGERY

sacrospinous ligament fixation and uterosacral ligament suspension procedures enjoy a success rate of 80 -90 %. While Sacrocolpopexy and sacrohysteropexy yields about 80 -95% results. But even after the successful surgery, other organs might prolapse.

AFTER THE SURGERY

While open surgery will require more time to heal, laparoscopic surgery will heal earlier. One should refrain from sex and vigorous exercise for a period of 6 weeks. Vaginal surgery will heal much faster than abdominal surgery. The vagina may release a white creamy discharge for 4 -6 weeks after the surgery due to the stitches.

RISKS WITH THE SURGERY

The following effects may be seen after the surgery –

  • Pain during sexual intercourse
  • Pelvic pain
  • Bladder incontinence
  • Infection, blood clots or bleeding may be seen in some cases. There are also chances of injury to the nearby organs during the process. The mesh may also pose a risk of pain and infection.
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