Prolapse can occur in any of the pelvic organs, and can present as a lump protruding from the vaginal opening, causing discomfort, or it may be asymptomatic. Pelvic organ prolapse can lead to loss of control over urination or defecation, or conversely, difficulties in emptying the bladder or bowels. The drooping mucosa can also be prone to injury or friction, resulting in external bleeding. Often, this condition is accompanied by significant anxiety, which can be alleviated through an explanation of its benign nature.
Treatment options for pelvic organ prolapse include:
1. Pelvic floor physiotherapy: For mild to moderate cases of prolapse, discomfort can be alleviated and further aggravation prevented through pelvic floor exercises. This involves improving posture, strengthening the abdominal muscles, and exercising the pelvic floor muscles using techniques such as biofeedback and electrical stimulation.
2. Pessary supports: In cases of severe prolapse or for women who are not suitable candidates for surgery due to their general condition or personal preference, pessary supports can be used. These are ring or cube-shaped devices that are inserted into the vagina to lift the prolapsed organs. The type and size of the pessary are determined by a doctor and can be self-inserted and removed by the patient. In older age, when self-insertion becomes challenging, a doctor or nurse may assist in insertion and removal. Regular follow-up and examination are necessary, even when the patient inserts the pessary herself. Vaginal estrogen preparation is often recommended alongside pessary use.
3. Surgical treatment: Surgical options for lifting pelvic organ prolapse vary and can be performed through vaginal, open abdominal, or laparoscopic approaches, depending on the severity of the prolapse and the patient's age. With advancements in minimally invasive techniques and the use of biological and synthetic meshes, a range of solutions are now available. Older women can also be considered for corrective surgeries, despite the tendency to minimize surgeries and anesthesia in this age group.
In summary, the treatment of pelvic organ prolapse involves a range of approaches, from pelvic floor physiotherapy and pessary supports to surgical interventions tailored to the individual's condition and age. Regular follow-up and ongoing management are crucial for optimal outcomes.