Prolapse Surgery

What is a prolapse?
A prolapse is a bulge in the wall of the vagina. It is caused by weakness of the supports around the vagina.

There are different types of prolapse.

Normal female pelvic anatomy

An Anterior prolapse occurs when the supporting tissue between the vagina and bladder become weakened. This is when bladder drops into the vagina.
A Posterior prolapse occurs when the supporting tissue between the vagina and the bowels become weakened.
A uterine prolapse occurs when the womb (the uterus) moves down from its normal place into the vagina.
If you have had a hysterectomy (operation to remove your womb) in the past, there is also risk of developing a vault prolapsed. This is where the top of the vaginal wall also begins to drop downwards.

You may have one, or a combination of these prolapse.

What causes prolapse?
A prolapse is usually caused by childbirth. However it can occur in women who have never been pregnant. This is usually noticed after the menopause (50-52), when oestrogen levels are low. Other related issues like long term constipation, doing a job which involves strenuous activity; being overweight and having a long term cough can make the problem more noticeable earlier.

Why do I need a prolapse repair?
A prolapse can cause the following problems:
• A ‘sensation of something coming down’.
• The feeling of having not fully emptied your bladder or bowel.
• The need to press on the back wall of the vagina to empty bowel completely.
• A bulge in the vagina, which can cause discomfort when having sex and difficulty keeping a tampon in.

What are the other options?
There are other nonsurgical options available to treat prolapse. You may choose to try pelvic floor exercise under supervision of a specialist physiotherapist or a nurse specialist. This may control your symptoms. You may choose to have a vaginal pessary fitted. Pessaries can lift the prolapse up. You are required to get the pessary checked every 4to 6 months. If you are interested in any of these options you can talk to your doctor or nurse about it to know whether it is an appropriate option for you.

What are the benefits of having a prolapse repair?
The aim of the surgery is to restore the supports for the vagina, bladder and bowel. The surgery is primarily aimed to improve your symptoms.

What type of surgery will I have?
The management of prolapse may involve one or a combination of the following procedures:
1. Anterior Repair (Repair of the front wall of the vagina)
2. Posterior Repair (Repair of the back wall of the vagina)
3. Vaginal Hysterectomy (Removal of womb through the vagina)
4. Sacrospinus Fixation (Suspension of the vagina)

Useful Contacts
Helen Barker: 01536 411241