Prolapse is a hernia of the vagina that a woman may feel as a bulge or pressure. This is referred to in many different ways. Sometimes it is called a "dropped bladder", "dropped uterus," "dropped vagina," or "dropped rectum."
Is prolapse something serious?
Prolapse may be uncomfortable, especially if you can feel the bulge after walking or standing for long periods of time. The good news is that prolapse is generally not life-threatening and many treatment options are available. For most women, the treatment they choose depends on how much they are bothered by their symptoms.
Can prolapse get worse?
For some women, their prolapse gets worse over time. For others, their prolapse will stay the same with conservative treatment options. Prolapse generally does not improve without surgery.
What will happen if I just ignore this problem? Will it get worse?
Most likely. Prolapse, left untreated, almost always gets worse over time but this is usually a gradual change.
When treatment is considered?
Treatment of prolapse should be based on your symptoms. In rare cases, severe prolapse can cause urinary retention (inability to empty the bladder) that progresses to kidney damage or infection. When this occurs, prolapse treatment is considered mandatory. In most other cases, patients should be the ones to decide when to have their prolapse treated - based on the symptoms they are having.
Do I have to have a hysterectomy as a part of my surgery?
No. Any or all of the operations for prolapse and incontinence can be performed with or without a hysterectomy . However, hysterectomy is often performed along with these operations for a variety of reasons. In some cases, removing the uterus first makes the rest of the surgery easier to perform. In other cases, there is another reason besides prolapse or incontinence (such as cancer or excessive bleeding) to remove the uterus. Whether or not to remove the uterus should be discussed between the patient and her surgeon, and the decision should be individualized from patient to patient.
I have prolapse, but I don't leak urine. Do I still need bladder testing?
Most likely. If you are going to have surgery to correct the prolapse, bladder testing (called urodynamics) usually is done first. That's because the prolapsed portion of your vagina may be pushing on your urethra and preventing urine leakage. If that is the case, having the prolapse corrected can give you a new problem - urinary incontinence. The best way to tell whether a continence procedure is needed at the time of prolapse surgery is to perform urodynamics while holding the prolapse up in its normal position.
How successful is surgery for pelvic organ prolapse?
Many factors affect the outcome of reconstructive surgery. Some of the factors that originally contributed to your pelvic floor problems , such as decreased muscle and nerve function and weak connective tissue, might still exist after the reconstructive procedure has been performed.
Hernias in the pelvic floor are technically more difficult to repair than other hernias because pressure in the pelvic floor from daily activities puts a lot of stress on the surgical repair. As a consequence, some women have a persistence or recurrence of their prolapse after surgery.
WHEN TO GET BACK TO WORK ?
The amount of time necessary for you to "bounce back" from surgery has a lot to do with the route of surgery. In other words, if an abdominal incision is necessary to perform your operation, you will probably have more pain after surgery than if your procedure is performed through a laparoscope or through the vagina.
What are the risks with using graft material?
Graft material, most often used for prolapse repair, is a medical grade polymer or plastic called polypropylene. This graft material is also used for abdominal and groin hernia repairs. Approximately 90% of patients do very well with this material.
women with severe or recurrent prolapse who prioritized retaining sexual function gain the greatest benefit from mesh reinforcement procedures. Every woman has a different risk/benefit profile regarding graft repairs.
HOW TO DO KEGEL' EXERCISE?
1.Make sure you have an empty bladder before you begin.
2. Sit in a chair or lay down on the floor.
3. Squeeze your pelvic floor muscles for five seconds. It will feel like when you are trying to hold urine in.
4. Release your muscles for ten seconds.
5. Repeat the exercise ten times.
6. Build toward squeezing your pelvic floor muscles for ten seconds at a time.
REPEAT the same 10 sets each time for 4 times a day
How to have long term symptom free period after surgery?
There are 2 overarching principles for managing prolapse repair long-term :
1. Minimising the downward load on your pelvic floor - decreases the risk of straining your prolapse repair
2. Maximising your pelvic floor support from below - optimises the ability of your repair to withstand pressure