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Kegels, Pessaries, Surgery. A Snapshot of Pelvic Prolapse Treatments

A doctor holding a female patient's wrist as she reads a chat

Medically Reviewed by Merritt King, III, MD

At its most basic, Pelvic Organ Prolapse is a woman’s bladder, uterus or rectum pushing down on her vagina.

“The first thing you need to know is: this will not kill you,” says McLeod Gynecologist Dr. Merritt King.  “Prolapse may cause discomfort and embarrassment, but it is not life-threatening.”

CONSERVATIVE TREATMENTS
Pelvic floor exercises, called Kegels, and physical therapy are the first line treatments.

A study by the Women’s Health Initiative found that the prolapse gets larger and larger over time in some women. A few women might even improve on their own, but that’s pretty rare.

The study looked at 300 women who were treating their prolapse with exercise or physical therapy. Over 3-5 years, 75% of the women saw their condition improve or stay the same.

PESSARY
There are 2 options if conservative management does not work: pessary or surgery.

A pessary is typically a ring-shaped device. However, they do come in all shapes and sizes. It flexes so it can be inserted into the vagina, where it opens back up. It keeps the bladder, rectum and uterus in place in the body.

Very rarely does a woman experience a problem with the pessary. After some brief training in the physician’s office, a woman can usually take the pessary out, rinse it and reinsert it.

It can typically restore continence. So, it’s a good option for people who do not want surgery or for whom surgery is not an option for whatever reason.

SURGERY
The surgery is simple and generally requires only an overnight stay. The surgery is successful in about 70% of the women. So, it is not a cure-all for all women. But for someone who has severe symptoms, has complete prolapse where everything has dropped down, or has significant side effects with their bladders or bowels, this is a good treatment option.

FINAL THOUGHT
Prolapse may not be life-threatening, but can be troublesome and embarrassing. There is a range of treatments that can help a woman live a full, normal life. Don’t hesitate to see a Gynecologist to talk about your problem and its solutions.

Find a Gynecologist near you.

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