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Treating a Prolapse Without Surgery

How to fix a prolapse without surgery

1 in 10 women will have had surgery for a prolapse by the time they are 80. So, despite it not being talked about much, pelvic organ prolapses are very common.

Some prolapse diagnoses come as a complete surprise. You may be diagnosed following a routine examination such as a smear test, and not have experienced any symptoms or pelvic discomfort. Or you may have not recognised the symptoms you were feeling as being a result of a prolapse. Such as a dragging sensation in your vagina, or issues with fully emptying your bladder or bowel.

If you have been diagnosed with a pelvic organ prolapse, you will be wondering what to do next. Surgery is obviously the last resort, but hopefully it won’t get to that stage. Below you will find tips on how to fix a prolapse without surgery.

Prolapsed uterus treatment at home

  • Do nothing as a prolapse is not life threatening.
  • Treat your prolapse with non-surgical treatments and lifestyle changes.
  • Treat your prolapse with surgery and lifestyle changes.

Following a diagnosis by your GP you should know what grade / stage your prolapse is. Only women suffering from the most severe grades of prolapse are recommended to undergo surgery.

How to fix a prolapse without surgery

Non-surgical treatments can be completed in isolation, but you will see the most benefit if you incorporate them all into your life. They can also be used as preventative measures if you believe you are at risk of developing a pelvic organ prolapse. Learn more about how to prevent a vaginal prolapse .

Daily Pelvic Floor Exercises (aka Kegel Exercises)

You've probably already had a go at trying pelvic floor exercises, but most women forget to do them each day, or struggle and give up insisting that they don't work. It's not uncommon to struggle to find the correct muscles or even forget to regularly do them. Sadly, most of us give up before we start to feel the benefit. But by sticking with it, they are proven to increase the tone and strength in the muscles, lifting and holding your pelvic organs back in place.

To make your exercises even more effective, try an electronic pelvic toner. These contain exercise programmes specifically targeted for each type of prolapse so you can make the most out of your time. Top UK Physio Amanda Savage has created a easy to use 12 week programme for prolapse management for the Kegel8 Ultra 20 v2 - it will help you to manage the symptoms of prolapse and more importantly - potentially stop it from getting worse.

Use a biofeedback machine to follow and measure your progress. The Kegel8 Biofeedback device shows you what you are doing with your muscles when you contract them independently. The soft, air-filled vaginal probe connects to the small handheld monitor. With each kegel, you squeeze the probe and the monitor displays the strength of your squeeze.

There are also apps available, like the NHS squeezy app, which can remind you to do your exercises and help you follow your progress.


Vaginal Pessaries

Vaginal pessaries are fast becoming the top option by women who want to support severe prolapses whilst they strengthen their pelvic floor with pelvic floor / Kegel exercises. A prolapse pessary can also be fitted as a permanent measure and changed by a healthcare professional around every six months.

The benefits of using a pessary include:

  • They take pressure off your pelvic floor whilst you concentrate on strengthening it.
  • They can stop the prolapse from developing further by acting as support.
  • You can remove it at any point if your prolapse is sufficiently repaired or your pelvic muscles have strengthened enough.
  • They can be used during your pregnancy, and removed for delivery.
  • They can be used following child birth.
  • If you have decided to opt for surgery, you can wear a pessary to relieve the symptoms whilst you wait. You may even reconsider undergoing the surgery once you become familiar with how easy using a pessary can be.
  • You can continue to be active, there is no recovery period following having a pessary fitted.
  • They do not prevent you from falling pregnant.
  • You avoid having to undergo surgery!

The risks of using a pessary include:

  • Risk of infection and soreness if the pessary rubs - the pessary can be removed straight away and you can be prescribed with an oestrogen cream to apply to the affected area to encourage healing. Once you are healed, you can get a new pessary fitted.
  • Occasionally you can experience urinary incontinence due to the position of the pessary - your GP can adjust the pessary to improve this.
  • You may experience unpleasant vaginal discharge - removing the pessary will clear this up.
  • The pessary can move and be no longer beneficial - your GP can adjust the pessary to improve this.

Read more about how pessaries work here.

Wear support garments

Compression underwear gently activates the pelvic floor muscles which helps to strengthen them, treating the cause of prolapse while improving your level of comfort.

Lifestyle Changes

Many of the lifestyle changes you can make to prevent a prolapse, can also improve the condition of your prolapse. When in conjunction with pelvic floor /Kegel exercises, you may see a huge improvement and mild and moderate prolapses may be resolved completely. So don't be hesitant, make a change:

  • maintain a BMI of less than 30
  • avoid heavy lifting
  • avoid constipation and straining - Elevate your knees when you poo with a Go Better toilet stool.
  • treat persistent coughs
  • perfect your posture
  • take daily vitamin d3 and K2 combined supplement
  • avoid high impact exercise, and when you do exercise - take care and support the floor!  Wear support garments like SRC Restore to compress and support where you need it most. SRC are clinically proven to support and help a weak pelvic floor and are a registered medical device.

Hormone Treatment and Vitamin D3 and K2 Supplements

Supplements and topical oestrogen creams can be prescribed to boost the hormones you begin lacking through menopause and ageing.

Vitamin D3 and Vitamin K2 is an all-round good supplement to begin taking. It can help with many things, including period pain and weight loss and has been clinically proven to benefit your pelvic floor. 80% of reproductive age women are insufficient in Vitamin D, putting them at risk of not just prolapse, but other conditions including cardiovascular disease and diabetes.

Rectal prolapse treatment without surgery

Rectal prolapse is caused as a result of your rectum pushing through the anus. If it’s rectal prolapse you’re suffering from, your doctor may suggest non-surgical rectal prolapse treatments that can help. These include:

  • eating fibre-rich foods such as fruits and vegetables
  • taking osmotic laxatives, such as Fybogel, Movicol to help you empty your bowels without straining
  • drinking 1.5-2 litres of water a day.

How to fix a prolapsed bladder without surgery

A prolapsed bladder, also known as a cystocele, is when your bladder sags into your vagina. Treatment may include the following:

  • a pessary placed within the vagina to hold the bladder in place
  • oestrogen replacement therapy to strengthen the vagina muscles. HRT is sometimes offered where prolapse is attributed to the menopause. HRT increases the level of oestrogen to rebuild muscle strength, alleviating the symptoms and preventing the prolapse from worsening. However, it carries a number of risks, therefore its suitability for you must be discussed with your GP.

Is uterine prolapse surgery right or me?

Surgery is a last resort reserved for women who have tried non-surgical treatments but they have not provided a quick enough or sufficient improvement in their quality of life. 1 in 10 women who suffer from a prolapse select surgery. 25-30% of which will experience a second prolapse after the surgery and as a result 19% will undergo a second surgery. The others will look at non-surgical treatments to improve their symptoms rather than go through a second surgery.

The most important thing to note is that all pelvic organ prolapses are a result of a weak pelvic floor, which is why organs often prolapse together. There is no surgical procedure that can restore the strength in the pelvic floor muscles. Surgeries instead involve each organ being stitched back into place to prevent them from being able to move. Because of this you will still need to incorporate non-surgical treatments into your life, after going through surgery, to support the surgery and prevent recurrence.


Sources

Aggarwal, N. Sharma, S. (2017) Journal of Mid-Life Health. Vitamin D and Pelvic Floor Disorders. [online] 8(3), p 101-102. [viewed 28/10/2024]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5625572/

Choi, K. H Hong, J. Y. (2014) Korean Journal of Urology. Management of Pelvic Organ Prolapse. [online] 55(11), p 693-702. [viewed 28/10/2024]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4231145/

Farag, K. A. Uzoma, A. (2009) Obstetrics and Gynecology International. Vaginal Vault Prolapse. [online] 275621, p 1-9. [viewed 28/10/2024]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2778877/

Giarenis, I. Robinson, D. (2014). F1000Prime Reports. Prevention and management of pelvic organ prolapse. [online] 6(77). [viewed 28/10/2024]. Available from: http://f1000researchdata.s3.amazonaws.com/f1000reports/files/9008/6/77/article.pdf

Kekre, A. Jacob, K. S. Navaneethan, P. R. Varghese, L. (2015) Journal of Mid-Life Health. Vitamin D deficiency in postmenopausal women with pelvic floor disorders. [online] 6(2), p 66-69. [viewed 28/10/2024]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4481742/

NHS. (2021) Pelvic organ prolapse [online] National Health Service, 2021 [viewed 28/10/2024]. Available from: https://www.nhs.uk/conditions/pelvic-organ-prolapse/

NICE. (2019). Urinary incontinence in women: management, 1 Recommendations [online] National Institute for Health and Care Excellence, 2019 [viewed 28/10/2024]. Available from: https://www.nice.org.uk/guidance/ng123

Propagator Ltd. (2024). squeezy [online] Propagator Ltd, 2024 [viewed 28/10/2024]. Available from: http://www.squeezyapp.co.uk/

Royal College of Obstetricians and Gynaecologists. (2022). Information for you: Pelvic Organ Prolapse [online] Royal College of Obstetricians and Gynaecologists, 2022 [viewed 28/10/2024]. Available from: https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/gynaecology/pi-pelvic-organ-prolapse.pdf

Women's Health Concern. (2021). Prolapse: Uterine and vaginal [online] Women's Health Concern, 2021 [viewed 28/10/2024]. Available from: https://www.womens-health-concern.org/help-and-advice/factsheets/prolapse-uterine-vaginal/