Treating a Prolapsed Uterus

There are many treatments for uterine prolapse including non-surgical and surgical options. In general, non-surgical treatments such as pelvic floor exercises and a vaginal pessary work best in cases of mild uterine prolapse or when surgery is not an option. Surgery can provide a long-term solution to uterine prolapse and can now be performed using techniques, such as the ELEVEST^® procedure, that preserve the uterus.

The exact treatment choice will depend on the severity of your uterine prolapse and whether you have any related pelvic floor defects. Your expectations regarding childbearing and sexual function are important considerations, and you should discuss them with your doctor. By working together with your doctor, you can help ensure that your treatment plan is tailored to meet your needs.

Surgical Treatment Options

• Laparoscopic techniques – Pelvic organ prolapse including uterine prolapse is one of the most common reasons for gynecological surgery. A large-scale survey of almost 150,000 women found that the lifetime risk of undergoing an operation for prolapse or incontinence was 11.1%.¹ The true figure is probably even greater.² Surgery can provide long-term symptom relief.
• Vaginal hysterectomy has been the treatment of choice for symptomatic uterine prolapse. But there are surgical techniques for treating uterine prolapse that do not involve removing the uterus. With the ELEVEST procedure, for example, the ligaments are shortened and strengthened using minimally invasive laparoscopic technique to restore the uterus to its anatomically correct position. If you have uterine prolapse requiring surgical correction, ask your doctor if the ELEVEST procedure is right for you.
• Uterine prolapse commonly occurs with other types of pelvic organ prolapse. Therefore, your doctor may recommend several procedures in addition to the one used to correct your uterine prolapse. These procedures can be performed at the same time as your uterine prolapse repair. All of the defects must be corrected to restore pelvic support and provide a lasting repair. Repairing only one of the prolapsed areas may predispose you to developing a prolapse in another area of your pelvic floor. You may then have to have repeat surgery.

Therefore, if you are having problems related to uterine prolapse, it is important to talk to your doctor about your symptoms and expectations.

Non-Surgical Treatment Options

• Pelvic floor exercises – In cases of mild uterine prolapse, pelvic floor exercises such as Kegels may limit the progression of the prolapse and alleviate symptoms such as low back pain and pelvic pressure. However, once the prolapse has progressed, the exercises are no longer useful. Additionally, biofeedback may be incorporated into the instruction process to help ensure that the exercises are being performed properly.
• Vaginal pessary – A device similar to a diaphragm can be inserted into the vagina to help support a prolapsed uterus. Pessaries have been used for many years to treat uterine prolapse, but their use has declined with advances in surgical technique.
  
  Pessaries are available in a variety of types and shapes. They must be fitted by a health care professional and require the active patient involvement for successful use. Patients must learn how to manage the device including insertion, removal and cleaning.