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FAQs

Is surgery always necessary to treat a prolapse?
Severe prolapse is usually most effectively treated by surgery. For women who wish to avoid, or at least delay surgery, a pessary fitted by a health-care professional may be a useful option. Kegels and other exercises that strengthen the pelvic floor muscles may help in cases of mild prolapse, but they will not correct a serious prolapse.

Is a hysterectomy always a necessary part of prolapse surgery?
No, a hysterectomy is often unnecessary, unless the uterus is a significant part of the prolapse. Whether or not you will need a hysterectomy depends on the type of prolapse and its severity. For mild cases of prolapse, a hysterectomy should not be necessary, nor is it a necessary part of treating a cystocele, entrocele or rectocele. Although a hysterectomy was once a standard part of most prolapse surgeries, increasing numbers of surgeons are now repairing cystoceles, entroceles and rectoceles without removing the uterus. Discuss your options with your physician.

Can women give birth after prolapse surgery?
Yes. If a hysterectomy has not been done and you are still fertile, then you can become pregnant. It is safe to carry the pregnancy to full term. A cesarean section is usually recommended for the birth. Pregnancy, however, may impact upon the long-term success of the prolapse surgery. For this reason, it is usually recommended that women delay surgery to correct prolapse until their childbearing is complete.

Is vaginal bleeding a sign of prolapse?
A pelvic prolapse does not usually cause vaginal bleeding. However, in some cases, women may be unaware of their condition until the prolapse is severe, and standing or other physical activity makes vaginal tissue protrude through the vaginal opening. When this vaginal tissue rubs against a woman's clothing, it may become irritated and bleed. In this situation, blood on the underwear or other evidence of vaginal bleeding, may be the first sign of a prolapse.

 

The pelvic floor is a layer of muscles that stretches like a hammock from the pubic bone at the front of the pelvis to the base of the spine in the back. These muscles support the weight of the pelvic organs and enable everyday activities like walking and sitting. Ligaments within the pelvis hold the organs in place.

The pelvic floor muscles also play a crucial role in the functioning of pelvic organs. For example, bands of muscle encircle the urethra (the opening you urinate through) and bowel. These bands are called sphincters. Sphincters control the release of urine and feces. Other muscles surrounding these organs control the filling and emptying of the bowel and bladder.

Muscles throughout the pelvis also work when a woman gives birth. Some of these same muscles contribute to the enjoyable sensations of female orgasm.

Damage or weakness in these muscles can interfere with all of these functions. One of the most obvious signs of damage is a prolapse.

Think of the pelvic floor as a mesh of muscles, like a nylon stocking. When these muscles are weakened or damaged, runs or even holes appear in the mesh and it can no longer support the pelvic organs. A prolapsed organ is an organ that has shifted position and begun to protrude through this mesh. Most commonly, prolapsed organs press down against the vagina, since this is the largest opening to the pelvic floor. This causes a bulge in the wall of the vagina. In severe cases, a prolapse can push part of the vaginal wall out through the vaginal opening.

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Pelvic Prolapse

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