A pelvic prolapse occurs when the pelvic floor muscles which are made of muscle tissue and ligaments, become weak and collapse. These muscles are supposed to hold the pelvic organs in place. When they fail, these organs drop down and cause a bulge in the vagina. It is a fairly common problem, especially among women who have had several pregnancies or a hysterectomy. By the age of 80, about 1 in 10 women will have experienced this problem.

Pelvic organ prolapse commonly affects the normal functions of the human body like defecation and urination. It affects the sexual function as well, making sexual intercourse very difficult, painful or even impossible.

Due to this common occurrence, a new field called uro-gynecology has been created to treat the problem. The symptoms and extent of the pelvic prolapse will determine the course of treatment. Mild symptoms don’t usually need any treatment.

These cases can be treated through lifestyle changes and exercise. Pelvic prolapse does not worsen on its own, but when the symptoms become worse, medical attention may be required.

The first line of treatment is through estrogen medication, which may be advised for women whose pelvic prolapse was caused by menopause. If you have pain or any discomfort due to lifestyle changes or the conservative treatment failed, you may want to consider surgical treatment.

In other cases, there may be a need for further attention in the form of surgery. There are several forms of surgery for pelvic prolapse depending on the location of the prolapse.

Rectocele

This surgery is used to treat pelvic prolapse due to the rectum pushing against the wall of the vagina causing a posterior prolapse. It is most evident when bending over. It is most common after labor, as it exerts a lot of pressure on the pelvic floor muscles.

The rectocele procedure involves the repair of the tissue between the rectum and the vagina to regain its strength. Further strengthening of the vaginal wall may also be done to prevent a recurrence of the prolapse.

Enterocele

When the bladder, rectum and small bowel push against the vagina, this causes a vaginal vault prolapse. To treat this prolapse, the surgeon strengthens the vaginal tissues using a synthetic mesh and then attaching it to the tailbone.

Vaginal vault prolapse

Vaginal vault prolapse is a repair of the vaginal wall which has prolapsed. It occurs when the upper part of the vaginal prolapses down into the vaginal canal or even outside of the vagina. This medical condition is more common among women who have had a hysterectomy, a total removal of the uterus.

Vaginal obliteration

Vaginal obliteration, also known as a closure of the vagina, consists in removing the entire vaginal lining except for about 1 to 1.5 inches, followed by a sewing of the vagina. If the uterus is not removed during the surgical procedure, a small opening is left in order for uterine fluids to drain.

Hysterectomy

If the uterus is pressing down on the vaginal wall, this too can cause a pelvic prolapse, it is repaired through a hysterectomy. A hysterectomy involves removing the uterus. It can be the best option for a woman who does not intend to have any more children or one who has already reached menopause.

Surgical procedures

Surgery for pelvic prolapse can be done in one of two ways:

Invasive

This involves making an incision through the abdomen to reach the problem area. It is a major surgery and requires that you pick your surgeon very carefully if you want the surgery to be successful and with minimal risk, or a relapse.

Minimally invasive

The surgeon can also approach the problem area through the vagina without having to make an incision. With the help of an assistive robot and camera, the surgery can be minimally invasive and still be effective.