Non-surgical treatments for prolapse

A vaginal pessary can be used to support a prolapse and is similar to a cap used for contraception. It sits at the top of the vagina, just below the cervix and supports the uterus to prevent it from coming down into the vagina. It works well in many women and can help to make sex easier than before.

We insert the pessary for you, and if it works well it can stay in place for 3-4 months before it needs to be replaced. 

Surgical treatments for prolapse

Several surgical alternatives are available, and the type of surgery is chosen by the consultant gynaecologist based on each individual patient’s circumstances. We offer the full range of surgical procedures, and the final choice depends on your age, your expectations, your weight and how mobile and active you are.

Having a hysterectomy

In some women, the most effective treatment for a prolapse is to have their uterus removed. At The London Clinic, we perform hysterectomies using laparoscopic (keyhole) surgery, using several small incisions. In some women we can operate through the back wall of the vagina, so there are no abdominal scars at all.

This form of surgical treatment for prolapse is obviously only suited to women who are past childbearing age, or who have completed their family.

Although a hysterectomy prevents uterine prolapse, you may still have problems with the vaginal walls after surgery, which can collapse inwards. If you are thought to be at risk of this we can perform a sacrocolpopexy at the same time as your hysterectomy. This involves putting a supportive mesh in place at the top of the vagina to keep the vaginal walls in position.

Vaginal repair operation (Colporrhapy)

This is where the walls of your vagina are reinforced, and tightened up, usually by making a tuck in the wall of your vagina and using stitches to hold the tuck in place. The operation is usually done through your vagina and so you do not need a cut in your abdomen. In some cases, a mesh or special tape may be sewn into the vaginal walls.

Supporting the uterus using slings and stitches
Another type of surgical treatment involves leaving the uterus and other reproductive organs intact, and so is suitable for younger women who want to become pregnant afterwards.

There are different techniques but the general principle is to insert a supportive sling made of a mesh-like material that supports the uterus in its normal position. This stays in place and prevents further prolapse of the uterus and of the vaginal walls.

  • In a sacrohysteropexy, part of the suspension sling is attached to one of the lower vertebrae in the spine while another part is joined to the cervix at the base of the uterus. This is done by keyhole surgery through the abdomen.
  • In an infracoccygeal sacropexy, the suspension sling is placed in a similar position, but the surgery is done through the anus and vaginal wall, rather than through the abdomen.
  • In a sacrospinous fixation, support for the uterus is provided by attaching the body of the womb to one of the ligaments in the pelvis using strong, permanent sutures. This type of surgery is done through the vagina.

Simple steps to avoid prolapse

  • Regular pelvic floor exercises, especially if you are planning to get pregnant, are pregnant, or have given birth.
  • Try to lose weight if overweight.
  • Eat a high-fibre diet (plenty of fruit and vegetables and wholegrain bread and cereal) and drink plenty of water to avoid constipation.
  • If you smoke, try to stop smoking.
  • Avoid heavy lifting