Most worsening pelvic organ prolapses can only be fully corrected with surgery. However, the type of treatment that is appropriate to treat prolapse depends on factors such as the cause and severity of the prolapse, whether the woman is sexually active, and the woman’s treatment preference.
Nonsurgical options may be most appropriate for women who are not sexually active, cannot undergo surgery because of medical reasons, or experience few or no symptoms associated with the condition.
Surgery is the treatment option that most sexually active women who develop prolapse choose, because the procedure is usually effective and allows sexual activity.
Home Care for Pelvic Organ Prolapse
Home treatments for vaginal prolapse include one or a combination of the following:
Activity modification: For a prolapse that causes minor or no symptoms, the doctor may recommend activity modification such as avoiding heavy lifting or straining.
Pessary: A pessary is a small device, usually made of silicone, that is placed within the vagina for support. Pessaries come in several sizes and shapes. This nonsurgical treatment option may be the most appropriate for women who are not sexually active, cannot have surgery, or plan to have surgery but need a temporary nonsurgical option until surgery can be performed (such as women who are pregnant or in poor health). Pessaries must be removed and cleaned at regular intervals to prevent infection. Some pessaries are designed to allow the woman to do this herself. A doctor must remove and clean other types. Estrogen cream is commonly used along with a pessary to help prevent infection and vaginal wall erosion. Some women find that pessaries are uncomfortable or that they easily fall out.
Kegel exercises: These are exercises used to tighten the muscles of the pelvic floor. Kegel exercises might be used to treat mild-to-moderate cases of prolapse or to supplement other treatments for prolapses that are more serious.
Medications for Pelvic Organ Prolapse
Estrogen replacement therapy may be used to help the body strengthen the muscles in and around the vagina. The therapy may not be an option for some women (such as in those with certain types of cancer). Women’s bodies stop creating estrogen naturally after menopause, and the muscles of the vagina may weaken as a result. In mild cases of prolapse, estrogen may be prescribed in an attempt to reverse prolapse symptoms, such as vaginal weakening and incontinence. For more severe prolapses, estrogen replacement therapy may be used along with other types of treatment.