Treatment:

Treatment is not necessary unless the symptoms are bothersome. Uterine prolapse can be treated with a vaginal pessary or surgery.

A vaginal pessary is an object inserted into the vagina to hold the uterus in place. It may be a temporary or permanent form of treatment. Vaginal pessaries are fitted for each individual woman. Some pessaries are similar to a diaphragm device used for birth control. Many women can be taught how to insert, clean, and remove the pessary herself.

Pessaries may cause an irritating and abnormal smelling discharge, and they require periodic cleaning, sometimes done by the doctor or nurse. In some women, the pessary may rub on and irritate the vaginal wall ( mucosa), and in some cases may damage the vagina. Some pessaries may interfere with normal sexual intercourse by limiting the depth of penetration.

If the woman is obese, attaining and maintaining optimal weight is recommended. Heavy lifting or straining should be avoided.

Measures to treat and prevent chronic cough, such as smoking cessation, are also recommended.

Surgery should wait until symptoms are worse than the risks of having surgery. The surgical approach depends on:

• Degree of prolapse
• Desire for future pregnancies
• Other medical conditions
• Preservation of vaginal function
• The woman's age and general health

There are some surgical procedures that can be done without removing the uterus, such as a sacral colpopexy. This procedure involves the use of surgical mesh material to support the uterus.

Often, a vaginal hysterectomy is used to correct uterine prolapse. Any sagging of the vaginal walls, urethra, bladder, or rectum can be surgically corrected at the same time.

Expectations (prognosis):

Most women with mild uterine prolapse never have symptoms and don't need treatment.

Vaginal pessaries can be effective for many women with uterine prolapse.

Surgery usually provides excellent results, however, some women may require treatment again in the future for recurrent prolapse of the vaginal walls.

Complications:

Ulceration and infection of the vaginal walls may occur in severe cases of uterine prolapse.

Urinary tract infections and other urinary symptoms may occur because of a cystocele. Constipation and hemorrhoids may occur because of a rectocele.

Calling your health care provider:

Call for an appointment with your health care provider if you have symptoms of uterine prolapse.