Vaginal Wall Prolapse

Duke offers newer approaches and techniques for treatment of vaginal wall prolapse that have dramatically improved the outcome for women with these problems. Treatments include non surgical/conservation treatments as well as surgery.

Vaginal prolapse is the loss of support to the pelvic organs that surround the vagina. It results in the bulging (or dropping) of the bladder, urethra, rectum, or uterus into the vagina. Women with this problem are often aware of “something falling out of the vagina,” while others are only troubled by a deep pelvic pressure, or a dragging sensation in the lower abdomen. It is often associated with urinary or fecal incontinence.

Conservative treatments include:

• Pelvic floor muscle exercises
• Avoiding constipation by adding high fiber foods and natural stool softeners
• Pessaries

Performing pelvic floor exercises will help prevent progression of the vaginal prolapse. They are also useful to perform to prevent recurrent prolapse after surgical repair.

Pessaries

There are a variety of pessaries, which are devices placed in the vagina to support the vaginal wall.

The design most appropriate for you will be fitted in the physician's office, and you will be taught how to remove it for cleaning, and replace it yourself. The pessary can be a temporary treatment for prolapse or it can be used for many years if the patient desires.

To clean and replace your pessary:

• Remove your pessary as often as you would like. Typically, it can be removed at bedtime once or twice a week.
• Clean your pessary with warm water and a nonirritating soap.

Surgery

Our goal is to identify all sites of weakness in the vaginal wall so that surgical repair, if needed, addresses each of these, thereby minimizing the risk of recurrence.

The techniques that we rely upon are state of the art and may involve the replacement of weak vaginal wall with new grafted materials. These operative repairs are often combined with repairs for urinary and fecal incontinence.