Brief overview: Treatment options for vaginal prolapse
Medical therapy: Topical use of estrogen suppositories or creams after menopause can be helpful for mild forms of vaginal prolapse.Surgical treatment: In some cases surgery may be necessary. Depending on which pelvic organs have additionally sunken, different procedures are available. In some cases it may also be necessary to remove the uterus (hysterectomy).Physical therapy: An important part of the treatment of vaginal prolapse is pelvic floor exercises. The muscles can be strengthened through targeted exercises, which can alleviate the symptoms and prevent further prolapse.Lifestyle Changes: Eating a diet high in fiber and drinking enough fluids can help prevent constipation. It is also important to maintain a healthy body weight and avoid heavy lifting.Self-management: Kegel exercises and therapeutic pessaries can help relieve symptoms of prolapse. These methods can be done at home. Vaginal pessaries that have been properly fitted by a doctor can sometimes be used by women themselves.
Medical therapy
For almost all forms of vaginal prolapse, local therapy with estrogen suppositories or creams can be considered after menopause, provided there are no contraindications. Estrogen plays an important role in the health and elasticity of vaginal tissue. After menopause, estrogen levels decrease, which can cause tissue to become thinner and less elastic. Local therapy with estrogens can help to balance these changes and thus alleviate the symptoms. However, it is important to only carry out this form of therapy under medical supervision as it is associated with certain risks. Before taking medication, it is always important to speak to your doctor to clarify possible side effects and interactions.
Surgical treatments
If the symptoms are severe, severe prolapses are present or if other therapies are not sufficient, surgery may be necessary. Often the bladder, uterus and/or intestines are lowered into the vagina; In the event of a bladder or bowel obstruction, overstretched, excess tissue on the anterior or posterior vaginal wall can be removed and the remaining tissue can be tightened to repair the organ prolapse (anterior and posterior vaginoplasty). Furthermore, the upper end of the vagina as well as the uterus can be fixed upwards using the body’s own tissue, sutures or even nets, thus resolving the prolapse. In some cases it may make sense to remove the uterus (hysterectomy).
The exact type of operation depends on various factors such as the degree of prolapse, the desire to have more children, the general risk of surgery due to age or previous illnesses, sexual activity and the patient’s wishes. The decision for or against a procedure should always be made in consultation with an experienced specialist and is based on a thorough examination and advice.
physical therapy
Pelvic floor training plays an important role in the treatment of vaginal prolapse. The pelvic floor muscles can be strengthened through targeted exercises. A strong pelvic floor can better support the organs in the pelvis and thus counteract further prolapse. Pelvic floor training can be learned under the guidance of a physiotherapist and then carried out at home. The so-called Kegel exercises are particularly well-known and effective. They can be performed in any position and do not require any special aids.
change of lifestyle
A healthy lifestyle can help reduce the risk of vaginal prolapse and relieve existing symptoms. This includes a high-fiber diet and adequate fluid intake to prevent constipation. Constipation can increase pressure on the pelvic floor, causing prolapse. Avoiding heavy lifting is also important, as this can increase pressure on the pelvic floor and thus promote vaginal prolapse. It is also important to maintain a healthy body weight for the same reason. Smoking should also be avoided as it can lead to chronic obstructive pulmonary disease (COPD) with severe coughing, which in turn increases pressure on the pelvic floor.
Self-management
Kegel exercises and therapeutic pessaries can help relieve symptoms of vaginal prolapse. Kegel exercises strengthen the pelvic floor muscles and can be done at home in any position. Pessaries are small rings, cubes, or cup-shaped devices made of rubber or silicone that are inserted into the vagina to support the organs in the pelvis. They need to be taken out regularly for cleaning and in some cases can be an alternative to surgery, particularly for women who do not want surgery or for whom surgery would be too risky.